So most people have probably heard scary stories about the US Health system and/or seen Michael Moore’s documentary Sicko and have a lot pre conceived notions about the US Health System.
Look Michael Moore did focus on the absolute worst types of cases to get his message across but the genesis core of his message is true.

The US Health System is first and foremost a business and secondary a process for caring for people!

So while there a few exceptions, most processes follow that rule and also is why the corporate players in this industry make a lot of money  (i.e. owners of clinics, pharmaceutical executives, owners of pharmacies, etc.).

As foreigners (or non=immigrants as we are classified) on a working visa like H-1B, L-1, E-3, etc. or other types of visa like J-1 we also have an additional set of things we need to be wary of when living in the US. Some states like Massachussets make health insurance mandatory either via the employer or paying yourself.

For the true working visas; H-1B, L-1, E-3, etc. there is no specific requirement that you have health insurance. In most cases you will be with employer who either mostly or fully pay your monthly premiums on your behalf for medical, prescription, dental and vision insurance. At the corporate negotiated rates this probably amounts to hundreds of dollars a month (probably minimum $350-$400/month for all three).

There is no public health system in the US…Repeat….There is no public health system in the US

So If your employer does not provide you with private health insurance and you don’t take it out yourself, you are not covered for anything in any situation. Should you choose to visit a doctor for a general check up at the casual rate, your bill can run into the hundreds of dollars!

While I will give you further tips in another post, even if you have health insurance, the insurers are looking to deny you coverage at any possible opportunity so don’t assume automatically they will pay for your visit. Like I said it is a business firstly!

So stay tuned in the future as I will tell you how to frame doctor visits and write letters to insurance companies to appeal their ridiculous judgments.

For the J-1 visa holders, your health insurance is mandatory in most cases and either via your sponsor organization or an approved insurer you will need to pay for a travel type insurance policy. (occasionally some interns will have nice employers that provide them full insurance but this is rare).

This travel policy generally is designed to cover only the basics when you are truly sick or hurt performing general activities. It is not for general check ups, issues with sexuality/pregnancy, usually only emergency minimal dental, no optical coverage, no alternative care or chiropractic, etc.

Depending on your policy for all visa holders , you will also have to pay what is known as a co-pay (co-payment) for your doctor visits and this ranges mostly between $0-50 depending on your plan. So often even with full coverage insurance that applies to your visit you will still have to pay money! This increases even more if you are talking about hospital visits and surgeries.

I know this post sounds like all doom and gloom…well it is for a large proportion of US citizens as well but I will do my best in my posts to help you navigate through the mess!

CJ

Unfortunately it is the story of the day, the month and hey the year. We just find out today that a record almost 600,000 jobs were lost in the US in January alone. The current unemployment rate is now 7.6%. Many of those included foreigners on US working visas and the road is mcuh tougher for all of us in this category.

The two major problems that foreigners on working visas face compared to a fellow US citizen or resident who may have been laid off is;

1. No access to Social Security Benefits or any sort of unemployment support or safety net
2. Extremely Limited to time to find new employment and change visa legally without having to leave the US

Essentially this means if you are in this unfortunate predicament you have to bear all the costs from any savings you have of your regular expenses and finding a new position while trying to do it in record time and fit in with the regulations.

In actuality as you only are allowed to be out of employment legally for 10 days, you really don’t have any time to find a new position and transfer your position if, as most lay-offs are, sudden and unexpected.

Now many employers are very understanding in these situations given in an ideal world they never wanted to let you go having gone through so much for sponsorship to get you in the first place, that officially they will keep your position open even if you are not in it, allowing you time to find a new role and thus technically not be out of work for more than 10 days. They don’t have to do this but many do so request this if you can to buy you time.

There is no advice I really have in terms of finding a position than what you already did to get your initial role. If you were smart and dedicated enough to find a position in the US to begin with, I have no doubt, given the time and financial ability, you will find a position again even in this economy. There are positions out there…you only have to look at major job sites.

Hey even despite the gloomy numbers of January employment loss in the US, the health industry recorded an increase in positions so choose your target area wisely.

As for the situation of financially supporting yourself through this ordeal, paying your rent, etc. Well this is a decision you will have to make as it really depends how much you have, who you have to support and what your and the size of your obligations are. Like Americans it is probably a good time to live below your means for a while, save a little more. Your other problem is the US Dollar is getting stronger meaning transferring money over here from abroad buys you less.

I am sorry unlike other posts I didn’t have more advice for you but I wanted to at least address the current situation so you know the basic facts of what you can and can’t do and the basic tip about the employer holding your role open while you search.

I feel for you if you are in this situation and wish you well and a speedy find to continue your adventure…..

CJ

EDIT: There is one other option I recently was made aware of if you want to remain in North America but not specifically the US. The Alberta Immigrant Nominee Program for Canada is seeming to take more and more people in who had been laid off on a H1B or E3 visa. You don’t need a job offer or sponsor to get this visa as you can loof for work after entering if you are in this broad range of job categories. I am certainly no expert on it but hear it could be a good option and a fast track to permanent residency in Canada.