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Health Insurance Tips
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Tips: Strange things that could happen during your doctor visits

When I first arrived in this country, I was confused with the medical system in the States. In Thailand, everybody pays for his or her own medical expenses. We are neither required to purchase an insurance plan before we register for class nor must we show proof of insurance every time we go to a doctor. I soon met a friend from Korea, who was also confused with the system here. Because the Korean government pays for most medical expenses, he never needed to buy insurance or pay hospital bills when he was sick.

A Difference In Customs?

Due to a difference in medical care in the U.S. from other countries, international students may encounter "strange" phenomena when they visit a doctor in the States for the first time.

Phenomenon#1:
You need to have an appointment ahead of time.

In my first year, I showed up at the school's health center with a headache without an appointment. The staff asked me to pay an extra $5 for my non-appointment visit. I unsuccessfully tried to explain to her that my headache didn't try to make an appointment with me either, but that didn't help.

If you have a medical emergency, most school health centers will take patients without appointments, but you may have to pay some sort of penalty charge. For physicians who work outside of your school, you are required to make an appointment. For some doctors, the appointment may need to be made as much as two months in advance. You can choose to go to the emergency room (ER), but it will cost you a lot of money. I went to a local ER one night, and it cost me more than $400 for two X rays.

Phenomenon#2:
The emergency room is not really "emergency" here.

You may spend up to four hours waiting for a doctor to treat you. If you don't have a severe wound or weren't involved in a serious accident, you must wait "in line." I once saw a man with a bleeding hand sitting in the emergency room for 2 1/2 hours before he was treated.

Phenomenon#3:
You can't buy many kinds of medicines over-the-counter.

The first thing you probably do when you got sick in your home country is to ask a local pharmarcist to prescribe some sort of medicine. Here, the Food and Drug Administration (FDA) only allows certain kinds of drugs (called over-the-counter medicines) to be sold without a doctor's prescription. Therefore, you may be surprised to learn that you can't buy antibiotics, for example, without seeing a doctor first.

Phenomenon#4:
Physicians may deny treatment to you, if you can't show proof of health insurance.

Here, everything is according to the rules. Even if you are about to pass out, the nurse may ask to see your insurance card.

Phenomenon#5:
Some health insurance policies will impose a higher deductible if you visit a specialist without going to your school's health center first.

I suffered from chronic back pain for a few years, and I was almost certain that the doctor at the school health center could not help me (they don't specialize in chronic pain treatment). In order to save money on the deductible, I first had to visit the center and then try to convince them that they were not capable of curing my problem. After successfully doing so, they referred me to an orthopedist, who later treated me. Although I ended up saving about $25 on the deductible, I had to spend an extra hour at the school's health center.

Phenomenon#6:
Students from socially conservative countries may find some health questions offensive.

One of my more traditional friends went to see a doctor and was asked, "Are you sexually active?" My friend spent the next 10 minutes trying to explain to the doctor that he is a traditional guy who came to the U.S. just to study and nothing else. Since American society and its views are quite different from home, you have to understand that while some questions may seem a little awkward, they are really just a part of routine procedure and nothing personal. For example, for female patients questions such as "Are you pregnant?" are quite common and do not imply that you are sexually promiscuous.

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