Chapter 6 of 15

Health Insurance

NO universal healthcare, marketplace, employer-based, Medicare/Medicaid

Summary

The US is the only developed country without universal healthcare. The system is complex, expensive, and confusing. Most people are insured through their employer. Without an employer, you can buy insurance via the ACA Marketplace (Obamacare). Being uninsured is financially risky: a single ER visit can cost $5,000-50,000.

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Complete Emigration Guide United States

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Knowledge Base

Emigrating to the United States
Complete guide for emigrating to the United States.
Cost of living in the US
Overview of cost of living in the US.
Green Card lottery DV program
Everything about the Green Card lottery and DV program.
Healthcare in the US
Everything about healthcare in the US.
Taxes in the US
Explanation of the American tax system.

Glossary

Green Card (Permanent Resident Card)
The US permanent residence card. Gives you the right to permanently live and work in the US. Can be obtained through employment, family, the Diversity Visa Lottery or investment.
SSN (Social Security Number)
The US social security number. Essential for working, taxes, building credit, opening a bank account and virtually all official transactions. Apply at the Social Security Administration.
IRS (Internal Revenue Service)
The US tax authority. Here you file annual tax returns (before April 15). As a US taxpayer you must report worldwide income, even if you live in the Netherlands.
I-94 (Arrival/Departure Record)
The digital arrival/departure form that records your immigration status and permitted stay in the US. Always check your I-94 online after arrival — errors can have major consequences.
USCIS (Immigration Services)
The US immigration service. Handles all visa applications, Green Card applications, naturalization and work permits. Wait times vary greatly by category.
W-4 (Withholding Certificate)
The form your employer uses to determine how much tax is withheld from your salary. Fill this out on your first day of work.
H-1B Visa (Specialty Occupation)
The work visa for specialty occupations (minimum bachelor level). Annual lottery system with 85,000 spots. Your employer must sponsor the visa.
EAD (Employment Authorization)
The work permit that certain visa holders (H-4, L-2, asylum seekers) need to work in the US. Apply via USCIS Form I-765.
Credit Score
Your US credit score (300-850). Determines whether you get a rental, credit card, car loan or mortgage. Starts at zero as a newcomer — build it with a secured credit card.
Medicare / Medicaid
The public health insurance programs. Medicare for 65+, Medicaid for low income. Most employees get health insurance through their employer. Without insurance, medical costs can be ruinous.