Employer sponsored health insurance: what are the options for expats in case of job loss in the United States?

1. Prolong the benefits of your company health cover with the COBRA system

The COBRA (Consolidated Omnibus Budget Reconciliation Act) system was established in 1985. When your professional situation changes this system lets you keep, at your expense, the health cover which you had in your previous company; particularly if you lose your job (excluding redundancy for gross misconduct).

Prolongation of health cover, which can also cover your dependents, is generally possible for 18 months, which gives the policy-holder time to find a new job or to look for a new individual insurance plan.

The clear benefits of this system are, firstly, that identical health benefits are maintained and, secondly, there are few administrative procedures to undertake. But one disadvantage is that the insurance premium, which is payable entirely by yourself, can be very high!

> Also read: Average cost of medical consultations across 10 countries

2. Purchasing a new ACA Compliant American health insurance policy

If you are not eligible for the COBRA system (in particular if you are self-employed), or if this solution does not suit you, you can purchase an individual health insurance policy from an American insurer.

Since the implementation of the Obamacare reform in 2014, a "marketplace" system has enabled every eligible resident to compare and purchase their health insurance policy using an institutional application which lists the various offers of "ACA compliant" insurers (i.e. those which satisfy several approval criteria required by the State, relating in particular to the guaranteed cover, the applicable reimbursement caps and also the possible reasons for termination).

With this solution, an insurance policy cannot be purchased at any time of the year, but only during the Open Enrollment Period, i.e. at the end of the calendar year, for the following year. But if you lose your job, a specific window (Special Enrollment Period) opens to purchase a new plan during the year; at the earliest 60 days before, and at the latest 60 days after, the end of your contract.

3. Choose an expat health insurance policy, which covers you in the United States regardless of your working status

Since 2014, residents in the United States who are not covered by a company top-up scheme used to be obliged to purchase a local ACA Compliant insurance policy. But this is no longer the case since 1 January 2019, in most American States: expats, in particular, can now choose to purchase the health insurance policy of their choice, without risking financial penalties.

This represents an opportunity, as International health insurance is often the most appropriate solution for them. This type of insurance covers their health costs in the United States, but also in the rest of the world, including their country of origin. This choice therefore means that you do not have to purchase a travel health insurance policy each time you travel.

In addition to being practical when travelling, international health insurance policies are generally better suited to expats’ requirements than those available in the United States: there is a choice of types of cover, a system of direct payment, repatriation for health reasons, and more. These solutions are often more flexible and adaptable to your particular expat situation.

APRIL International health cover for expats in the United States

APRIL International health cover comes with you wherever you go, and offers all the guarantees which make life more simple for you as an expatriate. With its MyHealth International plan, there are no costs to be paid up front in the hospital, and you also have the advantage of direct payment when you choose your GP from the 690,000 doctors and the 5,700 hospitals in our American health network. And you can also make use of our remote medical consultation service, which is completely free.