Best Way to Get Healthcare While Back in the US

February 18, 2009 1:40 AM

I will be returning briefly to the US after 6 months abroad and I would like to partake in some of that wonderful US healthcare before I head back abroad. I have a couple of questions.

I was planning on spending a year abroad (in Israel) where I have the most basic emergency-only insurance that will not cover me in the United States. I will be spending a week in the United States at the beginning of March and if at possible I would like to see some medical professionals (dentist, dermatologist at least, possibly other stuff, depending). I will be in Georgia and Texas.

I have never been without health insurance before, so I am wondering if anyone has any experience about this or advice on what I should do. If it matters, the last time I had health insurance was COBRA in July, through an old job. This is not emergency stuff, just annual check-ups.

I assume I can just start calling up dentists and dermatologists in the areas I will be and see if someone will see me, but I'm wondering if there is a way to keep the costs down or if there is some sort of travelers insurance I can get that will help defray the costs.

posted by andoatnp to health & fitness (13 comments total)

In case it wasn't clear from my question, beyond the insurance/money issue, I am also curious if there is a better way to make an appointment than randomly calling up dentists and dermatologists near where I am staying asking if they have an appointment available for when I am in town.
posted by andoatnp at 2:22 AM on February 18

I don't know about dermatologists, but it's my understanding that most dentist's charge less (for basic check-ups and fillings) if you don't have insurance. That has been the case with my dentist at least.

As far as getting an appointment, you might want to ask people in the town/city you will be staying at for referrals. It'd be better to find out who is good and start calling now to try to get an appointment. You don't want to end up with a dentist à la Little Shop of Horrors.
posted by robtf3 at 2:41 AM on February 18

Are you certain that comprehensive health insurance in Israel is that expensive? I'm thinking it would probably be cheaper than in the US, even if you're not a citizen. Frankly, I'd expect private (no insurance) doctor's visits to be relatively inexpensive there as well. If you ask around you can find doctors who speak English well (or are anglos to begin with).
posted by lullabyofbirdland at 2:48 AM on February 18

You can try calling around. There are doctors who operate on a sliding scale, but those are mostly GPs volunteering for emergencies or chronic illness at low cost clinic. Most people without insurance in the US never see a dentist or dermatologist unless they are having a serious problem that has become unbearable. If there were some way to keep the costs down on preventative healthcare in the US we wouldn't be in the mess we're in.
posted by hydropsyche at 4:16 AM on February 18

Certainly, many doctors have a sliding-scale for those in need. Most, at least in my experience, merely have a slightly reduced rate for people without insurance. A dentist trip will still easily cost you well over $100 just for the checkup. Any work that actually needs to be done will be more. You might try looking for a dental school. The schools usually have open offices in which they train the students. There will still be a cost, but it should be a lot lower than a normal dentist.

Cost-wise, the same goes for a GP. Office visit...$100 or more. Any tests will be more. A lot more.

Unless they are on the lists of low-cost generics that many pharmacies like WalMart are handing-out, your prescriptions will be charged at full-cost. That can be quite expensive.

I can guarantee that a dermatologist will not have anything close to affordable or reduced rates.

Being without insurance in the US is a special kind of hell. Heck, even if you DO have insurance, that doesn't necessarily mean you can afford to go to the doctor, thanks to all the little things policies don't cover.
posted by Thorzdad at 4:45 AM on February 18

it's my understanding that most dentist's charge less (for basic check-ups and fillings) if you don't have insurance

Not in my experience. The insurance companies "negotiate" lower rates with doctors to become part of their network. Without insurance you won't get this discount.
posted by DarkForest at 6:07 AM on February 18

Do you have any insurance with dentists, DarkForest? Because when I stopped using insurance at my dentist, my bill definitely went down for the same procedures. The dentist told me that the discount was because they saved so much money by not having to bill the insurance company.
posted by grouse at 7:32 AM on February 18

I don't know what it's like where you are going to be but if I were you I would call NOW. Don't be surprised if the doctors cannot see you as soon as early March, particularly if you've never seen them before. In Asheville as a new patient you would be looking at an eight to twelve week wait for the first available appointment. Dentist appointments are usually easier to come by but doctors? Forget it. My experience has also been that you're looking at $100 for the dentist just to walk in the door; probably more for the doctor.
posted by mygothlaundry at 7:44 AM on February 18

Grouse: yes. This was how my dentist explained it to me when I questioned why my latest cap was 20% more expensive than the one I'd gotten under insurance.
posted by DarkForest at 8:12 AM on February 18

My dentist charges me 20% less if I pay cash. It's still absurdly high. Unless you have a serious skin condition dermatology (for acne, for example) is considered elective and not usually discounted. It can't hurt to ask but I suggest checking in Israel where you should be able to get pretty good care without insurance for less than in the U.S. If you decide to be treated in the US ask for recommendations for specific cities from friends or family. Often you need to book an appointment well in advance, so don't leave it until the last minute. Dental schools are also a good bet, as long as you're easy going about your treatment.

or if there is some sort of travelers insurance I can get that will help defray the costs.

Insurance doesn't really work that way and all traveler's policies I've ever seen do not cover preventative or non-emergency care. I live in the US and usually buy travel policies for the rest of the world, however I've noticed that travelers coming to the US pay much higher for travel insurance when they include the US in their options for "countries covered". In fact, the rates I've seen are usually calculated as "everywhere but the US" with the US as an expensive add on. This is because US healthcare costs so much more than most places.
posted by Bunglegirl at 10:30 AM on February 18

You should definitely ask people in Israel (perhaps here on MeFi) specific questions about the costs of the kinds of exams and treatments you want done if you haven't already. When I had to have sudden emergency treatment in Taiwan, I found myself at the nicest private hospital in Taipei getting X-rays, a consultation with a specialist, and prescriptions. I can't remember how much the total for everything was, but it was somewhere between $75 and $300. I had no insurance at all. The same thing in the US would have cost a small fortune.

Other than that, the only thing I know to do is ask if there's a cash discount. :/
posted by wintersweet at 11:27 AM on February 18

I´ve gotten cheaper rates at the dentist through buying a dental discount plan from a local health insurance broker. The discount plan I was on could be paid month-to-month, but needed to be started in the month before being used. There was a list of dentists where the discount could be used.

If you are having trouble making an appointment, many dental clinics in Mexico offer appointments on short notice. They are known for being cheaper than US dentists. Some offer transportation from major cities near the border. If you do need any dental work, you might be able to get it done the same day.
posted by yohko at 12:11 PM on February 18

If you're going to be in a town with a dental school or a tech school for dental hygienists, they often offer very inexpensive checkups in their clinics. Yes, you'll be treated by a student (overseen by instructors) but don't let that scare you - they're often much more thorough and careful and the cost can be next to nothing.
posted by ourroute at 4:09 PM on February 18