Many of our patients and their parents came to the US from other countries. The American system works differently from a polyclinic or a national health service, and a few basics make it much easier to use.

Start with a primary care provider

In the US, your first stop for almost everything is a primary care provider (PCP): checkups, everyday illnesses, chronic conditions, and prescriptions. Your PCP refers you to specialists when you need one. Many insurance plans require that referral. Read more: What is a primary care provider?

Know where to go

  • Your clinic for most problems, by appointment.
  • Urgent care for problems that can't wait when your clinic is closed.
  • The emergency room (ER) or 911 for life-threatening problems.

Read more: Clinic, urgent care, or ER?

Is health care free in the US?

Mostly no. In the US, health care is usually paid through insurance. With insurance, you pay part of the cost; without it, you pay the full price. Many people qualify for free or low-cost coverage through Apple Health (see below). Emergency rooms must examine and stabilize anyone with an emergency, even without insurance.

Insurance words you'll hear

  • Premium: what you pay every month to have insurance.
  • Deductible: how much you pay yourself each year before insurance starts paying for most services.
  • Copay and coinsurance: your share of the cost of a visit or medicine.
  • In-network: doctors and clinics that have a contract with your plan. Out-of-network care usually costs more.
  • Explanation of Benefits (EOB): a summary from your insurance. It is not a bill.

The official HealthCare.gov glossary explains more terms.

Getting coverage in Washington

  • Through work: many employers offer insurance.
  • Washington Healthplanfinder: the state marketplace, with financial help for many families. Open enrollment runs November 1 to January 15. Some life events, like a new job or a baby, let you sign up at other times.
  • Apple Health (Washington Medicaid): free or low-cost coverage for those who qualify. You can apply any time.
  • Medicare: for people 65 and older and some people with disabilities. Sign up around your 65th birthday to avoid late penalties.

Prescriptions

Your provider sends prescriptions electronically to the pharmacy you choose. Bring the packaging of medicines from abroad, because the same medicine often has a different name here. Read more: Medical records from another country.

Your rights

  • You can ask for a medical interpreter, usually at no cost.
  • Your health information is private by law (HIPAA).
  • You can ask for a copy of your records and an itemized bill.

For help finding local services, call 2-1-1 or visit wa211.org. And of course you can always ask us. At our clinic, you can talk about all of this in Russian or Hebrew.