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Health care throughout the United States, including New Jersey, is of a very high standard. Doctors are well-educated and hospitals are equipped with modern and highly technological equipment.  In typical emergency situations, New Jersey's medical staff reacts intelligently and efficiently. If you or a family member has a minor ailment, you might be better served by a local physician rather than waiting in the emergency room for hours. In addition, pharmacists may be a great source of help. Although, some medications require a prescription, your local pharmacist should be able to advise you in reference to over-the-counter medicines that may help cure minor illnesses.

One of the major problems that expatriates will face is acquiring a health insurance programme. The United States does not have a nation-wide public health care system in place, therefore, each individual citizen and resident has to pay for health care themselves. It is recommended that you already have a heath insurance plan prior to your arrival in New Jersey.

An important part of the overall experience of living in another country is learning to adapt to its culture. This is especially true when it comes to understanding the many different health care systems available in the state of New Jersey. One must be aware that differences do exist in each individual health care plan. A well-informed foreign national should learn as much as they can about the many health care programmes available and should examine their current insurance policy before leaving their home country.

All family members should get a complete physical examination in your home country, including dental and vision check-ups, prior to departure. Current medical problems should be diagnosed and treatment started before you leave your home country. Also, be sure to obtain a complete copy of all medical records for you and family members from your current doctor. Have your doctor include the generic names of the medications you are taking, allergies to foods or drugs, as well as past surgeries and illnesses.

Obtain up-to-date immunisation records on all adults as well as children. Make sure children have all the paediatric immunisations required for school entry. You may wish to have further non-required immunisations administered as a preventative measure. Some vaccinations, such as for hepatitis, may require a series of shots over a period of months. Consult your physician to discuss which immunisations may be beneficial.

If you do careful planning and research before you leave, you will find that your needs and expectations will be more than satisfied by your choice of health care in New Jersey.

Government Health Care
Unlike other countries, the United States does not offer a comprehensive health care programme for its citizens. In the United States, health care, except for the elderly or disabled, is the responsibility of the individual. There are three separate federal health care programmes in the United States Social Security System: Old Age and Survivors Insurance (OASI), Disability Insurance (DI) and Medicare.

Health care benefits are financed by the taxes paid by employers, employees and those self-employed. Based on the regulations set up by the Federal Insurance Contributions Act (FICA) and the Self-Employment Contributions Act, employers and employees are to contribute a percentage of their salary each year to these programmes. This percentage, which is subject to change each year, is spread out into equal portions and is taken out each pay period. Premiums, deductibles and expenses vary from state to state.

Insurance and Benefits
Employer-sponsored health insurance programmes are most often the only source of medical benefits for many individuals and families in the United States. Those who do not receive employer-sponsored plans may choose to purchase health insurance themselves. Unfortunately, however, individual coverage programmes tend to be extremely expensive, and not all insurance companies may offer these types of plans in the specific state in which you are living. Therefore, if an individual does not receive an employer-sponsored programme, they usually do not have any form of health insurance.

The employer-sponsored programmes available usually cover most medical expenses, such as hospitalisation, office visits, mental health care and chemical dependency treatment, and they may also cover the costs for prescription drugs.

Indemnity Plans
The traditional health indemnity plan, also known as a "reimbursement" plan, usually has a deductible of US$250 to US$500 per insured person, and reimburses a percentage of covered costs. One of the most common programmes offers 80 percent of the health insurance premium covered by the employer with the employee paying the remaining 20 percent.

Some plans have the employee pay the service provided for the fees directly, and then the insurance company reimburses the employee after four to six weeks. In order to receive reimbursement the employee must file an insurance claim with the insurance company within a certain period of time. For large medical claims, the service provider can bill the insurance company directly and then send a subsequent bill to the patient for the unpaid portion.

These types of plans do not limit the choice of primary care physician. Usually you can visit any doctor that you want without having to pay additional charges. Though still a popular form of health care throughout the country, indemnity plans are becoming less popular due to the emergence of managed care programmes, which tend to be less expensive.

Managed Care Providers
Managed Care health plans are an extremely popular form of health care and are considerably less costly than many of the other indemnity plans available. There are three basic types of managed care programs available. These are: Preferred Provider Organisations (PPOs); Health Maintenance Organisations (HMOs); and Point of Service (POS) plans.

With these types of services, the insured individual must choose from a network of doctors and hospitals supplied by the plan for their primary medical care. Usually managed programmes work on a “co-pay” basis. This means that the individual will only have to pay a minimal fee, from US$5 to US$20, for a visit to one of the doctors participating in the plan. Any services provided outside the specific network of doctors usually requires a referral by a participating network physician, or the insured will not be covered by the plan at all. Sometimes a larger deductible is added to the health care costs for a visit to a non-participating doctor.

Much like the indemnity programmes, employers will usually pay a percentage of the total cost leaving a small percentage (20 to 40 percent) the responsibility of the employee. The employer-paid percentage is usually deducted from the employee’s salary on a monthly basis.

The primary function of managed care plans is to achieve a controlled level of quality and efficiency for participating individuals and physicians. In the past, there has been some apprehension toward these types of programmes by individuals fearing that the choice of primary care physicians will be limited and of mediocre quality. This is no longer the case.

It is true that the more common managed plans, mostly HMOs, tend to limit the number of choices of physicians. Recently, however, these HMOs have been expanding their plans and attracting a larger number of physicians from various medical fields into their programmes. The choices are no longer limited to one or two physicians in a specific medical field.

With the costs for medical care skyrocketing, many employers are now choosing a standard managed care programme for their employees. These cost-effective managed health care programmes have become an excellent form of health care for both employer and employee.

Private Insurance Plans
These types of plans are the only alternative to employer paid benefits. The private health plans are among the most expensive in the world. Since there is not an employer paying a large percentage of the premium, the individual policy holder is responsible for all costs set forth by the plan.

There are various types of policies and coverage available for purchase. It is very important to choose a comprehensive medical plan that will fit all of your individual and/or family needs.

Considerations
Care should be taken when considering a particular insurance provider. American insurers are subject to both federal and state governmental regulation or quality control, so when choosing a policy make sure that these guidelines have been adhered to by the provider. The policy you choose is very important as there is no one governing body that dictates what benefits must be included in the plan and what will be omitted. This is why you must read any literature supplied by the companies very carefully and ask detailed questions on any points you do not fully understand. If you plan to include your spouse and/or children on the policy, make sure that you address their needs as well.

Before going through the difficult task of finding a new insurance provider in the United States, check to see if your current policy can be applied while you are in the US. However, it is more than likely that it will not be applicable unless you have a policy that has a special international policy. Do not assume that your company’s current plan will automatically cover you overseas. Although many plans cover a vacation to another country for up to one month, others specifically exclude any extended stays or relocation of more than one year.

What Does Your Policy Cover?
Most policies carry an initial deductible that the insured satisfies before any benefits are paid. This typically is US$250 to US$1,500, after which your medical expenses are paid on a percentage basis (80 percent or 100 percent) by the insurance provider.

Choice of Medical Facility
The city or town that you live in may not have the specific medical services available that you will need for particular illnesses. Make sure your policy covers whatever medical attention you may require from other facilities in another city or town.

Doctors and Dentists
Many policies, such as managed care plans, require that you visit one of the doctors that participate in their plan. These plans provide a listing of various doctors from which you can choose. You will have to decide on a primary care physician from this listing when you sign up for the programme.

If your company has a programme such as this, and you do not wish to use a participating doctor, you will have to obtain a medical referral from your primary care physician in order to visit a physician that does not participate in the plan.

The best advice in choosing a doctor is to ask your co-workers or neighbours whom they might recommend. You may have to choose a doctor that is part of your company health plan, in which case it might be wise to ask your co-workers the name of the doctor they use within the plan. This will enable you to make an informed decision when choosing a doctor of your own.

Some doctors are more than willing to give lengthy explanations of diagnoses and overall treatment. Usually you must initiate these discussions yourself and ask specific detailed questions, but you will find that most doctors are willing to spend enough time with you to help you understand. If you have difficulties in getting your questions answered adequately, you may consider finding a physician who will satisfy your informational as well as medical needs. This will make you feel more comfortable with the services provided.

There are many good dentists and orthodontists located all over the country. When interviewing a new dentist, be sure to ask many questions pertaining to his/her practice and procedures. Be sure to enquire about the office hours and types of dental insurance that are accepted. By spending a few minutes interviewing your dentist, you may save yourself undue stress later on. In addition, bring your dental x-rays and records to eliminate any unnecessary duplicate examinations.

Disability and Replacement of Income
While many major medical plans offer disability insurance, you may wish to purchase an additional disability insurance plan of your own. Private disability insurance for an individual can pay up to 100 percent of your current income if you become disabled while on the job.

Medications
It is quite common for medications offered in the US to have many different names. In addition to prescription medication, you will find that a lot of over-the-counter remedies are readily available and are often ‘prescribed’ to complement other medications. You will also find that many prescriptions have generic alternatives to the name brand medications. These allow you to receive the same medication at a fraction of the name brand cost. If you are already taking a particular medication, be sure to bring a few months’ supply with you until you can find an equal alternative in the United States.

When choosing a pharmacy, you should check to make sure that it is compatible with your health insurance plan or your prescriptions may not be covered. Without health insurance coverage, medications can get very expensive, especially if you need a regular supply of certain prescription drugs. Some larger grocery and department stores, such as K-Mart and Walgreens, may have a pharmacy within the store. There are also the regional and national drug store chains which offer pharmacy services, one of which is Eckerd Drugs. In Clinton, New Jersey, the local pharmacy is on Main Street. It offers free perscription delivery and 24-hour emergency service. Call (908) 735-5316 for more information.

HIV
As with many other countries, the United States requires that long-term foreign residents and students submit proof that they are free of the HIV virus prior to entering the country. If you are HIV positive and applying for a visa, be sure to check with the United States embassy on any restrictions or laws that would prohibit you from entering the country. If you have any specific questions regarding AIDS or HIV, contact the CDC National AIDS Hotline at Tel: [1](800) 342-2437 or the ATIS Health Information Service at Tel: [1](800) 448-0440.

FAST FACT:
If you are in need of any kind of emergency assistance call 911 at any time. This is a free service that operates 24 hours a day, seven days a week throughout the entire United States.

In Clinton, contact the following township departments for additional information:

Fire Station I
Tel: [1](908) 735-5214
Fire Station II
Tel: [1](908) 735-6702
Health Department
Tel: [1](908) 735-2934
Police Business Office
Tel: [1](908) 735-7230

Hospitals
Hunterdon Medical Center is located in Raritan Township, about twenty minutes outside of Clinton. Contact information is as follows:

Hunterdon Medical Center
2100 Wescott Drive
Flemington NJ 08822
Tel: [1](908) 788-6100
Fax: [1](908) 788-6111

Other hospitals located in New Jersey include:

Christ's Hospital
176 Palisade Avenue
Jersey City NJ 07306
Tel: [1](201) 795-8200

Englewood Hospital and Medical Centre
350 Engle Street
Englewood NJ 07631
Tel: [1](201) 894-3000

Greenville Hospital
1825 Kennedy Boulevard
Jersey City NJ 07305
Tel: [1](201) 547-6100

Holy Name Hospital
718 Teaneck Road
Teaneck NJ 07666
Tel: [1](201) 833-3000

Jersey City Medical Centre
50 Baldwin Avenue
Jersey City NJ 07304
Tel: [1](201) 915-2000

Medical Centre at Princeton
253 Witherspoon Street
Princeton NJ 08540-3213
Tel: [1](609) 497-4000

Palisades General Hospital
7600 River Road
North Bergen NJ 07047
Tel: [1](201) 854-4000

St. Francis Hospital
25 McWilliams Place
Jersey City NJ 07302
Tel: [1](201) 418-1000

St. Mary's Hospital
308 Willow Avenue
Hoboken NJ 07030
Tel: [1](201) 792-8100

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