University of Iowa

General Nature of the U.S. Medical Care Delivery System

Two characteristics distinguish the U.S. medical care delivery system from many others. First, it devotes considerable resources to prolonging the lives of seriously ill or injured people. The cost of medical care reflects the enormous investment in research, medication, and technology that this type of care requires.

Second, there is no general, governmentally-supported system for paying an individual's medical costs. That is, there is no overarching national medical care program or national insurance program.

The result of these and other factors is that medical costs in the U.S. are extremely high and they must be paid by the individual incurring them. Individuals can buy health and accident insurance that will pay some of their medical expenses. No health insurance plan readily available to students covers all medical expenses.  

What Happens When You Visit a Doctor

When you go to see a doctor, expect many questions. The doctor will expect you to give details about your symptoms--what they feel like, whether they are more noticeable under some conditions than others, how long you have had them, and so on. The doctor will ask you what treatments you have already tried.

In the U.S. health-care system, patients are encouraged to take responsibility for themselves by asking the doctors (or other care-givers) questions about their condition and its treatment. Patients are expected to ask about the costs of recommended treatment, and may be asked to participate in making decisions about treatment and medications. If the doctor does not know the likely costs, someone else in the office should be asked.

You should bring your insurance card with you to all health care appointments.

Health and Accident Insurance

Health Insurance Requirement

The University requires all international students to have health insurance. International students are automatically billed for insurance coverage unless they present evidence that they have comparable insurance under some policy other than the University one. ISSS provides complete information about health insurance requirements and procedures to newly arriving students.

International scholars are required to be on a University of Iowa health insurance plan.

Health Insurance Terminology

Understanding written information or discussions about health insurance requires understanding certain terms. These definitions of common insurance terms come from a publication called "To Your Health," from NAFSA: Association of International Educators:

  • Claim: A written request by the insured individual for payment by the insurance company for a cost incurred and covered under the insurance policy.
  • Co-payment: The portion of a covered expense, after the deductible is paid, which must be paid by the insured individual. The co-payment is usually expressed in a percentage, for example, if the insurance company pays 80 per cent of covered charges, the co-payment is 20 per cent.
  • Cost Containment: Actions or practices designed to minimize costs incurred by both the insured individual and the insurance company. Cost containment helps to maintain reasonable insurance premiums.
  • Covered Expense: Any expense for which complete or partial payment is provided under the insurance policy.
  • Deductible: The initial portion of a covered expense which must be paid by the insured person before the insurance policy pays its part of the expense.
  • Exclusion:  Any condition or expense for which, under the terms of the insurance policy, no coverage is provided and no payment will be made.
  • Fee for Service: Medical care which is provided in exchange for a fee which is paid to the provider at the time the service is rendered.
  • Insurance Policy: A written contract defining the insurance plan, its coverage, exclusions, eligibility requirements, and all benefits and conditions that apply to individuals insured under the plan. 
  • Insurance Premium: The amount of money required for coverage under a specific insurance policy for a given period of time. Depending on the policy agreement, the premium may be paid monthly, quarterly, semi-annually, or annually.
  • Lapse in Coverage: After an initial insured period, the period of time during which an individual is uninsured, usually because of failure to pay the premium.
  • Pre-existing Condition: A condition that existed prior to the commencement of coverage under a given insurance policy. Depending on the policy, a pre-existing condition may be defined as (a) a condition which had its origins prior to the commencement of coverage; (b) a condition which exhibited symptoms prior to the commencement of coverage; (c) a condition for which treatment was sought prior to the commencement of coverage; (d) a condition which was diagnosed prior to the commencement of coverage; or (e) a condition for which treatment was received prior to the commencement of coverage.
  • Preventive Care: Measures taken in advance of symptoms to prevent illness and/or injury.
  • Renewal: Paying a premium for an additional period of time (after the initial insurance period has expired) in order to continue coverage.

Coverage Provided by Health Insurance

Health and accident insurance does not cover all medical expenses. In general, it covers the higher costs that result from accidents and serious illness, with associated hospitalization, medical tests, and the services of doctors and nurses. The coverage provided by various health insurance policies varies. Literature accompanying each policy describes what it covers. Of course, policies that are more comprehensive in their coverage are more expensive.

Where to Receive Medical Care

Students in F-1 or J-1 Status

Student Health & Wellness, 4189 Westlawn South, 319- 335-8370 - Student Health & Wellness (SHW) is the University’s primary clinic for students to go to for health care. Students registered for more than four semester hours are assessed a health fee each semester. This fee allows a student access to the SHW to see a doctor with no office visit charge as many times during the semester as he/she needs.  This fee also covers health promotion services across campus and in the clinic including fitness assessments, tobacco cessation, nutrition counseling stress management, sexual health and substance abuse counseling. Patients who have been assessed the health fee still must pay for lab tests, supplies, physicals, immunizations, procedures, medications, and other costs. Students' spouses and children are not eligible for these services. Students should have their current identification (ID) cards and insurance cards with them when going to the SHW.

The mission of the wellness branch of SHW is to support student wellness and learning through educational and health promotion services that help students create healthy lifestyle. Please see http://studenthealth.uiowa.edu/wellness for consultations and programs SHW provides to promote healthy lifestyles.

The SHW hours during the academic year are 8-5 Monday through Friday.  See the web site for more hours during breaks and additional information.  When SHW is closed, some options are

J-1 Scholars and F-2/J-2 Dependents

Primary Care Providers - Most people in the U.S. have a "primary care provider."  This person in typically a generalist physician, usually specializing in Family Medicine or Internal Medicine, who can see patients for a wide variety of illnesses, tests, medication prescriptions, etc.  You may also see members of their staff including nurses, nurse practitioners, and physician assistants.  If necessary, your primary care provider will refer you to specialists, such as neurologists, dermatologists, etc.

In the Iowa City area, there are two main systems of primary care providers.  You may select which system you prefer (be sure to check with your insurance company as some providers may have more/less expenses covered by insurance):

  • University of Iowa Hospitals and Clinics health care:  Typically people have a primary care provider in either the department of Family Medicine or the department of Internal Medicine.  Children below 18 will be required to be seen in Family Medicine.
  • Mercy Hospital of Iowa City system:  Several offices with physicians associated with the Mercy Hospital system are located around Iowa City, Coralville, North Liberty, and other surrounding communities.

Quick Care Clinics - These can be utilized for some very basic and fast services similar to what a Primary Care Provider would offer, but without typical waits for appointments.  There are several offices located in the Iowa City area for either the University of Iowa hospital system or the Mercy Hospital system:   UI Quick Care https://www.uihealthcare.org/quickcare/ and Mercy Urgent Care http://www.mercyiowacity.org/urgent-care.   The student health fee does not cover visits to these clinics or the emergency room.  

Emergency Room Services:  The emergency room at UIHC or Mercy Hospital should be reserved for emergency situations only.  Medical situations that do not involve immediate threat to life or health should be seen by either your Primary Care Provider or one of the Quick Care clinics in the area.

911:  Dialing 911 for assistance is reserved for emergencies only (example auto accident, fire, heart attack, robbery).  Calling 911 for non-emergency assistance may cause you to be assessed a fine for abuse of the 911 emergency system.

 

Pre-Natal and Maternity Care and Family Planning (Birth Control)

In the United States a woman usually goes to a doctor or clinic for regular checkups during her pregnancy, and has the doctor deliver the baby in a hospital.

A private physician's fee for delivering a baby, including prenatal and postnatal checkup, plus hospital charges will cost thousands of dollars without insurance.   

Pregnant women in need of a physician's services can see a Primary Care Physician as noted above, or may go directly to the Obstetrics-Gynecology Clinic at University Hospitals, or in the Mercy Hospital system . 

If you are a student, you may visit Student Health & Wellness for information on birth-control information.

The Johnson County Public Health Department, Child Health Clinic (855 South Dubuque Street, Suite 217, 319-356-6060) provides free or very inexpensive services for infants from two months through children 16 years old. The Department operates a well-child clinic where an infant who is not sick can go for regular check-ups and immunizations. To use the clinic you must live in Johnson County and have a regular physician. Call to arrange a clinic appointment.

The Visiting Nurse Association (1524 Sierra Street, 319-337-9686) provides home visits for mothers with new babies and for the elderly. They also have some infant and toddler car seats available for use by families who need them.

Planned Parenthood of Greater Iowa, at 850 Orchard Street, 319-354-8000, can help a student in choosing a method of birth control. They also do routine gynecological exams and pregnancy testing and counseling.

The Emma Goldman Clinic for Women, located at 227 North Dubuque Street, 337-2111, offers birth control options and gynecological exams.

Dental Services

University students, scholars, and their families may benefit from the use of the Dental Clinic, which is staffed by professional dentists and by students who are training to become dentists and dental hygienists. Services generally cost much less than those of private dentists. Be aware that most health insurance policies do not cover dental care unless it is made necessary by an accident that has injured the teeth or mouth. Dental insurance options are available to both students as well as scholars. T