19

Suppose I travel to the US and stay there for a prolonged period of time. Can I meet with a registered physician and have him/her prescribe me meds?

Notes:

  • I'm a EU resident.
  • I have neither a US passport nor a Green Card.
  • I wouldn't mind if the prescriptions were only available in US stores.
5
  • 4
    A general advice is to always take a full list of your medications, your usual dispenser or GP should be able to give you one, and if you have unusual meds or go to a different part of the world to have the chemical names as well as the brand names.
    – Willeke
    Nov 28 '21 at 20:22
  • 1
    Note that some medication that is presciption only in the EU is over the counter in the US. It may be worth checking whether this applies for your drugs.
    – quarague
    Nov 30 '21 at 8:47
  • 2
    Not only are they allowed to, they have an obligation, morally (Hippocratic Oath) and probably legally, too, once you are their patient. Nov 30 '21 at 14:42
  • You may wish to purchase a health insurance plan, or a travel insurance plan that will cover your healthcare costs.
    – moonman239
    Dec 1 '21 at 18:42
  • @quarague and the other way around as well.
    – jwenting
    Dec 1 '21 at 21:24
25

As already answered, yes that is just fine. Except for controlled substances*, there really is not much of an issue at all.

As far as cost, there is huge variance in prices of prescription drugs. When health insurance is involved (not as likely for a foreign visitor), there are often negotiated prices and/or requirements for generics (where available) which significantly lower prices. If you are not covered by health insurance, or even if you are, it often pays to:

  • Get a generic when available. Can easily cut the cost in half.
  • Get an off-patent medicine. This applies to many different types of medicines, but particularly (in my experience) antibiotics. An old antibiotic might cost $ 10 or less for a course of treatment. A new antibiotic, or sometimes an old antibiotic in a new formulation (different dosage/frequency/etc.) might cost several times as much.
  • Ask for discounts. Sounds crazy, but some pharmacies will give you the "insurance price" if you don't have insurance, if you ask. Due to the way the insurance plans negotiate things (which is a huge mess), drug companies often keep a ridiculously high "retail price", which is the default if no additional discounts (insurance, coupons, whatever) apply.

Some pharmacists will handle all of this very easily for you. Some not quite as well. Talking to your doctor in advance can help a lot. A doctor will sometimes prescribe the latest antibiotic (or whatever) because they have a pen in their hand from the drug company. Seriously. That new drug has no generic available. But if you say "Is this available in a generic form?" then the doctor will know that cost is a concern and, unless there is a medical indication (e.g., the new antibiotic is significantly more effective for your particular type of infection), prescribe an older antibiotic that is available in generic form. Possibly dropping from $50 to $10 or less. But if you don't say anything, then the pharmacist has to call the doctor to get the change made, which takes time (both their time they could be using to fill other prescriptions and your time waiting, possibly a day, to get the prescription filled.)

I looked up one example. Actually two - first tried a common antibiotic and found it was pretty much only generic now (and quite affordable). Looked at a list of the most frequently prescribed medications. Found Atorvastatin = Lipitor. Typical dose 20mg per day. 30 pills is a typical order. From drugs.com $255.25 From the same site, typical generic atorvastatin: $19.76 - $25.96 == 1/10 the cost!.

And then the fun starts: From the lipitor.com (i.e., name brand) site they have a "Savings Card":

With the LIPITOR Savings Card, you may pay as little as $4 for each 30-day fill of brand-name LIPITOR.

Which is only available if you have typical insurance (employer or self-paid) or uninsured, but not if you have government (Medicare, etc.) insurance - presumably because government insurance rules restrict these types of things.

Which to me means: With regular insurance we're making enough off the insurance that we'll discount the copay to keep customers from jumping to generic and for the uninsured we'll just "be nice".

* In addition to the obvious controlled substances, there are a few over the counter medicines that currently need identification in the US. One of those is pseudoephedrine (a.k.a. "Sudafed", though it is available in house brands/generic and Sudafed now has many other products), which anyone can buy but only in limited quantities and you need to provide identification to do so. The exact procedure varies (at least in my area) between stores.

15
  • 2
    There are also various programs where low income/uninsured people can get drugs at a discount but these are usually for things like insulin which have to be taken monthly and I'm not sure if foreign residents are eligible.
    – JonathanReez
    Nov 28 '21 at 17:49
  • 2
    @NotThatGuy: It depends on the drug; OP should consult their doctor for specific advice. There are plenty of patented medications which are almost entirely redundant to their off-patent predecessors.
    – Kevin
    Nov 29 '21 at 15:37
  • 2
    @NeilMeyer They are generalisations. Sometimes a generic might save 20%. Other times 80% or even more. There is a lot of variability depending on numerous factors. As far as "money and effort that was spent in research and development", that is only partly true. In many industries, but particularly pharmaceuticals, only a small fraction of products make it market, and only a small fraction of those become big sellers. Those few products end up being priced to cover R&D (and marketing...and shareholder profits...and executive salaries...but I digress) of all the products. Nov 29 '21 at 17:06
  • 3
    Big pharma is not inherently evil. Modern drug development, in many cases, requires huge capital investments, and the only ways to do that are big companies or big government research. Or both. But the system of drug development & sales is complex and does (in my opinion, but easy enough to find examples) have some "bad actors" or "opportunists". Nov 29 '21 at 17:15
  • 7
    @NeilMeyer Why did you add "leftist" to your comment criticising people who say big pharma is evil? There are plenty of people on the right who say big pharma is evil (they're the main people spreading conspiracy theories about vaccinations recently). But there wasn't any reason to make this political. Also, we have plenty of evidence that pharma companies add huge markups (look up the 5000%+ price increase on Daraprim, for example). Some might see this as evil, others as greedy, others as just doing business, but in any case, it happening is simply a fact.
    – NotThatGuy
    Nov 30 '21 at 1:29
8

As the two other answers mention, no problem except for the absurd prices that you may encounter if you don't have a good medical insurance. Use https://www.goodrx.com/ to minimize drug cost, and if you only consult a physician to get a prescription from them, then you can do it online for a typically much cheaper price (eg 50 USD at https://www.goodrx.com/, but there exist other similar online services).

FYI: Given the name of a US pharmaceutical drug, how can I know its equivalent in other countries?

5
  • 2
    I'll confirm this. In Spain, I get levothyroxine without a prescription, six euro for a hundred pills. Here, a prescription is required (and a blood test to determine the dosage), twenty dollars per thirty pills (but you can get free cards for discounts like the GoodRX mentioned. Another similar is singlecare.com). Walmart has a four-page list of meds they sell cheap to attract people to their store.
    – WGroleau
    Nov 28 '21 at 20:10
  • Would GoodRx prescribe you stuff that requires a blood/stool/X-ray test first?
    – JonathanReez
    Nov 28 '21 at 21:09
  • @JonathanReez I guess so, as they are physicians so can easily prescribe such tests. I've only tested online medical providers plushcare and teledoc so far, as it's free with my insurance, and plushcare prescribed me blood tests. I had better experiences with plushcare, but perhaps got unlucky with the idiot I landed on with teledoc. Nov 28 '21 at 22:20
  • @JonathanReez GoodRx in this context is neither a prescriber nor a pharmacy - they're a drug discount plan. Your doctor might prescribe such. GoodRx has either a free version supported with ads, or a reasonable monthly subscription fee. GoodRx does have a separate service that allows you to chat with a physician who should be able to prescribe medications for you if indicated, but that's not included in the drug pricing feature at all - which is their primary business. Nov 30 '21 at 15:35
  • Many hotels will be able to provide a doctor (who probably has an arrangement with the hotel), but this will be incredibly expensive and making alternative arrangements is sensible (just as telephoning or getting laundry or even a bar drink is vastly overpriced).
    – Stuart F
    Dec 1 '21 at 16:13
7

Other answers have already covered that you absolutely can visit a healthcare professional, be prescribed drugs, and purchase them.

The notes about cost and coverage are pretty important.

Travel Insurance

A travel insurance policy is a very good idea for this reason; be sure to look carefully at the coverage provided like dollar and time coverage limits, but also whether prescriptions are covered at all (some plans do and some don't). Additionally, most of these policies of course have provisions against covering "pre-existing" conditions so if these are regular medications you already know you need, for an existing condition, they probably won't be covered in any case.

Local Coverage

While buying local coverage directly is often ridiculously expensive, there are subsidized options available for temporary residents sometimes.

You mention staying for an "extended period" but not via citizenship or permanent residency, so I assume "extended" for you means either as a tourist or on a non-immigrant visa such as a student (F) visa.

Some states do have medical coverage options for immigrants and non-immigrant visa holders. Options typically require that you are legally present and documented.

I know New York state best so that's the only examples I will give, but it will be helpful to look at the states where you are staying.

New York state

New York State lays out its immigration requirements for public coverage in this document. You would fall under Category 4 most likely, and thus be ineligible for anything but emergency care.

However, New York also has a health care marketplace called New York State of Health, and one of the options there for low/no-income applicants is called the Essential plan, and non-immigrant visa holders (such as foreign students) are eligible for this plan.

This page lays out various coverage options for immigrants (it's a New York City website but I think it applies to New York state generally).

More details about the Essential plan itself are in this document.

While the marketplace generally has an open enrollment period (a time of year when enrollment is open, and otherwise not available), the Essential plan can be enrolled into at any time.

Assuming you meet the income and other eligibility criteria, your monthly cost will either be $0 or $20. Other fees like co-pays (a small amount you pay for each doctor visit, or each prescription drug) may also be included, or may be $0 (anecdotally, those who I've helped apply for the program have paid nothing ever for any of the coverage, however they also had no income at all).

Unlike the health coverage most Americans have, this plan also covers dental and vision.

The one thing to be aware of is that this plan will only cover in-network providers. That means that only healthcare providers who have a pre-existing contract with the insurance company who backs this plan, will be covered by the plan. Depending on where you are from, this system, like much of US healthcare, will be confusing and probably surprising. The important thing to note is to check that any place you are receiving care accepts not only this insurance company, but the specific plan (it will not be accepted as readily as some other plans, even other plans from the same company).

This is not usually difficult to determine when you are seeing a single provider, and planning it in advance; it can mostly be a problem when going to a large hospital, especially for something unplanned like an emergency, because in large hospitals, not everyone you see at the hospital is part of the hospital for billing purposes, and may be out of network. I won't belabor this point more but it's something to research if you go this route.

3
  • 1
    Additional advice for OP for navigating in-network and out-of-network: Most major insurance providers allow you to fairly easily put your location in via web or app portal and find in-network providers near you. Regarding your second point, that practice of billing people at the hospital that are out-of-network without prior consent will become illegal effective Jan 1, 2022: cms.gov/newsroom/fact-sheets/… As it is a complicated law and new it is still worth researching and understanding the caveats.
    – Conor
    Nov 29 '21 at 19:55
  • Thank you for the additional info @Conor. Even now, at least where I am, surprise billing appears to be disallowed; for example every EOB I receive has a notice describing surprise billing and saying that I am not responsible for an charges that qualify as such. I am unclear whether that's due to existing state law, or insurance company rules for in-network providers, or something else. However, it does not prevent providers from billing it anyway, or trying to get paid, so as you said, worth researching and being cautious.
    – briantist
    Nov 29 '21 at 21:31
  • In addition, "prior consent" is in my opinion too vague. Every provider has, in one of the many poorly photocopied sheets they have you sign, a broadly worded agreement where you "acknowledge" that some providers may be out of network and where you "agree" to provide payment. I honestly don't know if that counts as prior consent or not, or whether it lowers the chances of winning a dispute. I do hope the provisions going into effect soon will address that, though it wasn't clear (to me) from the article you linked to.
    – briantist
    Nov 29 '21 at 21:33
6

Yes. You don't need a passport, green card, or even valid visitor status to receive medical treatment in the US.

The business side of US medicine is a huge mess, so you'll want to have good insurance. The ease with which you will be able to find an appointment will most likely depend on where you are and on the kind of doctor you want to see.

If the medication is a controlled substance, I suppose it's possible that there might be requirements relating to identification or something like that, which could be a matter of state law, but your valid foreign passport ought to suffice if such a requirement does exist. (There is such a requirement for the sale of pseudoephedrine, for example, even though a prescription is not required.)

7
  • @WGroleau perhaps, depending on the medicine and the country. In my experience generic drugs in Switzerland have proven to be rather more costly than in the US.
    – phoog
    Nov 29 '21 at 5:07
  • 3
    @NeilMeyer by the colloquial definitions of "controlled" and of "substance," perhaps, and the same could be said of many foods or industrial substances. In the context of US pharmaceuticals, however, the phrase is used with the meaning given at 21 USC 802(6). It includes a subset of prescription medications (as well as some substances that may not be prescribed), so there are indeed some prescription medications that are not "controlled substances"; a doctor or pharmacist will tell you that (e.g.) penicillin is not a controlled substance.
    – phoog
    Nov 29 '21 at 19:42
  • 1
    if you are bringing a lot of medication with you as suggested by @WGroleau, be sure to bring your own prescriptions proving these were doctor-ordered and approximately how long these are expected to last for. 999 times out of a 1000 it won't matter but on that one time it will really be good to save a Customs Officer or worse, DEA grilling.
    – Dragonel
    Nov 29 '21 at 23:46
  • 2
    And if you ever need paracetamol, it's called acetaminophen in USA. Other things we have our own words for, such as, we call a kilometer a "Speak English, man!" :-)
    – WGroleau
    Nov 29 '21 at 23:49
  • 2
    @NeilMeyer "controlled substance" refers to stuff which carries additional restrictions beyond simply needing a prescription. Stuff with addictive potential or recreational use--stuff that people might want for non-medical reasons. Nov 30 '21 at 3:25
6

The doctor's location matters. Not the patient's.

A doctor licensed in California can practice medicine on any human physically inside California at the time of care.

Doesn't matter where you're from.

In an emergency/rescue they will turn a blind eye, but normally cross-state doctor licensure is complicated.

If you go to an emergency room, they cannot refuse you care. They are going to give you whatever care is required to make you dischargeable, i.e. medically stabilized and with a post-discharge care plan in place.

Anywhere else you go, there will be a conversation about money before care is rendered.

In the emergency room, the conversation will happen at some point prior to discharge, and care -to-discharge will not be contingent on the answer.

Yes, the system has a vulnerability where people without insurance will ignore a simple infection that needs a $90 GP visit and $3 antibiotics, and present at the ER gone fully septic and needing a $100,000 ICU stay. Uninsured generally can't afford that, so hospital eats it.

As such, many cities, certainly all the large tourist cities, have programs of one kind or another to get the uninsured in front of a GP to get that $3 scrip. It's cheaper. An example is a "free clinic". So if you need GP care, that is an option.

Also, parts of the medical system are geared to work with cash-and-carry customers, and set reasonable prices accordingly. For instance Quest will do lab tests and Planned Parenthood will do STD testing. Lots of people do COVID testing, and it may take a little chasing for a foreigner, but most states will get you vaccines for free through one program or another. Very, very few people in America pay for COVID vaccines.

Some foreigners believe US healthcare is the best in the world. US immigration is very happy to have medical tourism from the foreign rich, as it props up struggling hospitals. In fact, the absurd "sticker prices" of medical procedures are for that demographic (they certainly don't expect domestic uninsured to pay it lol). However Immigration is on the watch for poor foreigners planning to steal healthcare by reporting to an ER and dodging the bill. They would refuse entry to such people.

5
  • Quest, reasonable?? Several years ago I had a billing issue with them--they billed the insurance wrong and got rejected. The deductible was not met, I was going to pay the bill anyway, but I wanted to pay the insurance rate, not the listed rate that was 10x the insurance rate. I talked to the insurance and found out the problem, explained it to Quest, they simply resubmitted without fixing the error. Rejected, explain, not fixed, round and round until the insurance finally said it was too old, disallowed. They ended up having to simply write it off. Nov 30 '21 at 3:30
  • the absurd "sticker prices" of medical procedures are for that demographic No, I don't think so. They are part of the game between many (not all) hospitals and insurance companies. Agree about pretty much everything else - nobody pays for COVID vaccines, and actually (for good reason) most other vaccines are pretty well covered. COVID testing is an interesting one - tests "just in time for a flight" can cost a bit, but most other COVID testing is free - but even there, some providers are opportunistically playing the insurance game, because they can. Patients who don't understand the game Nov 30 '21 at 4:21
  • can get quite worried when they see the EOB and "patient balance" but in the end most (not all) are not actually expecting anything from the patient - they just play the game to get what they can from insurance and/or govt. It's a mess. Nov 30 '21 at 4:22
  • @LorenPechtel i'm sorry you had a bad experience, but I was referring to the lab tests which Quest offers directly to the public on their web site and you pay with Visa/MC. I'm sorry but insurance is the usual racket that it is, and billers suck, and their bosses know that they suck. Nov 30 '21 at 18:14
  • @Harper-ReinstateMonica I was referring to the 10x difference between the insurance rate and the book rate. It was just a minor annoyance, keeping calling them up and telling them what they were doing wrong and they had their fingers in their ears. Maybe they have more reasonable pricing on the direct-to-patient stuff they have added but I haven't checked. Nov 30 '21 at 23:58
1

If you need medical care as a foreigner, you'll get it. And that includes getting medication.

Of course you may or may not have it covered by whatever travel and medical insurance you bring with you, which may make the purchase extremely expensive.

Haven't been to the US recently, but last time we were there my dad had to go to the ER and got treated like anyone else, and got the medication he needed as well like anyone else. Only difference was the way it's paid, as we had to pay for it out of pocket (rather than have it billed directly to the insurance company) and later declare the fees to our insurance once we got home.

That's little different from traveling to any other country really. We had similar experiences in Austria, Russia, Morocco, and Spain for example.

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Not the answer you're looking for? Browse other questions tagged or ask your own question.