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EXPENSIVE COMMODITIES INTERNATIONAL RNs MUST BE WARY OF.Ignorance about the most expensive commodities and expenditures is one problem that can make your first few weeks in America quite miserable. The early stages is always difficult. Learn about the most expensive services now so you don’t run into debt within the first few months on arrival. First on the list is Healthcare. Even though your employer offers you health insurance coverage, that ,as in most cases, may still not be enough. Your health/dental insurance benefit usually comes under different plans. First is the PPO plan which also comes in two categories; PPO in-network and PPO out-networks. Generally, this type of insurance gives you the leeway to visit a wider range of physicians, even those that have no contract with your insurance company. Whether you have a family or not you will usually pay monthly premium under this plan, and the premium is higher for those with a family. Insurance providers usually have their own conditions, variations and terms to whichever plan you choose. The other type, EPO, usually comes with no monthly premium to you. Your employer takes care of the premiums. It however restricts you to a particular physician(s) referred to as in-network. A couple of services are also not covered under this. There may be other plans that may fall in between the two major ones described above. The issue here is whatever the plan you subscribe to, the deductibles, percentages and co pays are still high.The deductibles for each year can range from hundreds to thousands of dollars any time you seek a particular medical/dental service. And it will depend on the type of service you are buying. For instance, when you have a procedure done or minor surgery say, lap appy or fixing a minor hernia, you will have to meet a deductible and co pay fees. In addition, you receive percentage bills from the surgeon, anesthetist, lab and the clinic itself; each in hundreds of dollars. Be aware that even with chest X-ray, you pay the clinic and the radiologist differently. Sometimes deductibles do not apply,or there is no coverage and so you have to pay the entire bill. Most of the medical/dental services have maximum limit; that is to say after the maximum coverage, any other bill is your sole responsibility,no coverage. Many RNs find this practice very different and strange to what they were used to back in their home countries. In fact, medical and dental services here are such expensive commodities that many prefer traveling outside USA to buy treatment. So it is advisable that you have all medical/dental problems (if manageable there) taken care of before arriving in USA. Just reserve your physician’s office for needed consultations. And always safeguard the health of your family. Your insurance package usually comes with many terms and unfamiliar wording; please make sure these lexicons are well explained to you by your employer. For whatever you are unclear about, seek further explanations before frequenting your doctor’s office or seeking cosmetic services. Or else you get your mail box inundated with hundreds to thousands of dollars in medical bills. The next on the most expensive commodity list is telecommunication. Compared to other nations, telephone calls are relatively expensive in USA. And unlike the practice in many countries, you pay for receiving and sending calls or text messages. In addition, you pay for minor components like greetings, call waiting, etc. And they will always try to lure you into signing at least 2 years contract. In order to push people into the contracts,they have made the prepaid service for the cell phone less attractive and more expensive than the 2 year contract package. My advice here is sign up for the cell phone if only you need it. But do not sign up for nation-wide and international package on your fixed lines. Instead, go for “local-coverage-only” package for the fixed line/home phone.That way you can receive faxes and calls from everywhere, but will only be able to fax and call locally. The “local-coverage-only” subscription can however call toll free numbers nationwide. Having done that, sign up with online call services i.e VOIP and buy credits for your international calls. Some of the online phone companies will usually offer free nationwide calls, including calling cell phones. You can also save much by acquiring personal equipment for faxing, photocopying, internet etc. Buying these services at the business centers is very expensive. College/university Education is next on the list. But a state like California has however subsidized education greatly. But you got to have resided in the state and paid state taxes for at least a year. Be ready to provide evidence to this assertion.It could be in the form of utility bills or lease/rent agreement. Some hospitals and employers make sponsorship and reimbursement for educational expenditure part of their employees’ benefits. My last but not the least of the most expensive commodities is Labor; unlike what the situation may be in your country, you pay good money for services you may consider petty and cheap in your country. Services like lock fixing, carpet cleaning, carpentry, painting etc are formal and well established businesses in USA. The caution here is to avoid neglecting or causing damage to your apartment, car and other properties. It is also important you learn some of the basic Do-It-Yourself skills,get your tools and you will not have to pay for all the expensive commodities.
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