What you need to know about health care in the United States
- Hospitals around the U.S. are facing shortages of healthcare workers and support staff. If you need to make a specialist appointment, plan ahead, as wait times can be on the order of months.
- Your medical record will not always be transferred, even between doctor’s offices in the US. Consider bringing any medical records you have on hand from your previous healthcare provider.
- Ambulances are costly (up to several thousand dollars); be mindful when you ask for one.
- Understanding health insurance is difficult, but can save you a lot of money. Be sure that your doctors are in your health insurance network. If not, you will be responsible to cover more expenses.
- Your health insurance plan may not cover dental procedures. The dental plans are separate from health insurance plans. Dental procedures, even with insurance, are quite costly. Dartmouth offers some options for dental insurance.
- Your health insurance may not cover all dermatological procedures. If you need a dermatological procedure, you should call a health insurance representative to understand the cost of it.
- Your health insurance will cover lab work and general medical procedures, but there is almost always a co-pay fee or a deductible that should be covered by you. If you don’t make a payment in a timely manner, your fee will increase. If you wait too long, this incident will be reported to collectors, which will affect your credit score as well. If you are unable to pay the full amount, you can set up a monthly payment plan with your healthcare provider. Be sure you have a correct mailing address associated with your health insurance.
- Urgent care is a more preferable resource than an emergency room. Call an emergency only if it's a life-threatening situation.
What you need to know about health care in the Upper Valley
- The Upper Valley is home to one of the premier healthcare facilities in New Hampshire, Dartmouth Hitchcock Medical Center. Dartmouth Health also operates other facilities in the region and bi-state area.
- Dick’s House is home of Dartmouth’s Health service, but is only accessible to students and their dependents. Postdocs cannot receive service.
- Dartmouth College has partnered with One Medical to create One Medical at Dartmouth, which is an excellent resource for preventive care.
- In addition to primary care and specialist resources, Lebanon has an urgent care center.
- There exist other facilities for specific types of care such as Planned Parenthood for sexual health, and many clinics for physical therapy, dentists and mental health.
Getting care
If you have an emergency, call 911. Emergency means you are at risk of death or urgent, severe health issues. In the US, ambulances are costly (up to several thousand dollars); be mindful when you ask for one.
If you need urgent care or emergency (feeling bad, but you still can help yourself), go to the urgent care (for example, Clear Choice in Lebanon) or the emergency room (there is one in the Dartmouth Hitchcock Medical Center). You will get immediate help at a reasonable price; typically, a big part is covered by insurance.
If you need to see a doctor for something not urgent, such as a cold, fever, covid, or a urinary tract infection, you can either see your primary care provider (if you have one), use telehealth or go to a walk-in clinic.
Set a telehealth appointment if an in-person appointment takes too long. You will get telehealth attendance quickly and a prescription if needed for antibiotics or whatever is required. It is fast, very efficient for minor things, and sometimes even free, or at least cheaper than in-person care. Telehealth can also provide you with a sick leave notice for the employer if needed. Cigna (Dartmouth’s insurance provider) has partnered with MDLive to offer telehealth. You can make an MDLIVE appointment through myCigna, which is Cigna’s platform.
Alternatively, you can use a walk-in clinic in Dartmouth Hitchcock Medical Center for non-urgent issues to see someone in person.
Setting up insurance
Dartmouth provides options for health insurance coverage, and covers some of the costs of the plan. You can estimate the cost of each plan online on the HR website.
At the HR orientation, you will be familiarized with health care plans provided by Dartmouth. It’s important to understand the details of your plan, especially if you have dependents. You have 30 days from your first day of employment to choose your healthcare plan. After 30 days, you will be set to the default option, which may not be beneficial for you, especially if you have dependents.
International fellows on some types of visas (such as J visas) have limitations on what insurance plan they can choose (see the OVIS site about health insurance requirements). Make sure, if you are on a visa, to choose a plan whose deductible is not higher than the limits imposed by your visa.
Setting up a primary care provider
Health care is usually cheaper and much more accessible when you have a primary care provider (PCP). You should start setting up a PCP as soon as you get to the Upper Valley. Many places are short staffed and do not accept new patients. If a place accepts new patients, you still might have to insist a lot on getting your PCP: keep calling and messaging the clinic until you get one. After you establish your PCP, getting health care gets much easier because you can get professional attendance just by contacting your PCP’s office (telehealth and in-person) and getting a referral. Here are the main options for the Upper Valley:
One Medical at Dartmouth
- First, you should call the office directly at 603-738-1164 to ask if they accept new patients. If so, set the first in-person appointment. Since this service is severely understaffed, it may take up to 3 months to get your first appointment. If you have a chronic medical condition (e.g. diabetes, lupus, etc.) be sure to bring a supply of medication for at least 3 months.
- While waiting for your first appointment, you will receive a letter by mail from One Medical to fulfill information about your health insurance, consent forms, history of existing medical conditions (is any), etc. It can also be done at the first in-person appointment.
- At your first in-person appointment, the nurse will create and give you access to your online account. You can communicate with your primary care provider using you account, as well as request medication, lab work, etc. You can also communicate via cell phone if you decide to do so.
- There is no pharmacy on site, so you would be referred to the pharmacy location at DHMC.
Dartmouth Health
- Dartmouth Health has several locations, including their main location (Dartmouth Hitchcock Medical Center), Alice Peck Day Memorial Hospital, the Dartmouth Hitchcock clinics on Heater Road in Lebanon or in Lyme, and critical service hospitals in New London and Mt. Ascutney.
- Call the office directly to set the first in-person appointment or try to create your account in my-DH. The latter will be your main health page for all resources with Dartmouth Health. The system works for all their facilities and keeps your full health history. You might get your PCP in any of their locations.
Mental Health
Therapy is great, and pairs well with healthy life habits. For example, you could try to find the things that make you happy, like nature, walking, sport, gathering with friends, etc. Therapy is an excellent addition to those things and a great way of reflecting. Since your mental health is one of the most important things, it is your responsibility to find what makes you happy and fulfill your life with meaning.
As a benefit, all Dartmouth employees have access to the Employee Assistance Program. This service provides free counseling, work-life solutions, legal support and financial information. There is an on-campus mental health counselor, and you can receive service in-person or online. You will need to disclose why you want to see a therapist upon making an appointment. Be mindful that you get 8 sessions per issue, so if you have multiple issues you can get therapy for a while.
Accessing mental health resources
- Due to the lack of mental health providers, Dartmouth provides a mental health exception that allows for 12 out-of-network mental health visits at the same cost as in-network providers.
- Mental health prescription medicine can be provided by nurses and primary care providers without the need of a psychiatry appointment.
- Dartmouth offers employees some mindfulness resources, such as Headspace, a mindfulness app. Other resources, such as the Tucker Center (on campus), offer spiritual well-being help.
- Counseling Associates of New London have an office in Hanover https://www.ca-mh.com/. One Medical at Dartmouth has a therapist, but rarely accepts new patients.
- If someone is in crisis, don’t hesitate to call 988, the nationwide Suicide and Crisis Lifeline.
Last updated: Jun 23, 2023