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NHS as previous coverage, six month bans and pre-existing health care issues

NHS as previous coverage, six month bans and pre-existing health care issues

Old Jul 21st 2009, 4:27 pm
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Default NHS as previous coverage, six month bans and pre-existing health care issues

Hi

There are a couple of common things that common up on health insurance and I'd like to work them into the wiki, but I know there isn't really a consensus or more appropriately, things have varied for folks given the particulars of their health insurance / health history.

Anyway, I want to work on the wiki on these three subjects:

1) What is a pre-existing condition?

2) Does having NHS coverage mean you had 'qualified coverage' prior to entering the US (such that pre-existing conditions were covered) and how do you go about proving that?

3) Is there a six month ban on insurance for new immigrants (since some have reported they had one and others have not had any problems).

So if anyone has any thoughts on these three issues I'll try to work them into the health care wiki. I still have to work in the thread I had a few months ago about health care costs but I've been lazy.

http://britishexpats.com/wiki/Health_Insurance

Thanks
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Old Jul 21st 2009, 5:48 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Can't answer for 1 and 2, but there was no 6 month exclusion period for me when I came to the US. Only a 1 month waiting period, but that was company policy as far as I know.
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Old Jul 21st 2009, 5:54 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Thanks!!

Q2 -

The NHS is a recognised "insurance provider" for the purposes of providing "creditable cover". (Details are available in this three page document: http://www.bcbsil.com/PDF/legislative_update_405.pdf and background information at: http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html)

This means that under the USA's federal law (and in my case my husband's healthcare plan), I am entitled to full health coverage immediately on arrival, including cover for pre-exisiting conditions.

My husband's insurance provider advised me that all I need do is provide them with a single page letter from my doctor or the NHS confirming that as a resident of the UK I have access to the UK's National Health Service.


"This is to certify that name (Date of Birth ) has been automatically covered by the NHS (National Health Service) from the her arrival in the UK on date/ or since birth etc etc . The National Health Service is a public health plan established and maintained by the government of the United Kingdom. It provides complrehensive health care to all citizens of the United Kingdom. Ozzidoc, as a resident and naturalised citizen of the UK, has been continuously fully covered by this plan since her arrival."
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Old Jul 21st 2009, 5:57 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by penguinsix View Post

1) What is a pre-existing condition?

2) Does having NHS coverage mean you had 'qualified coverage' prior to entering the US (such that pre-existing conditions were covered) and how do you go about proving that?
1) As far as HIPAA is concerned, a condition that you had medical advice, diagnosis, care, or treatment – recommended or received in the previous 6 months. Outside 6 months then it is not a pre-existing condition.

2) it's not qualified coverage, it's creditable coverage, and yes, NHS counts. It was even noted by name in official documentation regarding foreign health coverage. It works the same way as any other creditable coverage meaning if you are not covered by it for 63 days or more prior to your insurance sign up then it means nothing. You should only need a letter from your local trust saying that you have been covered under the NHS and the start and end dates. The end date would be the date you leave the UK. The dates are important because of the credit system and you want to be able to use all the days you were covered as credit.
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Old Jul 21st 2009, 6:17 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by penguinsix View Post
Hi

There are a couple of common things that common up on health insurance and I'd like to work them into the wiki, but I know there isn't really a consensus or more appropriately, things have varied for folks given the particulars of their health insurance / health history.

Anyway, I want to work on the wiki on these three subjects:

1) What is a pre-existing condition?

2) Does having NHS coverage mean you had 'qualified coverage' prior to entering the US (such that pre-existing conditions were covered) and how do you go about proving that?

3) Is there a six month ban on insurance for new immigrants (since some have reported they had one and others have not had any problems).

So if anyone has any thoughts on these three issues I'll try to work them into the health care wiki. I still have to work in the thread I had a few months ago about health care costs but I've been lazy.

http://britishexpats.com/wiki/Health_Insurance

Thanks
2. I (USC) had Anthem insurance through my work. My husband having NHS coverage was considered 'qualified coverage.' To prove it we sent a copy of his NHS card to the insurance company. Once he had a SSN #, the ins. company asked that I send it to them also. It seemed that our situation was not unusual for them to deal with.
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Old Jul 21st 2009, 6:26 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by Michelmas View Post
Can't answer for 1 and 2, but there was no 6 month exclusion period for me when I came to the US. Only a 1 month waiting period, but that was company policy as far as I know.
We also had 1 month, waiting period.

Reg. Frank R.
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Old Jul 21st 2009, 8:56 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

2- It's getting a letter from your doctor usually, but generally whatever proof the insurance company want/will accept.

3- Probably more along lines of probation before being allowed insurance from employer, ranging from getting it from day one, 30/90 days or longer.
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Old Jul 21st 2009, 9:15 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by penguinsix View Post
3) Is there a six month ban on insurance for new immigrants (since some have reported they had one and others have not had any problems).
With my current employer, insurance would only kick in the first month after 45 days of employment. So if you started around the beginning of a month, it could be almost 2 months before insurance would start.

Last edited by Bluegrass Lass; Jul 21st 2009 at 9:18 pm.
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Old Jul 21st 2009, 10:33 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

2) I was told by other posters on here this only applies if you are joining an employers scheme in the US. We were not doing that but buying our own insurance and the pre NHS coverage didn't count. Therefore pre-existing conditions were not covered for 6 months for me. Wife joined the Oregon Medical Insurance Pool and got immediate coverage for everything.

3) This seems to vary from State to State (like a lot of things). We got coverage in Oregon from day 1.
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Old Jul 22nd 2009, 12:21 am
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by penguinsix View Post
Hi

There are a couple of common things that common up on health insurance and I'd like to work them into the wiki, but I know there isn't really a consensus or more appropriately, things have varied for folks given the particulars of their health insurance / health history.

Anyway, I want to work on the wiki on these three subjects:

1) What is a pre-existing condition?

2) Does having NHS coverage mean you had 'qualified coverage' prior to entering the US (such that pre-existing conditions were covered) and how do you go about proving that?

3) Is there a six month ban on insurance for new immigrants (since some have reported they had one and others have not had any problems).

So if anyone has any thoughts on these three issues I'll try to work them into the health care wiki. I still have to work in the thread I had a few months ago about health care costs but I've been lazy.

http://britishexpats.com/wiki/Health_Insurance

Thanks
Good idea! You are brave trying to work this one out!

Q1. anything you have been seen by a doctor for before (there are probably leagl definitions and timelines, but I dont know them)

Q2. Our insurance company (blue Shield of CA) did consider NHS to be qualified coverage. We were asked to provide evidence (we supplied NHS cards) and a covering letter to explain that we paid set costs towards prescriptions, but nothing for dr/ ER visits, hospital stays or procedures or vaccinations.

Q3. This I think is probably tied to the US insurance provider's policy, and whether they accept that the NHS was qualified coverage. We were covered from Day 1.
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Old Jul 22nd 2009, 3:43 am
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

[QUOTE=penguinsix;7771256]Hi3) Is there a six month ban on insurance for new immigrants (since some have reported they had one and others have not had any problems)[./QUOTE]

If your insurance in via an employer there could be a waiting period and this will vary employer to employer.

The shortest period I ever had with an employer was 90 days, and the most 6 months, and anything in between.
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Old Jul 22nd 2009, 12:36 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by Chrissywissy100 View Post
Q1. anything you have been seen by a doctor for before (there are probably leagl definitions and timelines, but I dont know them)
There are legal definitions and this is not really an accurate description, see above.
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Old Jul 22nd 2009, 12:47 pm
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

Originally Posted by Duncan Roberts View Post
There are legal definitions and this is not really an accurate description, see above.
Well I think Penguinsix probably picked up on that based on my vague answer and caveat that there are probably legal definitions, but I didn't know them!
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Old Jul 23rd 2009, 5:59 am
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Default Re: NHS as previous coverage, six month bans and pre-existing health care issues

I got my husband on my insurance right after we were married which was 3 weeks after he arrived. I just had to fax them a copy of my marriage certificate and they emailed me a form for his info which I filled out online, They told me I had to add him within a month of our getting married for my plan.
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