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Getting Healthcare in the US

Getting Healthcare in the US

Old Jul 9th 2011, 3:34 pm
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Default Getting Healthcare in the US

Hi there

I'm new to this forum so please excuse me if this has been posted before and please re-direct me to the relevant link...

I've just moved to North Carolina with my wife and daughter. I'm English and my wife is American. We applied for Health insurance, which was approved and then the Health company told my wife that i did not qualify has i hadn't lived in the States for 12 months.

Is this a common thing? Has anyone else experienced a similar issue? Are there certain Healthcare companies that are better than others? Any help/guidance would be appreciated.

Cheers
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Old Jul 9th 2011, 4:19 pm
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Default Re: Getting Healthcare in the US

Originally Posted by rock_hound View Post
Hi there

I'm new to this forum so please excuse me if this has been posted before and please re-direct me to the relevant link...

I've just moved to North Carolina with my wife and daughter. I'm English and my wife is American. We applied for Health insurance, which was approved and then the Health company told my wife that i did not qualify has i hadn't lived in the States for 12 months.

Is this a common thing? Has anyone else experienced a similar issue? Are there certain Healthcare companies that are better than others? Any help/guidance would be appreciated.

Cheers
Sounds like you may have fallen under their "pre-existing conditions" clause, or had what is called "break in coverage". The insurance companies will do almost anything to avoid taking on any new risk - but it may be they don't recognize NHS as "insurance".

The break in coverage thing means if you go more than 30 without insurance, that gives them a reason to wait and see what kind of a risk you'll be. It's possible you can appeal their decision and maybe provide them with evidence of NHS coverage while you were in UK? Never forget, insurance companies over here are NOT about health care - they're about profits and the "bottom line".

Funny thing is, when my husband (who's English) signed up for group health with his employer, the insurance company seemed to appreciate the care the NHS had provided consequently, his health exam was cursory at best.

As for best insurance companies, kind of depends on where you are, who the insurance company is and whether or not you're going to join a group (employer) policy. Personally, we despise, detest and abhor insurance companies:curse: - we've worked too long in the medical world to feel otherwise. All the same, a necessary evil over here.
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Old Jul 9th 2011, 4:26 pm
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Default Re: Getting Healthcare in the US

Thoughtless me - forgot to say welcome to the USA and to the forum (though since I'm not the host, guess it's not my place to welcome you?). Am relatively new to it myself, although my OH has been quite verbal in various threads, all beginning with a problem getting his British passport renewed!. Good luck with your new abode and your insurance troubles. Wish we had more positive words for you - best we can do is warn you of possible treachery or pitfalls. My ex-pat would probably be better at it than I......
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Old Jul 9th 2011, 4:49 pm
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Default Re: Getting Healthcare in the US

Originally Posted by rock_hound View Post
Hi there



I've just moved to North Carolina with my wife and daughter. I'm English and my wife is American. We applied for Health insurance, which was approved and then the Health company told my wife that i did not qualify has i hadn't lived in the States for 12 months.

Is this a common thing? Has anyone else experienced a similar issue? Are there certain Healthcare companies that are better than others? Any help/guidance would be appreciated.

Cheers
Little more info, where are you and who refused you cover.

It is standard practice if you are buying individual insurance, not through an employer, for pre-existing conditions to be excluded for 6 to 12 months, but some form of cover is normally available at a price. Might be very expensive but it's there. If you cannot get cover does the State you live in run its own insurnace pool for people who can pay but have been refused cover.

When we came over we arranged cover from the UK, to start when we stepped off the plane in Portland. In fact I the UKC got health cover from an insurance company, Blue Cross/Blue Shield, my wife the USC who has diabetes was refused cover and enrolled in Oregon States high risk cover, which is run by Blue Cross/Blue Shield.
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Old Jul 9th 2011, 9:43 pm
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Default Re: Getting Healthcare in the US

Try Patriot America- I use them and they are good for 2 years - I was recommended by another expat on here
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Old Jul 10th 2011, 9:57 am
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Default Re: Getting Healthcare in the US

Originally Posted by CAdreaming View Post
Try Patriot America- I use them and they are good for 2 years - I was recommended by another expat on here
Does this work in the case of a UKC immigrating? The brochure seems to allude to travel only.
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Old Jul 10th 2011, 2:38 pm
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Default Re: Getting Healthcare in the US

Originally Posted by Gerber View Post
Does this work in the case of a UKC immigrating? The brochure seems to allude to travel only.
I have just moved over to USA on K1 in March
we spoke to them and its also for new immigrants and good for 2 years

have a word with them
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Old Jul 10th 2011, 9:19 pm
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Default Re: Getting Healthcare in the US

Originally Posted by Egg and Cress View Post
Sounds like you may have fallen under their "pre-existing conditions" clause, or had what is called "break in coverage". The insurance companies will do almost anything to avoid taking on any new risk - but it may be they don't recognize NHS as "insurance".

The break in coverage thing means if you go more than 30 without insurance, that gives them a reason to wait and see what kind of a risk you'll be. It's possible you can appeal their decision and maybe provide them with evidence of NHS coverage while you were in UK? Never forget, insurance companies over here are NOT about health care - they're about profits and the "bottom line".
It's 62 days before break in coverage flaps you over.

The NHS is considered credible coverage.

Someone gets a job which provides insurance is the best option, privately is a minefield.
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Old Jul 10th 2011, 11:16 pm
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Default Re: Getting Healthcare in the US

Originally Posted by Egg and Cress View Post
The break in coverage thing means if you go more than 30 without insurance, that gives them a reason to wait and see what kind of a risk you'll be. It's possible you can appeal their decision and maybe provide them with evidence of NHS coverage while you were in UK? Never forget, insurance companies over here are NOT about health care - they're about profits and the "bottom line".
That only really affects group policies, not individual ones. Individual ones can pretty much do what they want with regards to pre-existig conditions, except in the case of children. It's also 63 days between qualifying plans, not 30.
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Old Jul 10th 2011, 11:57 pm
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Default Re: Getting Healthcare in the US

Originally Posted by Duncan Roberts View Post
That only really affects group policies, not individual ones. Individual ones can pretty much do what they want with regards to pre-existig conditions, except in the case of children. It's also 63 days between qualifying plans, not 30.
oops, so I was a day off
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Old Jul 11th 2011, 12:13 am
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Default Re: Getting Healthcare in the US

Originally Posted by Duncan Roberts View Post
That only really affects group policies, not individual ones. Individual ones can pretty much do what they want with regards to pre-existig conditions, except in the case of children. It's also 63 days between qualifying plans, not 30.
Glad to know its that long - wonder if it's state specific? We've always been told by our insurance broker that 30 days was the breaker.
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Old Jul 11th 2011, 12:23 am
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Default Re: Getting Healthcare in the US

Originally Posted by Egg and Cress View Post
Glad to know its that long - wonder if it's state specific? We've always been told by our insurance broker that 30 days was the breaker.
it's federal
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Old Jul 11th 2011, 2:38 am
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Default Re: Getting Healthcare in the US

Originally Posted by Egg and Cress View Post
Glad to know its that long - wonder if it's state specific? We've always been told by our insurance broker that 30 days was the breaker.
As said, it's federal and it's set on stone. However, when you say insurance broker, do you mean a broker for a personal policy or a broker who runs a companies group plan? If it's personal, 30 days is a good deal as they aren't required to give you any.
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Old Jul 11th 2011, 2:41 am
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Default Re: Getting Healthcare in the US

Originally Posted by rock_hound View Post
Hi there

I'm new to this forum so please excuse me if this has been posted before and please re-direct me to the relevant link...

I've just moved to North Carolina with my wife and daughter. I'm English and my wife is American. We applied for Health insurance, which was approved and then the Health company told my wife that i did not qualify has i hadn't lived in the States for 12 months.

Is this a common thing? Has anyone else experienced a similar issue? Are there certain Healthcare companies that are better than others? Any help/guidance would be appreciated.

Cheers
Sounds like one of you needs to get a job with health benefits pretty sharpish. If you are playing the personal policy game then it really is russian roulette as the companies can pretty much say and do what they want. With a group policy like you would get via an employer, they have a lot more rules they have to follow and can't deny anyone.
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Old Jul 11th 2011, 5:22 am
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Default Re: Getting Healthcare in the US

Originally Posted by Duncan Roberts View Post
As said, it's federal and it's set on stone.
States can (and some do) provide additional protections to those provided under the federal HIPAA law.
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