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Health care / insurance in the US

Health care / insurance in the US

Old Nov 15th 2011, 2:52 pm
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Default Health care / insurance in the US

Hello

I'm based in Vancouver, Canada but have moved to Seattle for a job and thinking of making the move permanently.

I get medical health care insurance with my job (my wife doesn't work), but was wondering what the situation is in the US if I were to lose my job and when I retire?

In Vancouver everybody pays about $60 per month in mandatory health care payments to the (local) goverment and for that doctor and hospital visits etc. are free and there's no worries about big bills in the event of an accident or illness.

In the US if not working do you have to get medical insurance with a private company, what sort of prices is it roughly?

Its crazy here compared to the UK or Canada - my company is supposed to have one of the better health care plans, but even with that I still have to pay towards it every month and then on top of that trips to the doctor etc. still aren't even free. Medical care in the US seems like capitalism gone mad.

P.S.
What do unemployed / students etc. do for medical insurance?

Last edited by woofington woofchops; Nov 15th 2011 at 4:05 pm.
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Old Nov 15th 2011, 4:02 pm
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Default Re: Health care / insurance in the US

Yes it is crazy here compared.
If you lose your job you lose your insurance, but you can buy in we have found it to be cost prohibitive.
In Washington state theres this http://www.insurance.wa.gov/consumer.../jobloss.shtml
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Old Nov 15th 2011, 4:11 pm
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Default Re: Health care / insurance in the US

Yes, if you lose your job you will lose your health insurance unless your company is large enough that it can offer you COBRA cover for another 18 months. This means that you will continue with your company's insurance plan but you will pay ALL of the premiums not just the part premium you are paying now (when employed the employer pays a proportion of the premium).

If no COBRA and no job then you pay for a private health insurance plan which is usually much more expensive then Group plans.

There is no 'FREE' element of health cover in the US.

When you retire in the US if you have paid in 40 payments into Medicare then you will be eligible for Medicare cover from 65.

Surely you were aware of the US medical system before you left Canada?
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Old Nov 15th 2011, 4:33 pm
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Default Re: Health care / insurance in the US

Thank you - how do you pay in 40 payments to Medicare?

>> Surely you were aware of the US medical system before you left Canada?
Not the precise details, I knew my company had medical care that would cover myself and my wife so didn't need to worry in the short term.
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Old Nov 15th 2011, 4:54 pm
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Default Re: Health care / insurance in the US

COBRA can be a shock to the system. When I lost my job, the monthly cost of $65 went up to $1500 a month if I wanted to continue with the insurance....switched to my wifes.

What's on offer depends on the state, if you can get in on a group/union/association type deal. You do not want to have a gap of more than 62 days between cover, then pre-existing stuff can be excluded.

Medicare payments are taken out of your taxes, you don't have to do anything special to make those payments. You have to have a greencard for 5 years or be a USC by the time you hit retirement with those 40 quarter contributions though.

Unemployed people either go get something offered by the state, depending on the state, or they go without. Students, usually stay on parents insurance, or get a basic cover offered through the uni.

Prices on private insurance that isn't employer offered, how long is a piece of string? You can get a policy for $50 a month or $1500 a month, it all depends on level of cover, maximum cover, co-pay, pre-existings, levels of deductibles and what is/isnt' covered etc.
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Old Nov 15th 2011, 5:06 pm
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Default Re: Health care / insurance in the US

Originally Posted by SanDiegogirl
Surely you were aware of the US medical system before you left Canada?
When I left Canada years ago to come here, I had no clue. I had only lived in Britain and the Canada and I thought every country was as civilized when it came to healthcare. Came as quite a shock to learn how brutal this system is.


To the OP, some of this difficulty may get better in a few years if the Supreme Court doesn't strike down the new healthcare law, because eventually each state will offer its own plan and that will give the insurance companies a little competition and hopefully lower premiums. But Medicare will continue to be expensive - and probably only get worse. Finding out how much Medicare costs retired folks was the final straw for me in deciding to leave this country.
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Old Nov 15th 2011, 5:07 pm
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Default Re: Health care / insurance in the US

Originally Posted by woofington woofchops
Thank you - how do you pay in 40 payments to Medicare?

>> Surely you were aware of the US medical system before you left Canada?
Not the precise details, I knew my company had medical care that would cover myself and my wife so didn't need to worry in the short term.
You pay Medicare payments through your payroll - take a look at your paystubs and you should see the deductions there.

They are usually taken each quarter of the year - 4 per year. So 10 years of working usually gets you up to the necessary requirements for qualifications.

Re: your earlier question regarding students and unemployed.

Students can remain on their parents insurance policies until approx 26 these days or there are student policies at colleges, universities etc. The unemployed have a difficult time unless they are able to find private insurance they can afford. Charities and state 'pool' funds can sometimes help out.

The system in the US is a private,usually profit driven system where people pay into insurance plans run by insurance companies. The systems in Canada are mainly single payer systems where people pay into one 'public pot' via their payrolls and the public authority pays the bills.
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Old Nov 15th 2011, 6:11 pm
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Default Re: Health care / insurance in the US

So if I work here for 10 years and make medicare payments I don't have to worry about anything once I'm retired?

However my wife isn't working (and can't in the US currently anyway). If she were not to be eligible for medicare in later years, would it be a hugh expense to adequately cover her?
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Old Nov 15th 2011, 6:55 pm
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Default Re: Health care / insurance in the US

Originally Posted by woofington woofchops
So if I work here for 10 years and make medicare payments I don't have to worry about anything once I'm retired?

However my wife isn't working (and can't in the US currently anyway). If she were not to be eligible for medicare in later years, would it be a hugh expense to adequately cover her?

I wouldn't say you don't have to worry exactly, but 10 years of Medicare and SS payments will entitle you and your resident spouse to medicare and SS at retirement age, so your wife is covered by your payments. However, Medicare has it's own complications. part A is free, Part B costs $100/month and then you need to buy a supplementary policy on top of that too.

The US healthcare system is a mess, but as long as you can afford coverage for you and your wife through your work you are ok. As previous posts have said if you loose your job you might get the option of COBRA coverage, but failing that, or once 18 months has gone by, you'll have to navigate the state rules for coverage, private plans and ObamaCare if or when it starts.
if you have a pre-existing condition you might find it difficult and expensive to buy coverage. Your situation will depend on your state's rules.

For example I live in Massachusetts and we already have mandatory health insurance and no pre-existing conditions. It's good that you can't be denied insurance, but by law you must have a plan and that can cost $1000 for a family.

The good thing for you is that you are Canadian, so enjoy living in Seattle and if you loose the job just go back to your civilized home country and leave the Third World health care delivery system of the US far behind!
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Old Nov 15th 2011, 7:19 pm
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Default Re: Health care / insurance in the US

Of course, there's no rules forcing you to stay in Seattle if you lost your job, or indeed retired.

(on the contrary, on a work based visa, you'll have to leave the US if you lose your job so health insurance won't be a concern for a while!)


Don't let health insurance put you off. Seattle is the best city in the USA.


Having said that, it has a lot in common with Vancouver. What motivates you to go through all the cost and bother of getting visas and dealing with health insurance? Just curious.
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Old Nov 15th 2011, 7:25 pm
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Default Re: Health care / insurance in the US

Originally Posted by caleyjag
What motivates you to go through all the cost and bother of getting visas and dealing with health insurance? Just curious.
I work in software development and in general and in the specific area I'm in there are far more opportunities in Seattle than in Vancouver (and I don't want to move to Toronto). After being made redundant in Vancouver due to the hangover of the recession I was unable to find employment there, and was fortunate to find a company in Seattle that would apply for a visa for me.

Thinking long term - Vancouver (and Canada in general and Seattle) are too wet and damp and grey and cold for too many months of the year. At least the US has the opportunity to retire to a warmer part of it.
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Old Nov 15th 2011, 8:31 pm
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Default Re: Health care / insurance in the US

Originally Posted by woofington woofchops
I work in software development and in general and in the specific area I'm in there are far more opportunities in Seattle than in Vancouver (and I don't want to move to Toronto). After being made redundant in Vancouver due to the hangover of the recession I was unable to find employment there, and was fortunate to find a company in Seattle that would apply for a visa for me.

Thinking long term - Vancouver (and Canada in general and Seattle) are too wet and damp and grey and cold for too many months of the year. At least the US has the opportunity to retire to a warmer part of it.
Just a thought being that Seattle is that close to Vancouver can you not just drive up to Van for medical attention ?

I'm self employed and pay $$ for health insurance . it's one of the biggest reasons I'll move back to England when I get older.


Oops , just saw the part about retiring somewhere warmer ! 'scuse me ..
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Old Nov 15th 2011, 9:03 pm
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Default Re: Health care / insurance in the US

Originally Posted by woofington woofchops
So if I work here for 10 years and make medicare payments I don't have to worry about anything once I'm retired?

However my wife isn't working (and can't in the US currently anyway). If she were not to be eligible for medicare in later years, would it be a hugh expense to adequately cover her?
You still have to pay even with medicare, it doesn't cover everything and there are co pays and supplemental insurance to pay for.
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Old Nov 15th 2011, 10:15 pm
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Default Re: Health care / insurance in the US

Originally Posted by woofington woofchops
So if I work here for 10 years and make medicare payments I don't have to worry about anything once I'm retired?
I'm retired, have medicare, but live in the UK. I return to the States several times a year. I purchase the best yearly coverage UK travel insurance I can find that covers trips to the States. I figure my medicare card's best value is that at least it will get me through the front door of the hospital. But on reflection, I'm not sure medicare covers the cost of passage through hospital front doors.
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Old Nov 15th 2011, 10:45 pm
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Default Re: Health care / insurance in the US

Originally Posted by woofington woofchops
So if I work here for 10 years and make medicare payments I don't have to worry about anything once I'm retired?

However my wife isn't working (and can't in the US currently anyway). If she were not to be eligible for medicare in later years, would it be a hugh expense to adequately cover her?
You don't think those folks in their 70's/80's etc are working at Walmart for the enjoyment do you?

Once you retire, you have a basic level of cover, but the real expense is usually prescription meds, which means you needing supplemental coverage, which may or may not be affordable.

It's a minefield, no two ways about it.
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