Originally Posted by GeoffM (Post 10089604)

Another problem is we've not been resident for 6 months. So how are we supposed to get health insurance for the first 6 months, I asked. I don't know, was the answer. But she's going to look into it and get some inbound immigrant insurance better than what we've got already.

Originally Posted by GeoffM (Post 10089604)

Wife not working and I'm self employed in CA. I don't qualify for group insurance but this forum recommended a local chamber of commerce or something like the IGDA. So that's what I did - and we, the parents, been denied coverage! (We do have temporary, emergency cover)

Allegedly joining something like the IGDA would give group rates and cover pre-existing conditions (see http://britishexpats.com/forum/showp...2&postcount=34 for example). I can't comment on the former but the latter is apparently NOT covered - yes it's group coverage, but not employer-based group coverage, and doesn't cover pre-existing. I'm not blaming the posters here: up until now Association Pros, who handle the IGDA insurance, never said there would be these problems.

Meanwhile the kids have been approved because legally they're not allowed to be denied coverage. But there is no limit on the rates, so DS (4-year old) is $460 per month and DD (baby) is $920 per month. However, these ought to be lowerable by going to have a physical exam ASAP - something we had planned to do in anticipation of Blue Shield's response, but couldn't arrange until we knew what Blue Shield wanted from the exam, as the exams here are like menus of tests and things you can optionally include or exclude depending on who wants the results of the exam.

Another problem is we've not been resident for 6 months. So how are we supposed to get health insurance for the first 6 months, I asked. I don't know, was the answer. But she's going to look into it and get some inbound immigrant insurance better than what we've got already.

The final problem is my cataract surgery I had 9 months ago. They appear to be denying any coverage just on that one issue. I could manage with eyes being excluded but that doesn't appear to be an option. To be honest, it's all a bit confusing so that may not be the case after all.

Any ideas where we go from here appreciated!

Originally Posted by Noorah101 (Post 10089625)

I'm not familiar with all the insurance types out there...are you saying you and your wife were denied individual insurance policies?

Rene

Originally Posted by Moonshadow_Girl (Post 10089651)

Please check out this link for Healthy Families: http://www.healthyfamilies.ca.gov/HFProgram/Join.aspx. I'm not familiar with the program as I don't have any children myself. However, I do understand that you can at least have coverage for your children at a reasonable cost.

Check out this link for costs in your own county: http://www.healthyfamilies.ca.gov/Pl...ernardino.aspx

ETA: I don't remember your immigration situation, but if your children are U.S. citizens, then you can disregard the Immigration requirements.

Good luck, let us know how it works out.

Originally Posted by Nutmegger (Post 10089661)

I would really recommend finding an insurance broker who specializes in health coverage. HI is such a minefield that you really need a professional to help, and it doesn't cost you anything.

Originally Posted by lansbury (Post 10089666)

Blue Cross/Blue Shield of Oregon covered me from day 1 from the minute I stepped of the aircraft. In fact it was all arranged from the UK before we left. Are you dealing direct with the company or through an insurance broker who sells health insurance. We used an agent local to where we were moving to.

Originally Posted by markwm (Post 10089673)

You could try ex-pat health insurance to get you covered until you sort yourself out. http://www.staysure.co.uk/overseas/travel-insurance (says over 50s but I think they'll cover anyone for cash :))

Originally Posted by lansbury (Post 10089666)

Blue Cross/Blue Shield of Oregon covered me from day 1 from the minute I stepped of the aircraft. In fact it was all arranged from the UK before we left. Are you dealing direct with the company or through an insurance broker who sells health insurance. We used an agent local to where we were moving to.

Originally Posted by guitarmaan (Post 10089709)

How did you find the agent, from a site list or a recommendation?

Originally Posted by GeoffM (Post 10089727)

The IGDA application referred me to Association Pros.

What I'd hate to do now is to fill in yet another 15 page application form then wait 2 weeks for it to be summarily denied - again. Repeat ad nauseum.

Originally Posted by GeoffM (Post 10089692)

Thanks, at first glance it's a bit confusing wrt to category A/B/C, and seems rather expensive, but I'll dig more.

Originally Posted by GeoffM (Post 10089692)

Thanks, at first glance it's a bit confusing wrt to category A/B/C, and seems rather expensive, but I'll dig more

Originally Posted by GeoffM (Post 10089736)

Okay, I understand the table a bit better now. But my income exceeds the maximum so they don't qualify anyway.

Originally Posted by GeoffM (Post 10089604)

Wife not working and I'm self employed in CA. I don't qualify for group insurance but this forum recommended a local chamber of commerce or something like the IGDA. So that's what I did - and we, the parents, been denied coverage! (We do have temporary, emergency cover)

Allegedly joining something like the IGDA would give group rates and cover pre-existing conditions (see http://britishexpats.com/forum/showp...2&postcount=34 for example). I can't comment on the former but the latter is apparently NOT covered - yes it's group coverage, but not employer-based group coverage, and doesn't cover pre-existing. I'm not blaming the posters here: up until now Association Pros, who handle the IGDA insurance, never said there would be these problems.

Meanwhile the kids have been approved because legally they're not allowed to be denied coverage. But there is no limit on the rates, so DS (4-year old) is $460 per month and DD (baby) is $920 per month. However, these ought to be lowerable by going to have a physical exam ASAP - something we had planned to do in anticipation of Blue Shield's response, but couldn't arrange until we knew what Blue Shield wanted from the exam, as the exams here are like menus of tests and things you can optionally include or exclude depending on who wants the results of the exam.

Another problem is we've not been resident for 6 months. So how are we supposed to get health insurance for the first 6 months, I asked. I don't know, was the answer. But she's going to look into it and get some inbound immigrant insurance better than what we've got already.

The final problem is my cataract surgery I had 9 months ago. They appear to be denying any coverage just on that one issue. I could manage with eyes being excluded but that doesn't appear to be an option. To be honest, it's all a bit confusing so that may not be the case after all.

Any ideas where we go from here appreciated!

Originally Posted by Moonshadow_Girl (Post 10089743)

Copied from their website:

What if my child doesn't qualify for Healthy Families? Is there other health coverage I can get?

• If your income is below the limit for Healthy Families, you may qualify for no-cost Medi-Cal. You can let Healthy Families send your application to the county office near you to find out if you qualify for Medi-Cal.
• If your income is above the limit for Healthy Families, there may be other programs you can use. Call 1-800-880-5305 for more information. The call is free.

Originally Posted by SanDiegogirl (Post 10089755)

Since the OP is not a citizen of the US I don't believe he qualifies for Medical Medi-Cal (the Californian option for Medicaid):-

Do I qualify for Medi-Cal benefits?

IF YOU ARE ENROLLED IN ONE OF THE FOLLOWING PROGRAMS, YOU CAN GET MEDI-CAL:

SSI/SSP
CalWorks (AFDC)
Refugee Assistance
Foster Care or Adoption Assistance Program
In-Home Supportive Services (IHSS)

Originally Posted by SanDiegogirl (Post 10089734)

If I remember correctly you are a Software Consultant. Have you formed a company/partnership for your work?

The reason I ask is that if you have a company and there are 2 or more of you in the company (you and wife maybe?) you many be able to apply for Group health insurance for your company.

Originally Posted by SanDiegogirl (Post 10089734)

You need to get a Health Insurance agent as soon as possible. Not surprised that the work based groups did not cover pre-conditions - so few policies, apart from employment based policies, do.

Originally Posted by Moonshadow_Girl (Post 10089743)

Copied from their website:

What if my child doesn't qualify for Healthy Families? Is there other health coverage I can get?

• If your income is below the limit for Healthy Families, you may qualify for no-cost Medi-Cal. You can let Healthy Families send your application to the county office near you to find out if you qualify for Medi-Cal.
• If your income is above the limit for Healthy Families, there may be other programs you can use. Call 1-800-880-5305 for more information. The call is free.

Originally Posted by Jerseygirl (Post 10089827)

Sorry you're having to go through all this Geoff. This thread confirms what we say to new members who want to move or move their aged parents to the US.

Originally Posted by GeoffM (Post 10089839)

It's annoying as I thought I had it all in hand! Quoted before I left the UK, they knew the circumstances. Filled out the form (13 pages) soon after arrival, sent off. Some time later, "sorry, we sent you last year's form by mistake, please fill in the new 15 page form". Filled in and sent off. Two weeks later, this.

Originally Posted by GeoffM (Post 10089839)

It's annoying as I thought I had it all in hand! Quoted before I left the UK, they knew the circumstances. Filled out the form (13 pages) soon after arrival, sent off. Some time later, "sorry, we sent you last year's form by mistake, please fill in the new 15 page form". Filled in and sent off. Two weeks later, this.

Originally Posted by Giantaxe (Post 10090085)

Unfortunately "quoted" means essentially nothing until you've applied and a policy has been underwritten.

Originally Posted by guitarmaan (Post 10089709)

How did you find the agent, from a site list or a recommendation?

Originally Posted by lansbury (Post 10090995)

She was turned down as we knew she would be (diabetic), but the day we arrived the agent help her enroll in Oregon Medical Insurance Pool, which is run by Blue Cross/Blue Shield for the State as a high risk pool.

Originally Posted by GeoffM (Post 10089604)

Allegedly joining something like the IGDA would give group rates and cover pre-existing conditions (see http://britishexpats.com/forum/showp...2&postcount=34 for example). I can't comment on the former but the latter is apparently NOT covered - yes it's group coverage, but not employer-based group coverage, and doesn't cover pre-existing. I'm not blaming the posters here: up until now Association Pros, who handle the IGDA insurance, never said there would be these problems.

Originally Posted by Duncan Roberts (Post 10091211)

The most solid option you have is to go find a small business association and see if their brokers can get you an employer policy for you that would cover your family as well. They might be able to, they might not but figure it taking a month or so.

On the cost for the kids, what you quoted doesn't seem terribly bad. Kids are high risk.

Originally Posted by SanDiegogirl (Post 10091218)

You say that you were denied individual coverage because you could not complete the forms from the UK.

Have you tried applying again since being in the US?

Even though you have some pre-conditions (you eye operation) isn't it worth a try again?

Originally Posted by GeoffM (Post 10091245)

Have you got any ideas for an SBA though? Would it end up having the same problems as the IGDA?



I applied for individual cover from the UK but yes denied due to non-resident, despite putting in the notes that we would be resident from the effective date. That was Blue Shield.

I applied again through the IGDA when I arrived in the US and this was the result. The agent said she we could appeal and submit certain things (I now have a letter from my UK doctor after chasing it this morning - sent to wrong email address) but I've no idea whether appeals are worth trying. Certainly for the kids, the price "ought" to come way down once they've had physical exams, but I can't get appointments anywhere before late June!

Had a chat with a local broker this morning: this was unusual territory for her and she's going to do some digging and ring me back (I hope).

Originally Posted by Duncan Roberts (Post 10091211)

The most solid option you have is to go find a small business association and see if their brokers can get you an employer policy for you that would cover your family as well. They might be able to, they might not but figure it taking a month or so.

Originally Posted by Bob (Post 10091478)

That's kind of the idea of using the IGDA though as it's fairly large.

Still, for a local option, best bet is to google the town business association, well at least down my way, every town has one, either as a "local businesses accommodation" or "chamber of commerce" and for a bunch of the smaller local towns, they get grouped together.

Originally Posted by Duncan Roberts (Post 10091482)

It sounded like the IGDA was for individual policies rather than employer sponsored policies. If that's not the case then maybe the OP needs to reapply as a company and not individual.

Originally Posted by Duncan Roberts (Post 10091465)

I don't know about your area but I would start with Google and see what you can find. It wouldnt be the same as what you experienced as they would only broker your company under their umbrella to get a better rate as they are pushing multiple businesses to the insurance company.

Originally Posted by Duncan Roberts (Post 10091465)

You may also have to come to terms with the fact you may not get any insurance for the immediate future and when you do your pre-existing conditions won't be covered.

Originally Posted by Bob (Post 10091478)

That's kind of the idea of using the IGDA though as it's fairly large.

Still, for a local option, best bet is to google the town business association, well at least down my way, every town has one, either as a "local businesses accommodation" or "chamber of commerce" and for a bunch of the smaller local towns, they get grouped together.

Originally Posted by Duncan Roberts (Post 10091482)

It sounded like the IGDA was for individual policies rather than employer sponsored policies. If that's not the case then maybe the OP needs to reapply as a company and not individual.

Originally Posted by Bob (Post 10091520)

It offered both. A group rate for members applying as individuals or for small companies.

The rate was dependent on local factors, but the aim point about this was that it fell under a umbrella group policy, which would not exclude pre-existing conditions.

Something either went very wrong if that isn't the case, or there was a state issue in it.

Originally Posted by GeoffM (Post 10091532)

I've re-asked the question to Association Pros, in fact used your wording too, hope you don't mind!

Thanks.

Originally Posted by Bob (Post 10091577)

Good luck.

If nothing comes of this, then ask members of the board.

Dustin Clingman - Chair
Coray Seifert
Wendy Despain
Darius Kazemi

First name @igda.org to get in touch directly. These folks are ones to ping as the rest are pretty useless and you'll at least most likely get a response from Wendy and Darius if anyone.