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-   -   Health insurance, spouse and childbirth (https://britishexpats.com/forum/usa-57/health-insurance-spouse-childbirth-923656/)

destone Mar 28th 2019 1:51 pm

Health insurance, spouse and childbirth
 
Hello all,

I am moving to the States on L-1A, and will get comprehensive health insurance (provided by Cigna) through my employer. The health insurance will cover my spouse - wife, too.

Is pregnancy treated by US insurers as "pre-existing condition"? I.e. is there anything to worry about the fact that when the health insurance becomes active my wife will already be ~4 months pregnant? From a childbirth perspective.

Thanks

petitefrancaise Mar 28th 2019 1:58 pm

Re: Health insurance, spouse and childbirth
 
You're fine. General information and Cigna specific here.
https://www.cigna.com/individuals-fa...ting-condition

However, you will have costs that you will need to meet. I would have a discussion with your HR person about that so that you are aware of what you will need to fund and the best type of plan to cover you.

penguinsix Mar 28th 2019 3:09 pm

Re: Health insurance, spouse and childbirth
 
Hi and welcome, and congratulations on your new arrival.

While you say you will get "comprehensive health insurance" do you really know exactly what that means?

You could still be on the hook for a copay amount for every visit to the doctor or hospital, an annual deductible that means you won't get any money until you personally spend $xxxx, and or a coinsurance charge that requires you to pay 20% of the overall bill, not to mention the monthly premiums you'll be required to pay.

The reason I mention all this is just to point out that it is really important to touch base with the HR of your new employer to get the nitty-gritty specifics of the health care plan. They should have something they could send you that will outline the benefits IN DETAIL and explain what sort of costs you should be ready to take on eventhough you have health insurance coverage. For example, my first kid cost $29 USD with our insurance ($25 copay and $4 to watch TV while we waited), but changes by the time we had a second kid meant I had to pay about $1,250 (while the total bill was something like $14,000, most paid by insurance). I would really encourage you to send a note over to them and take a look through as you'll be using insurance quite a bit in the first year of your child's life.

And to second the previous answer, pregnancy is not a pre-existing condition (in most cases--some older personal ones grandfathered in plans may still have it).

Pulaski Mar 28th 2019 3:18 pm

Re: Health insurance, spouse and childbirth
 
Under these peculiar circumstances of timing, I would be inclined to ask my employer for a one-time (one pregnancy) exception, to refund out-of-pocket expenses related to the pregnancy. …. Depending on insurance you could get a bill for as much as several thousand dollars (I have heard of bills in the $4k-$5k range) after the birth.

penguinsix Mar 28th 2019 3:38 pm

Re: Health insurance, spouse and childbirth
 

Originally Posted by Pulaski (Post 12662344)
Under these peculiar circumstances of timing, I would be inclined to ask my employer for a one-time (one pregnancy) exception, to refund out-of-pocket expenses related to the pregnancy. …. Depending on insurance you could get a bill for as much as several thousand dollars (I have heard of bills in the $4k-$5k range) after the birth.

This is a good idea. It could be part of your relocation package, especially since she is already pregnant and you're being asked to relocate in the middle of this.

Pulaski Mar 28th 2019 3:40 pm

Re: Health insurance, spouse and childbirth
 

Originally Posted by penguinsix (Post 12662358)
This is a good idea. It could be part of your relocation package, especially since she is already pregnant and you're being asked to relocate in the middle of this.

And remember to ask for it to be "grossed up" (probably 4/3, 33%) as you will be liable for taxes on such a "cash benefit" from your employer.

Boiler Mar 28th 2019 5:16 pm

Re: Health insurance, spouse and childbirth
 
Does seem reasonable for the OP not to know how the US system works and that having comprehensive sic cover does not equate to no cost.

civilservant Mar 28th 2019 6:11 pm

Re: Health insurance, spouse and childbirth
 
If the company are not prepared to budge on their package with respect to the pregnancy, I would strongly consider the wife giving birth in the UK and then joining you in the US.

lizzyq Mar 28th 2019 6:15 pm

Re: Health insurance, spouse and childbirth
 

Originally Posted by civilservant (Post 12662492)
If the company are not prepared to budge on their package with respect to the pregnancy, I would strongly consider the wife giving birth in the UK and then joining you in the US.

And in that case I would also suggest asking for sufficient time off for the husband to return to the UK for the birth. The company may decide that it is simpler and more cost effective to support the pregnancy via a health insurance variation in the USA.

petitefrancaise Mar 28th 2019 6:27 pm

Re: Health insurance, spouse and childbirth
 
Unless the OP is extremely lucky, I doubt very much that the costs incurred by them will be paid by the company. They will be on the company health plan and that's that. There should be choices for health plans and I personally would look at paying a higher premium for lower out of pocket costs for this year. You will not only have the costs of ante-natal care, hospital care for mother and baby, post natal care but also visits to the pediatrician for baby.

Insurance plans run for each calendar year and in November you will be able to change to a different plan should you wish to.

Pulaski Mar 28th 2019 6:30 pm

Re: Health insurance, spouse and childbirth
 

Originally Posted by petitefrancaise (Post 12662508)
Unless the OP is extremely lucky, I doubt very much that the costs incurred by them will be paid by the company. ....

Normally I'd agree with you, but suggested it because she is already pregnant, so in fairness the employer should (might :unsure:) foot the unforeseen bill.

lizzyq Mar 28th 2019 6:56 pm

Re: Health insurance, spouse and childbirth
 

Originally Posted by petitefrancaise (Post 12662508)
Insurance plans run for each calendar year and in November you will be able to change to a different plan should you wish to.

Not necessarily calendar year - ours runs 1st April to 31st March.



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