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-   -   Health Insurance upon entering the US for myself and my wife. (https://britishexpats.com/forum/usa-57/health-insurance-upon-entering-us-myself-my-wife-830818/)

JeremyK Apr 8th 2014 6:30 pm

Health Insurance upon entering the US for myself and my wife.
 
Hi all,

We are getting quite concerned about health insurance and how what we do when we first arrive. We will both be looking for work, and depending on how quickly we find jobs...

So anyone here been in this situation? What did you do? We are looking at some insurance websites to get some quotes. My wife has not lived in the US for years, and I (UKC) have next to no knowledge of how things work over there for insurance.

Thanks in advance for any info,

Jeremy.

MidAtlantic Apr 8th 2014 6:57 pm

Re: Health Insurance upon entering the US for myself and my wife.
 

Originally Posted by JeremyK (Post 11210305)
Hi all,

We are getting quite concerned about health insurance and how what we do when we first arrive. We will both be looking for work, and depending on how quickly we find jobs...

So anyone here been in this situation? What did you do? We are looking at some insurance websites to get some quotes. My wife has not lived in the US for years, and I (UKC) have next to no knowledge of how things work over there for insurance.

Thanks in advance for any info,

Jeremy.

We did exactly what you are doing and, yes, as the UKC I had a massive struggle to even begin to understand it!

In the end we went with a policy with Blue Cross Blue Shield paying monthly. It was then easy to terminate that when we got jobs and our employment health scheme started.

I recommend signing up before you arrive so that you have easy access to your medical records if they need anything from your doctor. I recall that we had to get our UK doctor to complete a sheet and fax it across.

Don't be tempted to risk not having cover for the first few months and note that travel insurance doesn't work because your place of residence will no longer be the UK.

sir_eccles Apr 8th 2014 6:57 pm

Re: Health Insurance upon entering the US for myself and my wife.
 
Entering the US is a qualifying event so you should be able to go to healthcare.gov and check out the exchange offerings there rather than go to individual insurer websites.

Michael Apr 8th 2014 7:31 pm

Re: Health Insurance upon entering the US for myself and my wife.
 

Originally Posted by JeremyK (Post 11210305)
Hi all,

We are getting quite concerned about health insurance and how what we do when we first arrive. We will both be looking for work, and depending on how quickly we find jobs...

So anyone here been in this situation? What did you do? We are looking at some insurance websites to get some quotes. My wife has not lived in the US for years, and I (UKC) have next to no knowledge of how things work over there for insurance.

Thanks in advance for any info,

Jeremy.

Go to Healthcare.gov or call 1-800-318-2596 to enroll in the Affordable Care Act (ACA) for health insurance. Although open enrollment is closed for this year, you have a qualifying event (loss of insurance or immigration) allowing you to sign up within 60 days of arrival.

Click on the "See if you can get coverage" and then "Apply Now" and you should be either directed to the states web site that have their own health care exchanges or handled by the healthcare.gov web site for other states. Either way, there should be a list of plans available and the costs before you actually complete enrollment. Until you complete enrollment and send a check for the first months premium, the enrollment process is not complete. Insurance coverage probably will start at the beginning of the month following enrollment so there may be a period of time where you will be uncovered before insurance kicks in. When you have employer provided coverage, you can drop the ACA coverage. I'm not sure if you can sign up prior to arrival so that insurance kicks in immediately.

Michael Apr 8th 2014 7:38 pm

Re: Health Insurance upon entering the US for myself and my wife.
 

Originally Posted by MidAtlantic (Post 11210370)
We did exactly what you are doing and, yes, as the UKC I had a massive struggle to even begin to understand it!

In the end we went with a policy with Blue Cross Blue Shield paying monthly. It was then easy to terminate that when we got jobs and our employment health scheme started.

I recommend signing up before you arrive so that you have easy access to your medical records if they need anything from your doctor. I recall that we had to get our UK doctor to complete a sheet and fax it across.

Don't be tempted to risk not having cover for the first few months and note that travel insurance doesn't work because your place of residence will no longer be the UK.

Open enrollment is currently closed and medical records can no longer be requested by health insurance companies. Most health insurance companies indicated that they will only sell non ACA policies during open enrollment. However they may possibly sell policies if there is a qualifying event. It is probably better and easier to go to healthcare.gov to acquire coverage.

technolog Apr 8th 2014 9:30 pm

Re: Health Insurance upon entering the US for myself and my wife.
 
I've been a bit concerned about healthcare, especially as my USC fiancée (currently residing with me in the UK) has pre-existing conditions.

This thread prompted me to try to enrol on the healthcare.gov website.

I created a website account. After clicking an email address-verifying link in an email, I entered a few rudimentary details and then had to ring Experian to verify my identity. As expected this failed - probably due to having no US presence. I then had to ring another number to speak to a healthcare.gov representative in a further attempt to verify my identity.

Again it failed but the very helpful Jessica was able to give me what appears to be invaluable information. She had to put me on hold for several minutes while she gathered the necessary information relevant to my situation. The length of time I was on hold, together with the fact that she had changed her initial response on her return, gives me some confidence that what she told me has a good chance of being correct.

I am entering on a K1 fiance(e) visa. She said my fiancée (USC, currently UK resident) and I should apply separately for a healthcare plan about a month before entering the US. I'll need to provide information from my visa and my US address. Then, when we're married we should ring again and the two policies would be combined into one. Picking the same initial individual policy apparently makes this subsequent plan combination process easier. Finally she said that my fiancée's pre-existing conditions would not and indeed could not make any difference to the plan availability or their cost.

If it's as simple and straightforward as it sounds, it'll be a weight off my shoulders. Although of course we haven't seen any details of available coverage or its cost yet :eek:

sir_eccles Apr 8th 2014 9:44 pm

Re: Health Insurance upon entering the US for myself and my wife.
 

Originally Posted by technolog (Post 11210594)
Finally she said that my fiancée's pre-existing conditions would not and indeed could not make any difference to the plan availability or their cost.

This is one of the best bits of the ACA. It is essentially only based on age and smoking.

technolog Apr 8th 2014 9:55 pm

Re: Health Insurance upon entering the US for myself and my wife.
 
So will I be able to get a 'good' standard of cover through this route or is it bargain basement stuff?

Michael Apr 8th 2014 10:12 pm

Re: Health Insurance upon entering the US for myself and my wife.
 

Originally Posted by technolog (Post 11210635)
So will I be able to get a 'good' standard of cover through this route or is it bargain basement stuff?

None of the plans can have an maximum annual out of pocket expense of more than $6,350 per individual or $12,700 per family after premiums. The main difference will be whether you want a more inexpensive plan with high deductibles and high co-pays or a more expensive plan with lower deductibles with lower co-pays and lower maximum out of pocket expense.

The other primary difference is whether the plan is a PPO type plan or a HMO plan.

A PPO plan has an in-network group of doctors and hospitals and you can use any of those at your choosing to get the lowest co-pay and deductible. However you can also go to any doctor (known as out of network) but the deductible and co-pays are higher. Some PPO plans also cover you when you are outside the US.

A HMO plan requires you to have a primary care physician that will refer you to a specialist and all the doctors and hospitals that you use are approved by the HMO organization.

There are also other differences such as some PPO plans have in-network doctors and hospitals in many states and the list of in-network doctors can be in very large. I believe there are also separate deductibles and maximum out of pocket expenses for in-network services and out-of-network services so therefore, you normally want to try to stay in-network unless you really want to see one of the top specialists in the US or go to a facility such as a specific cancer center that is not in-network because you think the treatment will be better.

Therefore around the Cleveland area, there may be over a 1,000 doctors and a half dozen hospitals to chose from that are in-network for some PPO plans. However you have to look at the list of in-network doctors and facilities for each plan to determine that.


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