penguinsix

Basically, I need help.

I just did a brain dump of many of the things that have come up in the past about Health Insurance in the US. I thought it would be a good wiki article.

http://britishexpats.com/wiki/Health_Insurance

But I wasn't sure about the 'pre-existing coverage' bit and how NHS is treated / transfered, etc. If there is anyone who has some more knowledge on these matters feel free to go in and do some edits.

MsElui

vary helpful - thanks for tkaking the time to write it. One comment - should it be move to fall within the articles about the US specifically and not the whole wiki?

penguinsix

I thought it was in the USA section. Someone with more skills than I can move it if it is not.

AmerLisa

Not bad.....the only thing I can add is that Medi-care is also available to the disabled. In a lot of instances its better for an individual who is disabled to have medi-care as doctors are more willing to take that than the ordinary medi-caid. And yes doctors have been known to reduce their "medi-caid patients" another reason that people end up in the ER. However, some HMO's have taken over medi-caid patients (for example Kaiser was doing this in California.) Don't know if that's worth adding in your comments section or not.

Giantaxe

True but you have to (i) actually convince social security that you are disabled, and (ii) have received social security disability benefits for at least 24 months before being eligible for Medicare. Those can loom as two big obstacles for many people.

AmerLisa

Well if you just walked in and said I'm disabled - what's preventing anyone from getting the benefits? Anyway, it really wouldn't pertain to anyone that is an incoming immigrant anyway.

Giantaxe

Strawman. It's not exactly difficult to discover the travails of many who have tried and failed to get this determination from the ssa despite pretty strong evidence that they are actually disabled.

So why did you raise the issue in respect of the wiki? If Medicare benefits for the disabled are relevant to the wiki at all, then surely so are the eligibility requirements for it.

AmerLisa

It is if you're not familiar with the whole concept. Or what is the whole wiki for anyway?


Well I guess because if you're going to add that Medicare is available, then it should be defined a bit more. Certainly a lot of people here think Medicare is just for the elderly - it isn't.

Does that meet your approval? Since you seem to be on the committee to pick apart my posts.

Giantaxe

I'm trying to provide accurate and useful information for the blog. Ymmv, I guess...

AmerLisa

Ymmv?

DollyLlama

your mileage may vary

Bob

The NHS as previous coverage, should be allowed, in theory, reality is, your unable to get a letter of cover that an insurance company will accept, though there are some states that vary and make it easier.

I can't remember the thread, but wasn't it Tracey that put the info out there?

Also make it clear that a PCP=GP

Might want to mention that if your not admitted for over night stay at the ER, you might have a higher deductible, or that you might have to pay for the ambulance too...

naomi

Nice job. I wanted to clarify something though: at least in my experience, out of network providers do have a billing and fee arrangement with the insurance provider--the out of network plan usually costs more though.
Naomi.

Tracym

I believe it was me. I found some official guide to insurers or something - would have to hunt it up again. I also found something on a big insurer's website (Blue Cross?) that said they would.

Also, the state of Illinois told me they would accept the NHS, but I never put that to the test.

The insurance company we ended up with requested a statement of creditable coverage or something else acceptable. We seem to have succeeded with a letter from a NHS doctor stating he had been covered by birth. Haven't had it too long, so I say "seem to" in case I have problems in the future.

Not saying it will work for everyone, but...

Tracym

Here's some - this is apparently the HIPAA "final rules":

http://www.cms.hhs.gov/HealthInsRefo...IPAA-05-01.pdf

"For example, coverage through Britain’s national health care program, or through the U.S. Veterans Administration, neither of which previously satisfied the definition of public health plan under the interim final group market regulation, must be considered creditable coverage for that purpose."

From Blue Cross, re. legislative update:

http://www.bcbsil.com/PDF/legislative_update_405.pdf

Text won't copy for me, see paragraph beginning at bottom left of page 2, continuing onto top of next column.

Willis Legal & Research Group:

http://www.willis.com/Documents/Publ.../BAIssue30.pdf

'The final rules also add two new categories of health coverage that now qualify as HIPAA creditable health coverage for individuals seeking to reduce or eliminate any preexisting condition limitation period under a new health plan. Coverage provided under a state children’s health insurance plan (SCHIP) or coverage received under a foreign national health plan (such as may be found in Canada or Great Britain) now constitutes creditable coverage. Unfortunately, the rules tend to dismiss the obvious administrative headaches facing an employer who must try to ascertain whether coverage existed in a foreign national health plan. However, the regulations acknowledge that an employer may request documentation showing that the individual actually established legal residency in the foreign country before the employer must recognize that coverage as “creditable.” '

The last sounds as if you simply need to prove residency.