Healthcare

Old Jun 15th 2016, 6:37 pm
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Default Healthcare

I should have my Visa in July, all being well and finally get to be with my USC husband. The healthcare issue is a HUGE worry for me. Is it just because we have it so good in the UK? Well, good in that you don't end up in debt by being ill.... It's a hell of a lot of money to pay... What if you have no job, too ill to work so no money to pay insurance, old and not working etc etc. I keep hearing of people whose insurance companies refuse to pay anything sometimes, long term problems etc and someone with cancer who ended up owing $90,000. How do expats cope with this? I feel I won't be able to sleep at night worrying about whether I get sick. In Britain if a family member is really ill you would call an ambulance without a second thought but in the States you'd be thinking about the cost all the time wouldn't you?
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Old Jun 15th 2016, 7:20 pm
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Default Re: Healthcare

All depends on the insurance cover you have. Ask your husband about his policy, presuming he has cover, which you could be added to.

There are plenty of threads going over the ACA/Obamacare, that you can find by looking down a bit, which should give you a bit of an idea on things.
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Old Jun 15th 2016, 7:29 pm
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Default Re: Healthcare

We pay about $160/mth for high deductible insurance (for Mrs P, little Miss P, and me) and use the money we saved on premiums to put, pre-tax into a Health Savings Accounts (one each for Mrs P and me, HSAs work like a UK private pension, but can be drawn on immediately for medical expenses). After six years, our HSA balances are suffient to pay our maximum possible "out of pocket" medical expenses for probably five straight year, and as we continue to put more money into our HSAs, in reality it would probably be 10+ years before we ran out of money in our HSAs.

Meanwhile we save more in taxes (compared to what we were paying in the UK) than our health insurance premiums and HSA savings contributions combined.

In short, IMO it is nowhere near as bad as some people will try to tell you. ..... I will concede it might be very different if you have chronic health issues.

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Old Jun 15th 2016, 7:52 pm
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Default Re: Healthcare

It does depend...maybe things are worse in SC, but i work for a small company (7 employees) and we don't get the benefit of group protection. Consequently, we are paying $1,200 per month for a family of 5 and although our deductibles are something daft like $5K per person, this does not qualify as a high deductible insurance so we cannot use an HSA. In practise, this is a 'disaster policy' - we pay for pretty much everything on top of the premia and are only protected against a major illness/injury.

It is worth putting the effort in to be familiar with your policy, what is covered and what is not - a work colleague had kidney stones recently and went to the nearest hospital (which turned out to be out of network). He has now been handed a $6,000 bill.
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Old Jun 15th 2016, 8:17 pm
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Default Re: Healthcare

Originally Posted by newadventure View Post
It is worth putting the effort in to be familiar with your policy, what is covered and what is not - a work colleague had kidney stones recently and went to the nearest hospital (which turned out to be out of network). He has now been handed a $6,000 bill.
This!

In an effort to control costs, insurers are using very small networks of providers. Read the fine print, work out who is in your network.
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Old Jun 15th 2016, 8:23 pm
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Default Re: Healthcare

Originally Posted by newadventure View Post
It does depend...maybe things are worse in SC, but i work for a small company (7 employees) and we don't get the benefit of group protection. Consequently, we are paying $1,200 per month for a family of 5 and although our deductibles are something daft like $5K per person, this does not qualify as a high deductible insurance so we cannot use an HSA. In practise, this is a 'disaster policy' - we pay for pretty much everything on top of the premia and are only protected against a major illness/injury. ...
Do you not have a high deductible policy option. In a company of that size (very small), I would lobby my colleagues to support an HD policy and request a formal meeting to ask for a high deductible option - and if everyone is in the same boat (unless someone has chronic illness in their family), everyone would be better off with an HD plan with lower premiums but the OoP costs would be the same.
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Old Jun 15th 2016, 8:27 pm
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Default Re: Healthcare

Originally Posted by sir_eccles View Post
.... In an effort to control costs, insurers are using very small networks of providers. Read the fine print, work out who is in your network.
That's only half the story. Round here the "small networks of providers" seem to be snapping up the smaller networks and previously independent clinics and facilities - so while there might be only a few options for "in network treatment", in practice those networks seem to cover most of the treatment locations.

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Old Jun 15th 2016, 8:27 pm
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Default Re: Healthcare

Originally Posted by newadventure View Post
It does depend...maybe things are worse in SC, but i work for a small company (7 employees) and we don't get the benefit of group protection. Consequently, we are paying $1,200 per month for a family of 5 and although our deductibles are something daft like $5K per person, this does not qualify as a high deductible insurance so we cannot use an HSA. In practise, this is a 'disaster policy' - we pay for pretty much everything on top of the premia and are only protected against a major illness/injury.

It is worth putting the effort in to be familiar with your policy, what is covered and what is not - a work colleague had kidney stones recently and went to the nearest hospital (which turned out to be out of network). He has now been handed a $6,000 bill.
Unfortunately for us, our premiums and deductibles are even higher than yours (age related)
To make matters worse, I recently received a letter from our insurers UHC that they will not be able to offer insurance in FL for 2017. Looking at other insurers, cover will be astronomic, so we will return to Europe soon.
We love the US but there is a limit.
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Old Jun 15th 2016, 8:36 pm
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Default Re: Healthcare

Do you not have a high deductible policy option. In a company of that size (very small), I would lobby my colleagues to support an HD policy and request a formal meeting to ask for a high deductible option - and if everyone is in the same boat (unless someone has chronic illness in their family), everyone would be better off with an HD plan with lower premiums but the OoP costs would be the same.
We can pretty much choose the plan we want. I believe there was very little difference in the HD policy premium, and the differences in other parts of the policy meant it wasn't worth doing. I am a fan of the HD option, but it just didn't make sense for us
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Old Jun 15th 2016, 8:39 pm
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Default Re: Healthcare

Originally Posted by sir_eccles View Post
This!

In an effort to control costs, insurers are using very small networks of providers. Read the fine print, work out who is in your network.
+1

We have group insurance through my ex-employer (we are retired). It costs $697/mo for the 2 of us but has the out of State network we need as we travel extensively (6+ months a year out of State since retiring in 2010). Last year I looked at policies on the marketplace but no insurers where we live were offering any "PPO" policies at all, they were all very narrow "HMO" networks.

We are in our 60's, minor ailments, but have over the past 3 years run up out of pocket costs (including the premiums) between 8 and $12,000 /year. I had budgeted for $15,000/year, it's just something you have to be prepared for.
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Old Jun 15th 2016, 9:23 pm
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Default Re: Healthcare

Originally Posted by newadventure View Post
We can pretty much choose the plan we want. I believe there was very little difference in the HD policy premium, and the differences in other parts of the policy meant it wasn't worth doing. I am a fan of the HD option, but it just didn't make sense for us
But if you got an HD policy that would open the door to an HSA, which you then fund pre-tax and can draw on to meet your medical expenses. So even if the premium saving was zero by taking an HD policy, you'd still get the advantage of paying your medical expenses with pre-tax money. ..... Unless the "other differences" are the issue.
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Old Jun 16th 2016, 12:37 am
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Default Re: Healthcare

If your husband has a decent health insurance plan (especially if it is a Group company plan) then you should have nothing to worry about. You should be able to join his - have you researched this yet?

If he does not then you have to get your own - either under your State exchange or the Fed Government one.

For either of the above , you should have budgeted for a few hundred dollars a month to pay for the premiums and the other costs.

Presumably you are not old, out of work, too poor to pay for premiums or any of the other 'worries' you have - otherwise you would not have obtained visa and be moving to the States in July.

People who think of moving to the States are aware of the health insurance situation and, if after researching the costs, think they are unable to pay such costs, don't move.
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Old Jun 16th 2016, 1:48 am
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To add...... you would be amazed at the welfare programs available in the US!
From children's programs to healthcare for the low income.

If you really are too poor to pay for healthcare insurance your State will surely have a program you can register for.

I was in hospital a few years ago and in the bed next to me was a homeless woman. Because she was a VET the local VA hospital was picking up all the bills.

Not begrudging her treatment at all, just saying there are welfare programs around.
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Old Jun 16th 2016, 10:43 am
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Originally Posted by SanDiegogirl View Post
..... If you really are too poor to pay for healthcare insurance your State will surely have a program you can register for. ....
That depends on the state, and whether they signed up to "expand medicaid".
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Old Jun 16th 2016, 1:42 pm
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Originally Posted by SanDiegogirl View Post
To add...... you would be amazed at the welfare programs available in the US!
From children's programs to healthcare for the low income.
As mentioned, definitely depends on the state. In MA, on paper, they also have awesome programs but the reality is less so. 8 year waiting list to get childcare help for instance.
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