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Healthcare advice please

Healthcare advice please

Old Mar 25th 2015, 4:38 pm
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Default Healthcare advice please

One of the conditions my husband placed on his relocation package negotiations was that for medical cover we wouldn't be any worse off than our cover (NHS and private insurance) here in the UK, essentially no co-pays, excess etc. We have this cover for the life of the project, although we do have the option of taking a more standard US insurance policy if we wish to. Policies, options and the whole raft of new terminology is a lot to get our head around so we feel the International Solutions option we've taken is best in the short term

http://www.aviva.co.uk/healthcarezon...ge/gen5320.pdf

Now to my concerns, questions. I've followed most of the recent healthcare threads with interest as I try to familiarise myself with the US system and I am worried about the day to day stuff

I've been part of a familial history cancer clinic for 11 years (think Angelina Jolie) and I've been a part of a clinical trial for a year. Existing conditions are covered, but I haven't got a condition, I'm being monitored as my chance of developing breast cancer is 85-90%

I'm a little over-sensitive at the moment as I'm due my yearly bloods and screening next week.

Do we look at US medical cover sooner rather than later? Are these sort of preventative programmes common and, more importantly, would they be covered by insurance?

I'm bogged down with reading so much info on healthcare options so any plain English replies would be very much appreciated
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Old Mar 25th 2015, 5:11 pm
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Default Re: Healthcare advice please

In my experience as long as you have insurance you can go an see a specialist for check ups and screening.
The annual physical me and Mr Chog have here is far more comprehensive than in the UK. lots of routine blood draws and tests.

Mr Chog has a cancer history and he sees a Gastro guy and an Oncologist annually just for screening and checks to make sure there is still nothing there.
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Old Mar 25th 2015, 5:42 pm
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Default Re: Healthcare advice please

Originally Posted by BubbleChog View Post
In my experience as long as you have insurance you can go an see a specialist for check ups and screening.
The annual physical me and Mr Chog have here is far more comprehensive than in the UK. lots of routine blood draws and tests.

Mr Chog has a cancer history and he sees a Gastro guy and an Oncologist annually just for screening and checks to make sure there is still nothing there.
Thank you that's reassuring. The recent threads have been very negative. I suppose you don't come onto a forum to tell everyone how good it is as often as you would to vent/rant or share a negative experience or look for advice on how to get a better outcome.

Healthcare is a minefield and it's a worry. With all its faults, I really value the NHS.

Last edited by loubiblu; Mar 25th 2015 at 5:55 pm. Reason: Typo
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Old Mar 25th 2015, 5:52 pm
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Default Re: Healthcare advice please

The care we've had is nearly always great and the affordable Care act has meant lots more screening and preventative stuff is covered but you should still check with the insurance company.

Don't get me started on random hospital bills though
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Old Mar 25th 2015, 6:04 pm
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Default Re: Healthcare advice please

I find it much more thorough here than my experience would have been under the NHS. I have a family history of breast cancer too. Due to that I had a baseline mammogram this year. That's in addition to the usual yearly prods, pokes and bloods. Mine was all covered under my health insurance but you can phone your insurance before a treatment to check. My sister has the same family history (obvs) but won't be offered a mammogram for 10 more years under the NHS.
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Old Mar 25th 2015, 6:14 pm
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Default Re: Healthcare advice please

Originally Posted by Weeze View Post
My sister has the same family history (obvs) but won't be offered a mammogram for 10 more years under the NHS.
Tell her to go back and insist. I was 31 when I was first referred to the family history clinic and I've had mammograms every 12 months since then. It took 7 years before I was brave enough to have genetic testing, but when they confirmed my dodgy gene I also get bloods and other screening annually. My 16 year old daughter can be referred when she's 21 also. This is all NHS, but it does depend on the nature of the family history.
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Old Mar 25th 2015, 6:29 pm
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Default Re: Healthcare advice please

Originally Posted by loubiblu View Post
Thank you that's reassuring. The recent threads have been very negative. I suppose you don't come onto a forum to tell everyone how good it is as often as you would to vent/rant or share a negative experience or look for advice on how to get a better outcome.

Healthcare is a minefield and it's a worry. With all its faults, I really value the NHS.
Usually most companies offer PPO plans that give you an almost unlimited choice at your discretion of who you want to see and when you want to see them. Others also offer HMO plans such as Kaiser Permanente which are top grade.

Most of the complaints are from plans offered on the ACA exchanges for individuals and the kinks haven't been worked out yet. Others may possibly opt for employer provided EPO plans to save on premiums but are much more restrictive than employer provided PPO plans.

For employer plans, what is more typical was experienced by Sugarmoona where her husband experience a heart attack, a medevac helicopter was flown in, he spent time in the ICU, and has regular checkups and although there were a few glitches with the billing, I believe in the end, their co-pay was about $2,000 for bills that probably exceeded a 1/4 million dollars. Another example, when I had an employer PPO plan and had some issues, I just made an appointment with Stanford Hospital which specialized in my condition since all doctors at the hospital were in-network. Also every doctor that I ever wanted to see in the SF bay area was in-network.

So even if your company offers a high deductible PPO plan ($12,500 maximum annual out of pocket expense for a family) through someone like Anthem Blue Cross and the company is willing to pay for the deductible, you should have access to probably over 100,000 in-network doctors and thousands of hospitals and/or cancer clinics throughout the US at your discretion without payment.

Last edited by Michael; Mar 25th 2015 at 6:47 pm.
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Old Mar 25th 2015, 6:49 pm
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Default Re: Healthcare advice please

Originally Posted by loubiblu View Post
Tell her to go back and insist. I was 31 when I was first referred to the family history clinic and I've had mammograms every 12 months since then. It took 7 years before I was brave enough to have genetic testing, but when they confirmed my dodgy gene I also get bloods and other screening annually. My 16 year old daughter can be referred when she's 21 also. This is all NHS, but it does depend on the nature of the family history.
Thanks. I've texted her.
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Old Mar 25th 2015, 8:33 pm
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Default Re: Healthcare advice please

Originally Posted by Weeze View Post
Thanks. I've texted her.
Another vote for her pushing. I'm only 38 and I get annual mammograms on the NHS due to family history.
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Old Mar 25th 2015, 10:55 pm
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Default Re: Healthcare advice please

The Affordable Care Act also covers preventative care without copay or coinsurance. I have Cigna and all of these screenings are covered at no cost at the point of care.

https://www.healthcare.gov/preventiv...enefits/women/
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Old Mar 26th 2015, 3:36 am
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Default Re: Healthcare advice please

Originally Posted by loubiblu View Post
Thank you that's reassuring. The recent threads have been very negative. I suppose you don't come onto a forum to tell everyone how good it is as often as you would to vent/rant or share a negative experience or look for advice on how to get a better outcome.

Healthcare is a minefield and it's a worry. With all its faults, I really value the NHS.
Health care and health insurance are two different things. I've been in the US for 17 years and have a wife and 4 kids. We've had many medical visits and a few major surgeries between us. In general, the health CARE has been first class and access (IF you have good health insurance or pots of cash) has been much better than the NHS in our experience. The health INSURANCE aspect has been a complete nightmare.
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Old Mar 26th 2015, 6:01 am
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Default Re: Healthcare advice please

So you are going to pay the Obama tax penalty?
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Old Mar 26th 2015, 6:44 am
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Default Re: Healthcare advice please

Yes, people really like to whinge here. We ARE British after all and it's what we are good at. As others have said, dealing with the insurance companies (health, dental, vision) and endless paperwork everywhere all the time is the worst part. If you have insurance where you pay lower monthly premiums and therefore have to pay more for stuff/have less control over who you can see or you don't have any insurance I can see how you would complain profusely about it.

In my albeit brief experience, my doctor has referred me almost instantaneously to see specialists. Be wary though of having expensive drugs thrown at you and being pushed into unnecessary procedures.
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Old Mar 26th 2015, 12:57 pm
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Default Re: Healthcare advice please

Originally Posted by loubiblu View Post
One of the conditions my husband placed on his relocation package negotiations was that for medical cover we wouldn't be any worse off than our cover (NHS and private insurance) here in the UK, essentially no co-pays, excess etc. We have this cover for the life of the project, although we do have the option of taking a more standard US insurance policy if we wish to. Policies, options and the whole raft of new terminology is a lot to get our head around so we feel the International Solutions option we've taken is best in the short term
when I was in the US, my healthcare insurance was a similar ex-pat package. It seemed to be in the top 1% of insurance - wherever I went, whichever doctor I saw, whatever prescription I had, I had no issues whatsoever and paid nothing out of my own pocket*. If your policy is as encompassing as mine, I don't think you will have any problems continuing to get screening in the US. I have a family history of severe osteoporosis, and I discussed screening at my annual check-up - they would have been more than happy to put me forward for that, but I'm not reached menopause, so no point doing it yet.

My insurance company had two offices I could call - one in the US and one back in the UK. May be worth calling your insurance company if you can do that in advance to put your mind at rest.

if you're interested, this are the kind of things I had:
  • Annual gynecological screening
  • Annual mammogram with additional follow-up (turned out to be 'lumpy boobs', nothing serious)
  • Two lots of physiotherapy (over 20 sessions) for a spasming back muscle - second physio turned out to be much better than the first and addressed the root cause rather than symptoms, but both were at modern, well equipped clinics.
  • annual flu jabs
  • treatment for bronchitis - it took 3 goes to get the doc to realise this wasn't just a cold, but less than stellar GPs can be found on both sides of the atlantic. I saw a different doc the third time who was fab.

*Not strictly accurate - the only time I paid my own money:
  • Bought a stretch strap from the physio to help with home exercises, still use it
  • Was prescribed a portable TENS machine to help with acute muscle spasm, insurance wouldn't pay as they only pay for their use for 'post-operative pain' , but it turned out to only cost $60 so happy to buy myself.
  • Major dental work still carried a 50% copay - the amount I paid for a new crown cost more than the cash price at my (private) UK dentist. When I came back he said the work was fine, but his eyebrows disappered into his hairline when I said how much I'd paid (and that it was only half of the total cost). Regular check-ups and cleans were 'free'.

Hope that helps.....
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