Vinnyvagus

Hi there

I'm hoping someone may be able to help here.

I'm moving to North Carolina later this year with my wife and 2 year old son due to a work relocation they are offering me. One of the things I am looking for is information regarding the medical. Now my company will sort ths out for me and they have told me the monthly fees. The issue is that my 2 year old son, although a healthy boy now, was born premature and had a couple of complications when born. As I say he is fine and all OK with him now, but I'm worried that moving to America the medical insurance may say something along the lines of we cant cover him due to him being born premature. Am I just be silly in worrying about this or is this really something that they could say?

I wouldnt want to live out in the States and then a year later find he needs some medical treatment for whatever reason but find he was or is not covered under X,Y and Z ruling and therefore I end up with a massive medical bill.

Sorry this may seem a bit of a weird thing to ask but I am looking at all the small things I need to figure out before accepting this relocation with work.

As I say...my boy is a healthy boy and the Dr's here say he has no complications from his premature birth.... but I will have to declare this in the paperwork for the medical insurance saying he was premature right?

Duncan Roberts

It sounds like it will be a group plan in which case, since you have all been covered under the NHS, any pre-existing conditions will be covered without question. For ease, bring a letter from your GP or local NHS trust saying you have been covered under the NHS since X date. You won't have to declare that he was premature when signing up.

flnycus

Good question, you would have to speak with your company's HR person and get the insurance company details. you could then call them and ask them any q's you have. I could be wrong but i dont see an issue. They will just deal with whatever conditions pop up when and if hes ill. good luck.

Vinnyvagus

Thanks thats some encouraging information Duncan. So this "group plan"...what exactly is this? Is this something my company would help me with set up or is it something extra I personally (or my family) will have to take out on top?

Duncan Roberts

Basically you have 2 types of insurance (not really but generally), private and group. Private you go out to the insurance company and buy a policy that you want. Group is provided by a company and is based on shared risk of all employees covered by it. There are specific laws around group policies to minimize the exclusions private plans throw in, plus it's a very simple procedure to set up since its a few forms and a set price with guaranteed acceptance. The letter from the NHS is just backup. Unless you were diagnosed, treated or received advice for a condition in the previous 6 months then, on a group policy, it never happened. If the coverage is provided by the employer then it will be a group plan, but check in with them to make sure.

I should add that the policy they offer will not cover every single procedure, doctor, test or medication so things can crop up that will cost money but that will be the case for everyone on the plan, not because of a prior issue.

Jerseygirl

Being part of a group plan means your monthly payments will be much cheaper than if you were on an individual plan. It also means if you or a member of your family are currently being covered by a healthcare provider (in your case the NHS)...they cannot refuse cover for existing illnesses.

This is not related to your son...but it may be an idea to find out what co-pays, deductibles etc you will be liable for and if you are covered for medications. Unlike the NHS...you will probably have to pay something every time you visit a doctor and get a prescription filled.

Bill_S

Further to Duncan's reply - your company negotiates a deal with a health insurance company - the employer gets a price break based on the number of employees covered. The insurance company's risk is spread over hundreds or thousands of employees. The company doesn't help you set anything up, the deal is already in place. You will enroll and participate in the plan.

Vinnyvagus

Thanks again Duncan. I will be talking to my HR this week. You have been a help though. As long as my son can be covered just as much as my wife and I can be covered then I will be happy.

Vinnyvagus

OK so the question I need to ask my company is that my son being premature a couple of years ago is going to be covered just as much as my wife and I will be then? (and that he has NO complications now anyway.) I assume that he will be covered just as much as myself, if I am enrolling us all as a family onto a group plan through my company....and as Duncan says...maybe having a letter from the NHS as backup??

Duncan Roberts

Assuming the plan has a family option, you will all have the same plan and be covered in exactly the same way. You don't have to do anything other than fill in the forms.

To give a little more info, I tried to keep it simple before! On a group plan an insurance company is legally able to exclude pre-existing conditions for up to 12 months after signing up or 18 months if you sign up outside a standard enrollment period. Pre-existing conditions are defined as something that you have been diagnosed with, have received medical advice for, been treated for or taken medication for in the previous 6 months. If you have previous creditable cover, which the NHS is, with no gaps of 63 days or more you can use the time covered by it to credit against the pre-existing condition exclusions. As long as you have been covered by the NHS for more than 12 months and/or you and your family don't meet the pre-existing condition definition you have nothing to worry about at all. The letter from the NHS is just for proof of previous coverage so you can use it as creditable coverage, not for any health related things.

Vinnyvagus

OK so for example he has not had any issues related to his prematurity for 2 years now so this would therefore exceed say 12 months of any pre-existing conditions then i guess?

Again thank you for the information and of course I will be talking to my HR about this question I have, but wanted to ask on this site as well as its been quite a good find on the net for me

Duncan Roberts

No, in that situation you are just concerned with the 6 month pre-existing condition definition. The 12 months comes in mainly if you have a pre-existing condition and no previous insurance. In that case the condition would not be covered until you have had the policy for 12 months.

In your case you have nothing to worry about since you have coverage via your employer and your son has had no issues for so long. The only thing that may cause a problem is if it doesn't kick in for a few months. Insurance is annoying and complicated if you hadn't figured it out already!

penguinsix

A bit of general information on how insurance works here might help you understand a few things:

http://britishexpats.com/wiki/Health_Insurance