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-   -   Moving to USA on L1-B With Pregnant Wife (https://britishexpats.com/forum/usa-57/moving-usa-l1-b-pregnant-wife-751961/)

Nutmegger Mar 23rd 2012 8:08 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by UK_Lad (Post 9969107)
Maybe its because the private medical insurance is with UK company? It's axa/ppp international and i thought it would be fine to insure with them but in their terms and conditions they have 10 months waiting period and the representative i spoke to confirmed that.

Are you setting up this insurance coverage personally? An individual policy will exclude you for a waiting period, but a company policy will not. Your wife's coverage should be with the US company's existing health insurance carrier in the US, set up by their HR people.

UK_Lad Mar 23rd 2012 8:46 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by Nutmegger (Post 9969127)
Are you setting up this insurance coverage personally? An individual policy will exclude you for a waiting period, but a company policy will not. Your wife's coverage should be with the US company's existing health insurance carrier in the US, set up by their HR people.

Ok so let me confirm, i should contact the HR people in the US to enrol my wife on to their health policy and then provide them with NHS letter. Should the letter work for any US medical policy or are some exempt/not intrested in NHS letter?

N1cky Mar 23rd 2012 8:58 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by UK_Lad (Post 9969172)
Ok so let me confirm, i should contact the HR people in the US to enrol my wife on to their health policy and then provide them with NHS letter. Should the letter work for any US medical policy or are some exempt/not intrested in NHS letter?

Correct. The letter should work for any Group US medical policy. They cannot impose a waiting period or deny coverage for a pre-existing condition (pregnancy) when you have been covered up to date.

Nutmegger Mar 23rd 2012 9:15 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by N1cky (Post 9969201)
Correct. The letter should work for any Group US medical policy. They cannot impose a waiting period or deny coverage for a pre-existing condition (pregnancy) when you have been covered up to date.

+1!

UK_Lad Mar 23rd 2012 9:21 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by N1cky (Post 9969201)
Correct. The letter should work for any Group US medical policy. They cannot impose a waiting period or deny coverage for a pre-existing condition (pregnancy) when you have been covered up to date.

Great! So on monday i'll get my company to contact their US counterparts and see what they can do. You all have been a great help! I'll let you know how i get on. Meanwhile, i'll appreciate if you guys can carry on providing advice/hints & tips.

Nutmegger Mar 23rd 2012 10:22 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by UK_Lad (Post 9969229)
Great! So on monday i'll get my company to contact their US counterparts and see what they can do. You all have been a great help! I'll let you know how i get on. Meanwhile, i'll appreciate if you guys can carry on providing advice/hints & tips.

Wait a minute -- it is getting confusing as to who is the employee! I looked back and see that YOU are the employee -- so you should be checking what YOUR coverage is with your employer and ensuring that they will be offering dependent coverage for your wife. The continuing coverage from the NHS will apply to both of you. HI should be part of your deal to relocate. Look in the wiki for suggestions of all the things that you should be requesting as part of your deal. Like shipping possessions, flights back home, temporary accommodation upon arrival -- the list goes on! But the HI is number one in your situation.

UK_Lad Mar 23rd 2012 10:40 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by Nutmegger (Post 9969322)
Wait a minute -- it is getting confusing as to who is the employee! I looked back and see that YOU are the employee -- so you should be checking what YOUR coverage is with your employer and ensuring that they will be offering dependent coverage for your wife. The continuing coverage from the NHS will apply to both of you. HI should be part of your deal to relocate. Look in the wiki for suggestions of all the things that you should be requesting as part of your deal. Like shipping possessions, flights back home, temporary accommodation upon arrival -- the list goes on! But the HI is number one in your situation.

The UK company's International medical insurance covers us both but not pregnancy. So im presuming if i speak to the US HR team they maybe able to help so pregnancy is covered once we are out there

SanDiegogirl Mar 23rd 2012 11:11 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by UK_Lad (Post 9969342)
The UK company's International medical insurance covers us both but not pregnancy. So im presuming if i speak to the US HR team they maybe able to help so pregnancy is covered once we are out there

I would not expect an International Medical Insurance policy to cover pregnancy, and I don't think you are understanding the type of insurance policy that is being described by the responders to this thread.

The UK part of your company may have International Medical Insurance for specific people within your company who regularly travel abroad for business. However, for the majority of people within your company who don't travel etc, presumably you are covered by the NHS in the UK.

In the US there is no NHS, its primarily a private system and you need insurance to cover you.

The majority of US companies have their own GROUP Health Insurance Plan which covers their employees in the US. The Plan is administered by a US Medical Insurance company.

If your company is transferring you to the States they must tell you what your company's GROUP Health insurance plan covers.

If your company are now telling you that pregnancy is not covered by the GROUP health scheme in the US, then the responders to this thread are telling you that because of the HIPPA laws and the fact that you have had continuous coverage by the NHS, the GROUP health plan should cover it.

If, on the other hand,you really are only being offered an International Medical Plan then possibly pregnancy is not covered by such a plan. It is not considered an illness but a life choice

DO NOT wait until you are out there to sort this out. Too late then if you find you are not covered.

penguinsix Mar 24th 2012 1:04 am

Re: Moving to USA on L1-B With Pregnant Wife
 
The fact that it's an "international" insurance plan puts a new wrinkle to things, as SanDiegogirl just pointed out.

However, I would not settle for an "international" insurance plan, just as I wouldn't settle for 'international' roaming for your company mobile phone. You are coming here to work and live and you really should be covered by a "US" group insurance plan.

If your company has US employees, chances are it has a US insurance plan and you should be made part of it.

To help explain, a bit of a hypothetical. A big employer in a city or state, say Catepillar Tractors, will hire an insurance company, say Blue Cross, to offer insurance to their 25,000 employees. They are based in Peoria, IL, which is covered by XYZ and ABC hospitals. Blue Cross sits down with the financial people of XYZ and ABC and says "you charge $15,000 for a pregnancy delivery. We think the charge should be $12,500. If you agree that the charge is $12,500, we'll make you a 'preferred provider' such that the 25,000 employees of Catepillar will use your hospital. $12,500 x so many births a year = $XXX,XXX for your hospital. $15,000 x ZERO births a year = $0. What do you say?"

Now comes in "UK International Insurance". They say "we have 2 employees in your city, if you agree to charge $12,500 we'll make you the 'preferred provider' for our employees." The hospital says "yeah, whatever, get lost". So your UK International Insurance is not going to steer you to XYZ or ABC hospital, but EFG hospital 50 miles away that is a public hospital that charges lower rates. When you get your 'UK International Insurance' card it will say 'go to this hospital or doctor if you are sick'.

Ok, that's a gross simplification, but it gives you a general idea of one of the reasons you would want a US insurance company. Better choice, more selection, hopefully somewhat lower prices. The US company will also have to obey US rules, such as insuring pregnant women, which doesn't seem to be part of the International plan. You might also see in some international plans "repatriation" clauses, such that "in case of major medical long-term care, such as cancer treatment, employee agrees to return to the UK for medical care" or something like that. The exact specifics vary, but these are some things you should consider in dealing with this offer.

If your company has a US presence, you should (likely) be put on the US healthcare. Go through the plans with a fine tooth comb and then negotiate to your best benefit.

Ozzidoc Mar 24th 2012 2:03 pm

Re: Moving to USA on L1-B With Pregnant Wife
 
.

Ozzidoc Mar 24th 2012 2:07 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by penguinsix (Post 9969518)

If your company has US employees, chances are it has a US insurance plan and you should be made part of it.

The US company will also have to obey US rules, such as insuring pregnant women, which doesn't seem to be part of the International plan.

If your company has a US presence, you should (likely) be put on the US healthcare. Go through the plans with a fine tooth comb and then negotiate to your best benefit.

Plus 1.

BMP Mar 24th 2012 4:15 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by penguinsix (Post 9969518)
The fact that it's an "international" insurance plan puts a new wrinkle to things, as SanDiegogirl just pointed out.

However, I would not settle for an "international" insurance plan, just as I wouldn't settle for 'international' roaming for your company mobile phone. You are coming here to work and live and you really should be covered by a "US" group insurance plan.

If your company has US employees, chances are it has a US insurance plan and you should be made part of it.

To help explain, a bit of a hypothetical. A big employer in a city or state, say Catepillar Tractors, will hire an insurance company, say Blue Cross, to offer insurance to their 25,000 employees. They are based in Peoria, IL, which is covered by XYZ and ABC hospitals. Blue Cross sits down with the financial people of XYZ and ABC and says "you charge $15,000 for a pregnancy delivery. We think the charge should be $12,500. If you agree that the charge is $12,500, we'll make you a 'preferred provider' such that the 25,000 employees of Catepillar will use your hospital. $12,500 x so many births a year = $XXX,XXX for your hospital. $15,000 x ZERO births a year = $0. What do you say?"

Now comes in "UK International Insurance". They say "we have 2 employees in your city, if you agree to charge $12,500 we'll make you the 'preferred provider' for our employees." The hospital says "yeah, whatever, get lost". So your UK International Insurance is not going to steer you to XYZ or ABC hospital, but EFG hospital 50 miles away that is a public hospital that charges lower rates. When you get your 'UK International Insurance' card it will say 'go to this hospital or doctor if you are sick'.

Ok, that's a gross simplification, but it gives you a general idea of one of the reasons you would want a US insurance company. Better choice, more selection, hopefully somewhat lower prices. The US company will also have to obey US rules, such as insuring pregnant women, which doesn't seem to be part of the International plan. You might also see in some international plans "repatriation" clauses, such that "in case of major medical long-term care, such as cancer treatment, employee agrees to return to the UK for medical care" or something like that. The exact specifics vary, but these are some things you should consider in dealing with this offer.

If your company has a US presence, you should (likely) be put on the US healthcare. Go through the plans with a fine tooth comb and then negotiate to your best benefit.

I can't agree with this I am afraid. When I was in the US on secondment from 2008 to 2010 my company insisted I had an International Medical Plan which was significantly better than the US Group Insurance.

Essentially company policy said that I couldn't be worst off than I was in the UK which meant I couldn't pay anything towards healthcare and had free choice. What this resulted in was that I had access to any US Doctor / Hospital without any deductibles or fees payable and I could go in and out of network as I chose. Apparently the plan was VERY expensive.

I remember on quite a fee times the admin people at the doctors being very surprised that a no deductible plan existed... This was much better than our Group Policy which I think had contributions capped at $5k for catastrophe situations.. and lots of co-pays.

Anyway the point is - read the small print ;)

Jerseygirl Mar 24th 2012 5:13 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by BMP (Post 9970225)
I can't agree with this I am afraid. When I was in the US on secondment from 2008 to 2010 my company insisted I had an International Medical Plan which was significantly better than the US Group Insurance.

Essentially company policy said that I couldn't be worst off than I was in the UK which meant I couldn't pay anything towards healthcare and had free choice. What this resulted in was that I had access to any US Doctor / Hospital without any deductibles or fees payable and I could go in and out of network as I chose. Apparently the plan was VERY expensive.

I remember on quite a fee times the admin people at the doctors being very surprised that a no deductible plan existed... This was much better than our Group Policy which I think had contributions capped at $5k for catastrophe situations.. and lots of co-pays.

Anyway the point is - read the small print ;)

Hasn't the OP already said that plan will not immediayely cover his pregnant wife? If she intends to move to the US she needs immediate healthcare insurance...if not they could easily find themselves owing tens (if not hundreds) of thousands of dollars in medical expenses.

BMP Mar 24th 2012 5:50 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by Jerseygirl (Post 9970296)
Hasn't the OP already said that plan will not immediayely cover his pregnant wife? If she intends to move to the US she needs immediate healthcare insurance...if not they could easily find themselves owing tens (if not hundreds) of thousands of dollars in medical expenses.

Yes, I noted that. I was just pointing out there are upsides to internnational medical plans. It might be preferable to get some short term coverage for the pregnancy but then get the family on the international plan in the long run..

Bob Mar 24th 2012 6:29 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by BMP (Post 9970340)
Yes, I noted that. I was just pointing out there are upsides to internnational medical plans. It might be preferable to get some short term coverage for the pregnancy but then get the family on the international plan in the long run..

That's the problem. Unless it is the employers group plan, there won't be any short term plan to cover her.

So it's a choice of get on employer based plan or not coming to the US, for her at least.

SanDiegogirl Mar 24th 2012 10:27 pm

Re: Moving to USA on L1-B With Pregnant Wife
 

Originally Posted by BMP (Post 9970340)
Yes, I noted that. I was just pointing out there are upsides to internnational medical plans. It might be preferable to get some short term coverage for the pregnancy but then get the family on the international plan in the long run..

You can't get any short term individual plan (or long term plan for that matter) to cover an already existing pregnancy.

That's like asking to obtain property insurance when your house is already on fire :)

Ozzidoc Apr 12th 2012 6:40 am

Re: Moving to USA on L1-B With Pregnant Wife
 
Any update?


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