British Expats

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-   -   Pre exisiting conditions and health insurance (https://britishexpats.com/forum/usa-57/pre-exisiting-conditions-health-insurance-634062/)

moving2nyc Oct 5th 2009 2:41 pm

Pre exisiting conditions and health insurance
 
Hi there,

We are moving over the the US and my company has insurance with Empire Blue for employees.

I've called them and explained my wife has a pre-existing condition. They said I need to show that she has 11 months of previous medical insurance in the UK and if so pre-existing will be covered.

We didn't have private healthcare in the UK but I saw on these boards somebody said they used the NHS for this.

I guess we pay our taxes in the UK and get the NHS in return so that should work. But they need a letter from the previous company which is the goverment I guess.

Anyone have any expereince or know where I can look for help with this.

Thanks in advance

Mike

Duncan Roberts Oct 5th 2009 2:50 pm

Re: Pre exisiting conditions and health insurance
 
Get a letter from you and your wifes doctors saying that you have been covered under the NHS since whenever you got NHS coverage, presumably since you were born. The NHS is specifically mentioned in the HIPAA regulations about being creditable coverage so you should have no issues.

moving2nyc Oct 5th 2009 3:24 pm

Re: Pre exisiting conditions and health insurance
 

Originally Posted by Duncan Roberts (Post 7990727)
Get a letter from you and your wifes doctors saying that you have been covered under the NHS since whenever you got NHS coverage, presumably since you were born. The NHS is specifically mentioned in the HIPAA regulations about being creditable coverage so you should have no issues.

Hi Duncan,
Thansk for the quick reply, that sounds perfect if it works. I did ask if a letter from the doctor would work and they said NO, it has to come from an insurance company?

Do you know anyone who's done this or do you have a reference doc for the HIPAA that I could review. I quickly searched the www.hhs.gov/ocr/hipaa/ but cant see anything

Thanks again

meauxna Oct 5th 2009 7:35 pm

Re: Pre exisiting conditions and health insurance
 
You just have to translate into language that they understand on this side. The doctor is presumably an employee of 'the insurance company' aka the NHS.

You can search this forum on HIPPA or 'creditable coverage' also, for more tips.

Duncan Roberts Oct 5th 2009 8:17 pm

Re: Pre exisiting conditions and health insurance
 

Originally Posted by moving2nyc (Post 7990809)
I did ask if a letter from the doctor would work and they said NO, it has to come from an insurance company?

They are wrong. You may need to ask to speak to somebody who will deal specifically in foreign national health system coverage. A letter from the doctor is a letter from the NHS so is acceptable.

Ozzidoc Oct 5th 2009 8:33 pm

Re: Pre exisiting conditions and health insurance
 

Originally Posted by Duncan Roberts (Post 7991659)
They are wrong. You may need to ask to speak to somebody who will deal specifically in foreign national health system coverage. A letter from the doctor is a letter from the NHS so is acceptable.

Agree. Several of us have had our GP write a letter, me included :)

moving2nyc Oct 5th 2009 9:21 pm

Re: Pre exisiting conditions and health insurance
 
Hi Ozzidoc and all the other kind folks who replied.

Can you remember what the letter exactly said? I need to get this right and imagine if its not they will try and squeeze out of it.

The company I work for has insurance from Empireblue, which number should I call to fnd the foriegn national health system person?

Thanks all again

Ozzidoc Oct 5th 2009 9:24 pm

Re: Pre exisiting conditions and health insurance
 
See post 3:

http://britishexpats.com/forum/showt...ntinuous+cover

Just ask your GP for a letter.

moving2nyc Oct 5th 2009 11:43 pm

Re: Pre exisiting conditions and health insurance
 
Thanks Ozzidoc.

From a timing point of view, we are hoping to get visa's very soon but my wife and children will not move out until next year.

Do we need to apply for insurance right away even if they are not living here yet? Or as soon as we get a visa are the days ticking by for being able to claim creditable coverage?

Also, the insurer has emailed be an application form, it's asking for lots of info and I'm concerned if I give the wrong info now I will not get the right cover.

Is there a service that I could use to help me navigate through this to avoid posting millions of questions on here?

Thanks everyone again for your help

:thumbup:

moving2nyc Oct 6th 2009 12:13 am

Re: Pre exisiting conditions and health insurance
 
1 Attachment(s)
Here is the form they have given me to fill in.

It looks like where it asks for previous health insurance for the last 11 months we all just reply "YES".

Then in the Name of Other Insurance Carrier we say "National Health Service" and "Your ID Number from Other Carrier" is our NHS number from the UK.

Does that mean we need a doctors letter for all of us to say we have been under the care of the NHS?

Along the lines of;

"This is to certify that name (Date of Birth ) has been automatically covered by the NHS (National Health Service) since birth. The National Health Service is a public health plan established and maintained by the government of the United Kingdom. It provides comprehensive health care to all citizens of the United Kingdom. My family, as a resident and naturalised citizen of the UK, has been continuously fully covered by this plan since birth"

Thanks again

Bob Oct 6th 2009 12:13 am

Re: Pre exisiting conditions and health insurance
 

Originally Posted by moving2nyc (Post 7992113)

Do we need to apply for insurance right away even if they are not living here yet? Or as soon as we get a visa are the days ticking by for being able to claim creditable coverage?

Depends on your insurance coverage and employer...you might have to suck it up and get coverage at the same time or find that they miss out for a year because there's only a small window to sign up for it such as joining a company or a life changing event such as getting married.

Also, read the wiki and search through previous posts, plenty of threads on the subject to get your head around the health topic, certainly so you know what questions to ask.

meauxna Oct 6th 2009 1:12 am

Re: Pre exisiting conditions and health insurance
 

Originally Posted by moving2nyc (Post 7992113)
Is there a service that I could use to help me navigate through this to avoid posting millions of questions on here?

It's ok to post here; it takes a team of thousands to figure out most insurance policies here. :(
The company's HR team should help you with a lot of it. Part of the problem is learning the terminologies. You need to find out from them what the enrollment limitations are for your family joining you later in the year.
Some people *have* paid for those policies for months while their family member is not yet here, just so they can get in on the enrollment when they have to.

moving2nyc Oct 6th 2009 1:36 am

Re: Pre exisiting conditions and health insurance
 
Thanks everyone, I'm amazed at how much help you've been and hope I can be as helpful to the next expat heading this way.

:thumbsup:

moving2nyc Oct 6th 2009 2:05 am

Re: Pre exisiting conditions and health insurance
 
Just to clarify, we don't have a company HR in the US as it's a small office right now. The idea of me being here is to grow it to the size of our UK office which is 60+

I think I understand most of the questions and have also found a friend who knows a broker who can help too

Hopefully it will all be straight forward

Duncan Roberts Oct 6th 2009 2:53 am

Re: Pre exisiting conditions and health insurance
 

Originally Posted by moving2nyc (Post 7992113)
Thanks Ozzidoc.

From a timing point of view, we are hoping to get visa's very soon but my wife and children will not move out until next year.

Do we need to apply for insurance right away even if they are not living here yet? Or as soon as we get a visa are the days ticking by for being able to claim creditable coverage?

Also, the insurer has emailed be an application form, it's asking for lots of info and I'm concerned if I give the wrong info now I will not get the right cover.

Is there a service that I could use to help me navigate through this to avoid posting millions of questions on here?

Thanks everyone again for your help

:thumbup:

The short version is this. The HIPAA continuous coverage rules state that for every day you have had creditable coverage you can apply those days towards exclusion periods for your new insurance providing there has not been a 63 day gap between insurances. The other thing to think about is that pre-existing condition is defined. Basically if you were diagnosed, treated or received medical advice for the condition during the previous 6 months then it's pre-existing. if not then it's not pre-existing. It comes in handy for some conditions that only require lifestlye changes and infrequent doctor visits.

The rules about taking up coverage are pretty straight forward. You can sign up within certain periods when you are first eligible for the plan, during open enrollment or with a life changing event which immigration counts as. So, as long as you have the policy your kids will be able to jump on it when they immigrate since they will be eligible for the policy and have creditable coverage.


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