pipm1979

Hi there,
We're preparing the move to the states (Miami) and my wife's job doesn't come with health insurance (it's rather complicated - the recruitment agency is in the UK, but needed someone with the right to work in the States).

We'll need health insurance, but as we don't plan to stay there for years and years, we were wondering if there were plans that would cover emergencies and not ongoing care. We have three young children, so they would need care, but are generally fit and well. We are healthy too. If something needed ongoing care, we'd probably just jack it all in, hop on the next plane back to the UK and get the next job that would take us.

My wife went to high school in Florida, but has never worked in the US, so has no idea how this stuff works.

Any help would be greatly appreciated. We are just trying to get our heads round everything we'll need to consider when moving over there. It's a lot, but this is probably the most important one to sort out. How does it work?!?

What would we be looking at paying per month for 2 adults and 3 children (aged 3, 2, 8 months) for the most basic policies - within reason?

Urgh, we moan about the NHS, but when you think about it, it's brilliant compared to what others have.

ian-mstm

Plan on spending $2000 per month for the 5 of you... that's for basic coverage and a high deductible. There will be other costs on top of that if you actually need to see a doctor.

Ian

Mummy in the foothills

You'd be crazy to come to the US without insurance, even just catastrophic ins wouldn't cut it with three tiny kids to see too, Doctor visits and meds for just an ear infection could run hundreds by the time your done, also what about the baby check ups and vaccinations. Our local doc is up to $100 a visit.
Buying your own means chances are you'll have a very large annual deducible (thats what you'd pay out before the ins pays 100% each year) When we bought our own our deductible was $5000 a year as to make it lower we couldn't afford the monthly payments. We had cover through Anthem Blue Cross
We have ins through work now, same one, Anthem blue cross but with a much lower deducible that we can afford.
http://www3.bcbsfl.com/wps/portal/bcbsfl

Sally Redux

Too risky.

I've always thought the NHS was brilliant and now I know it.

SanDiegogirl

..... and apart from the children, who are mandated to get insurance, you and your wife may not get offered a policy if you have pre-conditions.

Bob

If the jobs not offering health insurance, don't take it...it's a crapper.

With kids, emergency cover is probably not enough, health check up on the baby is probably going to run you $500 a pop and it's not the sort of thing you can skip, especially if you want them in school. Plus a fall and a broken leg can easily cost you $10K and the insurance probably won't cover it, unless you're paying huge premiums to lower the deductible.

penguinsix

Hi

Honestly, if the job isn't offering insurance, don't take it.

Seriously, if you already have the right to work / move to the USA, you can spend a bit more time and find a job that has some insurance, even if only a partial subsidy or something. Jobs without insurance exist, but you don't have to take them simply because it is there. Spend another month looking and find something better.

In the US, to get insurance, you need to show 'continuous coverage' under an insurance plan. If you are coming from the NHS, you have 'coverage' so the new insurance in the US can take effect immediately. If you delay getting new insurance, then you have a 'gap' and getting new insurance can be complicated and difficult, including having to go several months with a 'ban' on new claims.

If you are adamant that you have to take this job, then you should really budget for a decent insurance plan, not just catastrophic care. Kids go to the doctors at least once a year, usually a couple of times for this and that, and those bills will add up quickly.

I would be budgeting $1,500-$2,000 if you are buying your own plan without an employer's help. If you get a decent job that price could be cut by a 1/2 to 2/3rds or even more.

Here is a primer on insurance, since you said your wife hasn't worked here before and probably isn't familiar with some of the terms:

http://britishexpats.com/wiki/Health_Insurance

lisa67

And don't forget you'll probably need separate dental insurance and optical

cranston

exactly, they are taking the piss.....

pipm1979

Absolutely taking all that on board. My wife is less keen to return because of this one point...

The job comes with a very good wage, more than double what we both earn here. It's a very hard job to get and requires the candidate to meet very specific criteria and the betting process is long. It is a reputable company, but the contracts are very different as they employ one or two people in each post and post can be anywhere in the world. Hard to describe...but normally they look for single people.

We plan to stay for a year (contract term) and get immunisastions, etc before we go.

Healthcare is the one sticking point of an otherwise amazing opportunity. How can a country get it SO wrong??

We HAVE to have insurance, don't we? I don't disagree with that if the cost is fair. Can we insure the kids and not ourselves? What would we pay just to 'walk in'?

So confusing.

What would be deducted if you are on a company plan? What's the difference per month?

cranston

My son had an accident this year. He was knocked off his bicycle (his fault), he broke his collar bone and had a few cuts. He had X-rays, cat scans and spent 3 hours in ER. And that was a minor accident (according to our lawyer).

We were billed $28,000. Insurance helped.

It was $1200 just for the ambulance to take my son 8 miles.

pipm1979

Dear god...I'm so sorry. When I read he broke his collar bone, I think, "Aw what a shame, poor boy". When I see how much it cost, that's when I want to cry for you! May I ask what kind of plan it was?

The one solution we thought of is for me to get a job with insurance, but will they cover a family of 5? I'm a teacher here in the Uk, but teaching jobs don't seem to be aplenty over there, especially in Florida. I can get a job in a different field, just to get health coverage.

I love the NHS more every day!

cranston

I am self-employed and have a high deductible plan from Blue Cross Blue Shield.

My share of the cost $6k!

penguinsix

Don't just look at the salary. You need to factor in federal, state and possibly even local taxes. Property taxes (if you own property) and sales taxes on basically everything you buy. You also will need a car and have to drive far more frequently than you do now, and there will be insurance and fuel costs for that. When you add into this the cost of health insurance you'll soon see that your "double the pay" job is really giving you a much smaller actual cost of living increase, and possibly even a decrease.

read this thread:

http://britishexpats.com/forum/showt...ght=icu+ladder

It's from a member who didn't have health insurance. After a slip from a ladder, a simple accident, they found themselves facing $460,000 in medical bills.

Seriously, skip this job that doesn't offer insurance. You've asked how it works for Americans and the answer is it works because employers offer insurance, either fully paid, partially paid, or at least part of a cheaper group plan, to their employees. People who do not offer insurance are not the people you should work for. Seriously--skip this job and find a better one.

cranston

Cost breakdown, gross billing before insurance and PPO adjustments

20122 = hospital bill, xray, scans etc
1213 = ambulance
1570 = ER radiologist
2221 = ER Doctor # 1
488 = ER Doctor # 2 (5 minutes work)
29 = drugs
200 = orthopedic surgeon office meeting
240 = orthopedic surgeon office meeting
150 = orthopedic surgeon office meeting
66 = blood & urine test
494 = followup xray
494 = followup xray
487 = 1 physio session
33 = radiologist
33 = radiologist


In the hospital bill, there were 5 CT scans which cost $14,740.