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problem with pregnancy & medical insurance

problem with pregnancy & medical insurance

Old Mar 3rd 2011, 9:53 pm
  #1  
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Default problem with pregnancy & medical insurance

Ok, we are suppose to be flying out on Monday 14thto Lacey WA, we checked weeks a go with USAA about the medical insurance and they told us it would be no problem..we tried tonight to sort out the medical insurance only to be be told that they now class pregnancy as a pre existing condition and wont offer the insurance also they wont cover me because we are married, she is 15 weeks gone..our house is now sold and have no choice but to travel over..my wife (a usc) is now realy worried about the whole move..

Do we have any options, staying here isnt one of them..

On the plus side my 3yo son is covered $90 a month..and im not even sure what that covers,,its a mine field..

Any help would be greatly received

Phil
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Old Mar 3rd 2011, 10:43 pm
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Default Re: problem with pregnancy & medical insurance

I wouldn't do it, one bit of trouble early labor premature birth and you'd be in the hole for unimaginable amounts. Can't you delay, or I should say, Delay, find a way, or look for insurance somewhere else.
Do you have a job at this end, will they provide cover? If so when does it kick in, can she stay in UK till it kicks in?
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Old Mar 3rd 2011, 10:49 pm
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Default Re: problem with pregnancy & medical insurance

Originally Posted by stress_head View Post
Ok, we are suppose to be flying out on Monday 14thto Lacey WA, we checked weeks a go with USAA about the medical insurance and they told us it would be no problem..we tried tonight to sort out the medical insurance only to be be told that they now class pregnancy as a pre existing condition and wont offer the insurance also they wont cover me because we are married, she is 15 weeks gone..our house is now sold and have no choice but to travel over..my wife (a usc) is now realy worried about the whole move..

Do we have any options, staying here isnt one of them..

On the plus side my 3yo son is covered $90 a month..and im not even sure what that covers,,its a mine field..

Any help would be greatly received

Phil
Why are you moving to the US? Is it for work? Are you military?

I found this website, don't know if this will help....

http://www.parenthelp123.org/pregnan...ce/first-steps

Last edited by AmerLisa; Mar 3rd 2011 at 11:03 pm.
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Old Mar 3rd 2011, 11:30 pm
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Default Re: problem with pregnancy & medical insurance

Originally Posted by stress_head View Post
Ok, we are suppose to be flying out on Monday 14thto Lacey WA, we checked weeks a go with USAA about the medical insurance and they told us it would be no problem..we tried tonight to sort out the medical insurance only to be be told that they now class pregnancy as a pre existing condition and wont offer the insurance also they wont cover me because we are married, she is 15 weeks gone..our house is now sold and have no choice but to travel over..my wife (a usc) is now realy worried about the whole move..

Do we have any options, staying here isnt one of them..

On the plus side my 3yo son is covered $90 a month..and im not even sure what that covers,,its a mine field..

Any help would be greatly received

Phil
Has wifey been covered by the NHS up til now? If so, there are a few useful threads on here.

I'll look now.....

ETA: Some info here, but not the thread I was thinking of. http://britishexpats.com/forum/showt...ight=pregnancy

Still looking.....


ETA - OK. Here's one..... http://britishexpats.com/forum/showt...ntinuous+cover

Last edited by Ozzidoc; Mar 3rd 2011 at 11:35 pm.
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Old Mar 3rd 2011, 11:43 pm
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Default Re: problem with pregnancy & medical insurance

Here's some info by Tracym a member that's not around any more:

Yes, it is definite that the NHS is considered creditable coverage. I have mentioned some of these links before, but here they are:

The HIPAA final rule:

http://www.dol.gov/federalregister/P...px?DocId=10270

The rule was changed to specifically include foreign government plans such as the NHS. Also, it specifically says that a a certificate of creditable coverage is NOT required - just some reasonable proof (e.g. national insurance card, letter from doctor, etc.)

Search the document for the word "foreign" for applicable text.

Shorter version - here is a comment from Blue Cross/Blue Shield, which specifically mentions that the the law changed to include plans such as the NHS as creditable coverage.

http://www.bcbsil.com/PDF/legislative_update_405.pdf

FAQs address the fact that a doctor's letter or some such can suffice if a certificate of creditable cover is not available:

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

I have gotten this to work with a private insurer, and also for another person, it was accepted by a state high risk pool.

I believe it used to be a problem, but now the law has changed. Sometimes one has to point out the law, as not all insurers are aware of it (the state high risk pool wasn't) - but they were glad to oblige once it was pointed out to them.
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Old Mar 4th 2011, 12:14 am
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Default Re: problem with pregnancy & medical insurance

If the insurance is through work, then she's covered, the NHS is prior coverage so there isn't a break in coverage as long as you get enrolled sharpish and they have to cover pregnancy.

If it's a private insurance gig, then you might be in a pickle and yeah, they can do what they like pretty much.
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Old Mar 4th 2011, 12:31 am
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Default Re: problem with pregnancy & medical insurance

If it's a group plan and maternity care is covered generally then it doesn't matter about creditable coverage, it's illegal to class pregnancy a pre-existing condition. If it's an individual plan then that won't be the case for another 3 years. I don't really understand your post though. Are you saying that your wife is not being offered coverage for the pregnancy, you are not being offered coverage at all because she is pregnant and your son has a plan but you don't know what it covers? Who is providing the insurance? Who are you trying to get coverage for? What plans are you being offered? Are they employer sponsored plans? You really need to spend a lot of time looking into all this so you understand at least the basics of it. You left it a bit late but the only thing you can do now is keep talking to them over and over, try to learn about health insurance and figure out what your options are.

You say that staying isn't an option however if you truly can't get insurance then you would have to consider that if something doesn't go to plan, doesn't even have to be that big of a deal, you could easily be on the hook for 10, 20, 50, 100 thousand+ dollars.
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Old Mar 4th 2011, 3:08 am
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Default Re: problem with pregnancy & medical insurance

Originally Posted by Bob View Post
If the insurance is through work, then she's covered, the NHS is prior coverage so there isn't a break in coverage as long as you get enrolled sharpish and they have to cover pregnancy.

If it's a private insurance gig, then you might be in a pickle and yeah, they can do what they like pretty much.
It would appear that it is a private insurance, through USAA (you have to have some kind of affiliation with the military) They in turn go through Assurant Health and this is what I found out:

Plan Exclusions

While policies vary by state, the following general summary outlines expenses that are not covered by this temporary health insurance plan.

* Pre–existing conditions
1. A pre-existing condition is an illness or injury for which the covered person received medical treatment or advice from a physician within the 5 year* period immediately preceding the covered person's effective date; or that produced signs or symptoms within the 5 year* period immediately preceding the covered person's effective date.

*May vary by state.
* Intentionally self-inflicted sickness or injury
* Free services provided by a federal, veteran's, state or municipal hospital
* Dental treatment unless a hospital stay is required
* Eyeglasses, contact lenses, eye exams
* Artificial hearing devices
* Preventive treatment including routine physical exams and immunizations
* Normal pregnancy or childbirth


This of course may not be their plan.... But I'm wondering how they're connected to the military. Also if they're coming into the country without jobs, she may be able to get assistant through medicaid because she is a US citizen. She, and her son might have a few options.
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Old Mar 4th 2011, 4:18 am
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Default Re: problem with pregnancy & medical insurance

Normal pregnancy or Childbirth...

Does that imply that any complications out of the ordinary may be covered?
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Old Mar 4th 2011, 9:17 am
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Default Re: problem with pregnancy & medical insurance

Sorry guys let me go in to a bit more detail..

My wife has been in the UK for 10yrs, she'sjust home sick and wants to go home, she fell prengant after my green card etc was granted so we are emergrating..the sale of the house has taken ages (1 fell through and my visa now runs out in April..her farther is in the US army hence USAA, my wife has been with them for years so good credit etc..

I have an interview the week we arrive but not sure of the insurance even if a get the job, we will have some savings from the sale of the house but dont realy want to eat them away on medical stuff.

Ive read this NHS information and to be realy honest i dont realy understand it, we will have to get private medical as i wont have work untill i get a job, hence the insurance for my little boy which we took out yesterday at least he is covered.

I looked in to the medicare? and it all depends on income but as i wont be working we might qualify untill i get work, or will the money in the back be a problem $35,000..?

Thanks for the replys guys, this is stressing us out big time
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Old Mar 4th 2011, 12:39 pm
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Default Re: problem with pregnancy & medical insurance

Basically if you don't have employer sponsored healthcare and have to go for individual plans, you are at the mercy of the insurance companies. You could try brokers like ehealthinsurance.com. Once you have been denied and have an official denial letter you can often take that to state sponsored high risk plans and get on a plan that way. It takes a while to do and is not usually cheap but it's a way to get round pre-existing conditions. I know hindsight is 20/20 and it's not much help now but this is something you should have really, really spent a lot of time researching and have it set in stone by now. Healthcare costs bankrupt people every day of the week and pregnancy is something that can bankrupt you in a matter of hours if things go wrong. Start here and take the time to figure out the basics. https://www.wship.org/default.asp
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Old Mar 4th 2011, 1:40 pm
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Default Re: problem with pregnancy & medical insurance

Originally Posted by stress_head View Post
Sorry guys let me go in to a bit more detail..

My wife has been in the UK for 10yrs, she'sjust home sick and wants to go home, she fell prengant after my green card etc was granted so we are emergrating..the sale of the house has taken ages (1 fell through and my visa now runs out in April..her farther is in the US army hence USAA, my wife has been with them for years so good credit etc..

I have an interview the week we arrive but not sure of the insurance even if a get the job, we will have some savings from the sale of the house but dont realy want to eat them away on medical stuff.

Ive read this NHS information and to be realy honest i dont realy understand it, we will have to get private medical as i wont have work untill i get a job, hence the insurance for my little boy which we took out yesterday at least he is covered.

I looked in to the medicare? and it all depends on income but as i wont be working we might qualify untill i get work, or will the money in the back be a problem $35,000..?

Thanks for the replys guys, this is stressing us out big time
Your wife can probably go to DSHS when she gets back and they may very well help her and your son. I posted a link in my first post for something else, but DSHS would be the first place I would go.

Best of luck.
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Old Mar 4th 2011, 2:51 pm
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Default Re: problem with pregnancy & medical insurance

I thought you could buy individual cover, but it would not include pregnancy.

Akin to insuring the burning building.

I know it will be vary by State but you need to check what the high risk pool would cover.

And there are low cost/charitable sources. Millions of Baby's are born in the US every year to Parents with no cover or money.
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Old Mar 4th 2011, 3:56 pm
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Default Re: problem with pregnancy & medical insurance

Originally Posted by Boiler View Post
And there are low cost/charitable sources. Millions of Baby's are born in the US every year to Parents with no cover or money.
True, but these guys have some assets that might be vulnerable to a medical bill debt collector. When you have no income or assets, there is nothing for anybody to take.

I would look at Medicaid (not Medicare as the OP said). Eligibility varies from state to state, but they have a pregnant person in the family so (I think) every state would cover them, depending on how low their income is.
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Old Mar 4th 2011, 4:46 pm
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Default Re: problem with pregnancy & medical insurance

Thanks guys, gives us some ideas as to where to try, seems these only tell you what you need to know and keep back more inportant information..

once again thanks..head is a little less stressed..
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