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-   -   Proving loss of coverage from NHS (https://britishexpats.com/forum/usa-57/proving-loss-coverage-nhs-915884/)

RainyDays Aug 9th 2018 5:53 am

Proving loss of coverage from NHS
 
So I'm having some difficulties getting added to my husband's Blue Cross medical coverage. The form I filled in has 7 options for joining, ranging from marriage to newborn to open enrollment. None really apply, so I've ticked 'loss of coverage', as there is no box for newly arrived immigrant. Now the broker says they won't add us unless we have documentation proving loss of coverage. That's not really possible. I'm panicking a bit as my children and I currently have no medical insurance! Any ideas?

BritInParis Aug 9th 2018 5:55 am

Re: Proving loss of coverage from NHS
 
What are the seven options?

RainyDays Aug 9th 2018 5:58 am

Re: Proving loss of coverage from NHS
 
Newborn, adoption, court order, marriage, domestic partnership, loss of coverage, open enrollment.

shiversaint Aug 9th 2018 6:05 am

Re: Proving loss of coverage from NHS
 
Surely the broker can deal with this? Isn't being a new immigrant/resident roughly equivalent to being a new employee?

SanDiegogirl Aug 9th 2018 6:08 am

Re: Proving loss of coverage from NHS
 

Originally Posted by RainyDays (Post 12545821)
Newborn, adoption, court order, marriage, domestic partnership, loss of coverage, open enrollment.

As you are using a broker what do they suggest you put if the above are the only options you have? (it is in the broker's interest to get you onto your hubby's policy as he will get a commission).

Presume your husband's policy is an individual one and not a group scheme.

RICH Aug 9th 2018 6:21 am

Re: Proving loss of coverage from NHS
 
Why do you think "Marriage" does not apply?. Even if you were married years ago, you are still married. Married people are usually eligible to share a health insurance policy, but it is not mandatory.Loss of coverage from NHS is mandatory, if you are not resident in UK so it looks like you have 2 options.

edit. in case it was not clear, I am saying the status of being married qualifies you, regardless if that status has not changed (ie in the parlance, a "qualifying event" has not occurred recently)

Nutmegger Aug 9th 2018 6:22 am

Re: Proving loss of coverage from NHS
 

Originally Posted by RainyDays (Post 12545817)
So I'm having some difficulties getting added to my husband's Blue Cross medical coverage. The form I filled in has 7 options for joining, ranging from marriage to newborn to open enrollment. None really apply, so I've ticked 'loss of coverage', as there is no box for newly arrived immigrant. Now the broker says they won't add us unless we have documentation proving loss of coverage. That's not really possible. I'm panicking a bit as my children and I currently have no medical insurance! Any ideas?

Your prior coverage was the NHS. Point out to the broker that moving to the US has severed that coverage.

shiversaint Aug 9th 2018 6:41 am

Re: Proving loss of coverage from NHS
 

Originally Posted by RICH (Post 12545844)
Why do you think "Marriage" does not apply?. Even if you were married years ago, you are still married. Married people are usually eligible to share a health insurance policy, but it is not mandatory.Loss of coverage from NHS is mandatory, if you are not resident in UK so it looks like you have 2 options.

edit. in case it was not clear, I am saying the status of being married qualifies you, regardless if that status has not changed (ie in the parlance, a "qualifying event" has not occurred recently)

I think the confusion is that one would assume that question means "I have just married therefore I am now eligible", but I think actually you might be right. This is what my wife ticked when we arrived.

RICH Aug 9th 2018 7:07 am

Re: Proving loss of coverage from NHS
 

Originally Posted by shiversaint (Post 12545859)
I think the confusion is that one would assume that question means "I have just married therefore I am now eligible", but I think actually you might be right. This is what my wife ticked when we arrived.

I am sure I am right. The Marriage is the qualifying event, not the Wedding!

Think of all the normal Americans who have jobs and individual insurance. Once they marry, they may or may not move to joint insurance on one or the others' plan. My (ex) wife had an exorbitant plan for many health issues, and it was cost effective for me to get the low cost one from my employer, rather than be added to hers.

RainyDays Aug 9th 2018 7:48 am

Re: Proving loss of coverage from NHS
 

Originally Posted by RICH (Post 12545877)
I am sure I am right. The Marriage is the qualifying event, not the Wedding!.

But the paperwork says I have to apply within 60 days of the qualifying event. Doesn't that mean the date we married? (I agree - the wording is unclear.)

Also, that still doesn't cover my children.

I'm waiting to hear back from the broker. My own research suggests that proof that we moved internationally should be enough to prove that we qualify, even though there is no tick box for it.

Thanks everyone for your comments and suggestions.

Giantaxe Aug 9th 2018 7:50 am

Re: Proving loss of coverage from NHS
 

Originally Posted by RICH (Post 12545877)
I am sure I am right. The Marriage is the qualifying event, not the Wedding!

Think of all the normal Americans who have jobs and individual insurance. Once they marry, they may or may not move to joint insurance on one or the others' plan. My (ex) wife had an exorbitant plan for many health issues, and it was cost effective for me to get the low cost one from my employer, rather than be added to hers.

I disagree. It is the act of getting married that allows one to have a "special enrollment period" to sign up at that point rather than having to wait for the next open enrollment. That's the case whether this is an individual policy or an employer-provided one. My employer, for example, gives you 60 days after marriage/becoming domestic partner to sign up outside of open enrollment.

https://www.nerdwallet.com/blog/heal...llment-period/

Imo, it is the loss of NHS coverage that entitles the OP to have the right to sign up outside of whatever the open enrollment period is for their spouse's plan.

shiversaint Aug 9th 2018 8:18 am

Re: Proving loss of coverage from NHS
 
What about using a copy of the form you send to HMRC to let them know you're no longer a tax resident? Can't remember the code but that form would effectively prove you can no longer get UK tax derived benefits such as NHS access.

MidAtlantic Aug 9th 2018 8:27 am

Re: Proving loss of coverage from NHS
 

Originally Posted by Giantaxe (Post 12545902)
I disagree. It is the act of getting married that allows one to have a "special enrollment period" to sign up at that point rather than having to wait for the next open enrollment. That's the case whether this is an individual policy or an employer-provided one. My employer, for example, gives you 60 days after marriage/becoming domestic partner to sign up outside of open enrollment.

https://www.nerdwallet.com/blog/heal...llment-period/

Imo, it is the loss of NHS coverage that entitles the OP to have the right to sign up outside of whatever the open enrollment period is for their spouse's plan.

I agree - the wedding would have to be in the last 60 days for it to be the relevant event.

The event is becoming a lawful resident of the USA. Unfortunately there is no requirement for non-exchange policies to treat this as qualifying for special enrollment so the OP may find that she has to purchase a separate policy on the exchange, until her husband's open enrollment time comes.

Becoming a United States citizen (this qualifying event only applies within the exchanges – carriers selling coverage off-exchange are not required to offer a special enrollment period for people who gain citizenship or lawful presence in the US).Source: https://www.healthinsurance.org/obam...-you-coverage/

BritInParis Aug 9th 2018 8:36 am

Re: Proving loss of coverage from NHS
 

Originally Posted by shiversaint (Post 12545911)
What about using a copy of the form you send to HMRC to let them know you're no longer a tax resident? Can't remember the code but that form would effectively prove you can no longer get UK tax derived benefits such as NHS access.

It’s Form P85, but being resident for tax purposes and being eligible for NHS care are not the same thing.

RICH Aug 9th 2018 8:47 am

Re: Proving loss of coverage from NHS
 

Originally Posted by shiversaint (Post 12545911)
What about using a copy of the form you send to HMRC to let them know you're no longer a tax resident? Can't remember the code but that form would effectively prove you can no longer get UK tax derived benefits such as NHS access.

P85. Not likely to be helpful for the original post' purpose. The statute reneging NHS care from non residents would do the job. I don't know it is myself, or if it exists.

As for US healthcare, good link Giantaxe. I maintain that married folk can be covered by the spouses insurance without the waiting period and despite the "rules". Based on nothing more than common sense. I know that doesn't make sense.

adamas Aug 9th 2018 9:19 am

Re: Proving loss of coverage from NHS
 
I was in a similar situation two months ago, when I was still living in the UK and applying to enroll into my company's insurance plan.
I ticked the "Loss of coverage" box and provided the insurance broker with a letter from my GP practice stating that I was covered under the NHS, and that coverage terminates upon leaving permanently the UK to establish residence elsewhere. I had also provided a copy of my EHIC. The insurance carrier eventually accepted it and I was enrolled the first of the month after I immigrated.

Rete Aug 9th 2018 9:27 am

Re: Proving loss of coverage from NHS
 
You just arrived in the US. The reason you are going under your husband's healthcare policy is "marriage". There is no other reason and certainly not loss of coverage since NHS coverage never has been available in the US so does not count as a valid policy in the US.

Rete Aug 9th 2018 9:29 am

Re: Proving loss of coverage from NHS
 

Originally Posted by Giantaxe (Post 12545902)
I disagree. It is the act of getting married that allows one to have a "special enrollment period" to sign up at that point rather than having to wait for the next open enrollment. That's the case whether this is an individual policy or an employer-provided one. My employer, for example, gives you 60 days after marriage/becoming domestic partner to sign up outside of open enrollment.

https://www.nerdwallet.com/blog/heal...llment-period/

Imo, it is the loss of NHS coverage that entitles the OP to have the right to sign up outside of whatever the open enrollment period is for their spouse's plan.

I disagree. I left my company healthcare and went under my husband's. The reason "marriage" although we had been married for over a year. Never was questioned. And yes, I signed up outside of the open enrollment period. And it was Blue Cross/Blue Shield.

Nutmegger Aug 9th 2018 10:14 am

Re: Proving loss of coverage from NHS
 

Originally Posted by Rete (Post 12545954)
You just arrived in the US. The reason you are going under your husband's healthcare policy is "marriage". There is no other reason and certainly not loss of coverage since NHS coverage never has been available in the US so does not count as a valid policy in the US.

Rete, although it may not be relevant in this instance, it has been documented on the forum before that the NHS is a valid provider and that people can show that they have had no gap in coverage when arriving in the US by citing the NHS.

RICH Aug 9th 2018 10:24 am

Re: Proving loss of coverage from NHS
 

Originally Posted by RainyDays (Post 12545899)
But the paperwork says I have to apply within 60 days of the qualifying event. Doesn't that mean the date we married? (I agree - the wording is unclear.)

Also, that still doesn't cover my children.

I'm waiting to hear back from the broker. My own research suggests that proof that we moved internationally should be enough to prove that we qualify, even though there is no tick box for it.

Thanks everyone for your comments and suggestions.

I missed this reply earlier. I am not an expert, but I believe, despite the rules and unclear questions you are seeing, the law is that a spouse (and children) can, and must, be covered by an eligible policy.

Giantaxe Aug 9th 2018 10:28 am

Re: Proving loss of coverage from NHS
 

Originally Posted by Rete (Post 12545957)
I disagree. I left my company healthcare and went under my husband's. The reason "marriage" although we had been married for over a year. Never was questioned. And yes, I signed up outside of the open enrollment period. And it was Blue Cross/Blue Shield.

A lot more detail here on special enrollment periods. This link covers ACA, employer group and Medicare:

"There are time limits to your special enrollment period: 60 days after the triggering event normally with the Marketplace, and 30 days typically for workplace plans."

https://www.insure.com/health-insura...nt-period.html

And this link says there were recent changes to require documentation to be produced:

"As of June 17 [2016], consumers were required to provide documentation to enroll through any of these SEPs."

https://familiesusa.org/blog/2016/07...iages-and-more


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