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Relocating whilst pregnant

Relocating whilst pregnant

Old Apr 19th 2013, 11:53 am
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Default Relocating whilst pregnant

Hello,

I'm wondering if anyone can help.

My husband has been offered a job and we're due to relocate to the US in August. He'll be on an E2 visa and as I understand it, I'll receive a derivative E2.

I've just found out that I'm pregnant and I've gone from looking forward to the move to being incredibly nervous. (It'll be my first baby which adds to the nerves!)

I'm wondering - if we move when I'm six months pregnant, will I be able to have the baby there? Will it give me enough time to register in a hospital and have the care needed? (I'm only aware of the NHS and there are so many appointments you have to go to before you can "book in" to a hospital!)

My husband will be given medical insurance for both of us.

Any help or advice would be very much appreciated!
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Old Apr 19th 2013, 12:23 pm
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Default Re: Relocating whilst pregnant

Hi Faybes, congratulations!

I've actually just done the same move in reverse: USA to UK, 6 months pregnant, first baby. Had my NHS 'booking in' appointment here at 30 weeks, which confused everyone!

I don't know the answers, but some really important questions you need to ask are:

- does the health insurance absolutely, definitely, 100% cover you for pregnancy care? Health insurance here is incredibly complicated and you can't assume it will. There may be some kind of waiting period before you can qualify for maternity care. Since you're already pregnant, it may be classed as a pre-existing condition, and not covered. You may have large co-pays (charges per treatment) or a deductible (total you pay for treatment per year before the insurance kicks in and starts covering costs). You really need to find someone at your husband's company who knows about the insurance and go over the policy with a fine-tooth comb, and make sure everything is in writing.

- will you find an ob-gyn and hospital to accept you at 6 months? I've heard this can be very difficult, possibly because they're worried about liability (since they haven't supervised your first 2 trimesters). Standard care is very doctor-led here; I didn't have a midwife, just an ob-gyn who saw me at his clinic and referred me to hospital for tests, birth etc. Your insurance will probably limit you to certain doctors and hospitals, known as your 'in-network' providers. I would definitely want to contact these people before arrival to make sure they'll even let you register. Obviously, if you're actually giving birth, any ER will treat you (although you'll get a fat bill afterwards if they're not in your insurance network)... but this in in extremis, and naturally you'll want proper, monitored care for your 3rd trimester.

Insurance and care are the key things, but you might also want to think about:

- how much relocation assistance are you getting? Is it the kind of sweet deal where they'll give you an apartment for the first x months and plenty of hand-holding, or will you be organizing a lot yourself? It's just difficult to predict how you'll feel at 6 months, so try to negotiate as much help as possible and cut yourself some breaks.

In my case, our transatlantic move coincided with the few months of pregnancy during which I felt full of energy, which was lucky because it was mostly a DIY job. I spent my 1st trimester throwing up, and now I'm in my 3rd trimester I have a bad back, so I'm glad we got the move done at 6 months.

I'm sorry if that's a lot of overwhelming info, but the healthcare situation in the US is... unique. But the care I received during my first two trimesters was very good, so if you have solid insurance and an ob-gyn who'll take you on then at least that's once less thing to worry about.

Good luck with it all.

Last edited by MoshiMoshi; Apr 19th 2013 at 12:28 pm.
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Old Apr 19th 2013, 12:33 pm
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Default Re: Relocating whilst pregnant

Hello!

Congratulations too you also! Thank you so much for your advice.

I will get a copy of the medical insurance asap and read through this. I expected it to be a lot more complicated than I was hoping!

We're also not getting a huge amount of relocation support - just the money(which is helpful) but having never been 6 months pregnant before you're right to question how it will feel and with my husband working long hours I'm likely to be getting most of the move done alone.

Thanks again and good luck with everything!!

x
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Old Apr 19th 2013, 12:42 pm
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Default Re: Relocating whilst pregnant

We had our first in the UK on the NHS and it was free.

We have insurance in the US and our second one cost about 25000 dollars in total. Thankfully the insurance took the brunt of that, but it was not small change that had to come out of our pockets.

So i echo the warnings of others. Make sure that you are covered, explicitly ask the insurance company what is and more importantly what is not covered so that you will be aware of your financial expectations.
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Old Apr 19th 2013, 12:45 pm
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Default Re: Relocating whilst pregnant

Ok so I definitely can't afford 25000 dollars. I also can't bear the thought of having to stay in the UK and have my baby while my husband is in the US.

I'm hoping the medical insurance will cover it. Thanks again for your advice.
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Old Apr 19th 2013, 12:53 pm
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Default Re: Relocating whilst pregnant

A straightforward birth shouldn't cost too much if covered by insurance...but if the pregnancy or birth is not straightforward it can be costly...even with healthcare insurance. Here is a thread by Bob...his wife had a little girl prematurely.

If your baby is born in the US it will automatically become a US citizen...and a British citizen by decent (assuming you are British other than by descent). You may want to read up on what that entails. A USC child does not give the parents the right to live or work in the US.

There are plenty of people on here who have had straightforward births...hopefully they will be able to give you more advice.

Last edited by Jerseygirl; Apr 19th 2013 at 1:00 pm.
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Old Apr 19th 2013, 1:04 pm
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Default Re: Relocating whilst pregnant

Honestly in the unlikely case that I fell pregnant and carried to term (I'm in my mid-40s), my husband and I would want our baby to be born in the UK regardless, because I don't have any family or support to speak of here. Assuming I qualified for NHS (which I probably would not, because I'm a USC, unless I just happen to give birth in Scotland while on a business trip covered by my Tier 2 visa), it would be a lot cheaper for him to travel back to the UK for the birth than it would be for me to pay the part of the bills that insurance wouldn't cover here in the US.
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Old Apr 19th 2013, 1:14 pm
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Default Re: Relocating whilst pregnant

Originally Posted by Speedwell View Post
Honestly in the unlikely case that I fell pregnant and carried to term (I'm in my mid-40s), my husband and I would want our baby to be born in the UK regardless, because I don't have any family or support to speak of here. Assuming I qualified for NHS (which I probably would not, because I'm a USC, unless I just happen to give birth in Scotland while on a business trip covered by my Tier 2 visa), it would be a lot cheaper for him to travel back to the UK for the birth than it would be for me to pay the part of the bills that insurance wouldn't cover here in the US.
I'm not sure that you would not be covered by the NHS. If it was an emergency you would be...not sure about a straightforward birth...especially as your husband is British.
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Old Apr 19th 2013, 1:50 pm
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Default Re: Relocating whilst pregnant

Originally Posted by DavidLemon View Post
We have insurance in the US and our second one cost about 25000 dollars in total. Thankfully the insurance took the brunt of that, but it was not small change that had to come out of our pockets.
Originally Posted by Jerseygirl View Post
A straightforward birth shouldn't cost too much if covered by insurance...but if the pregnancy or birth is not straightforward it can be costly...even with healthcare insurance. Here is a thread by Bob...his wife had a little girl prematurely.
Totally agree that insurance which ostensibly 'covers' pregnancy and birth can leave you with bills, but it's worth mentioning that this isn't always the case. My husband had rock solid insurance through his employer and it covered us for everything during the first 2 trimesters. No confusing stuff with deductibles and 90/10 or 80/20 splits. I paid $10 for my first doctor's appointment and $10 for my first ob-gyn appointment, and everything after that was fully covered. Obviously we left before birth but I'd spent a lot of time checking our coverage for that, too, and it was incredibly comprehensive.

I just mention it because I can remember reading Bob's thread, and others like it, and they contributed to our decision not to start a family while in the US! I'd always hated dealing with our HMO and assumed they'd be very difficult if I was pregnant. Then I got pregnant anyway and was surprised to find that, on our insurance plan, it was basically fine and they picked up the tab on everything*.

It's still hard for me to get my head around the massive divergences on healthcare experiences in the US, even between people who have insurance. It's impossible to generalize, except to say: check everything, assume nothing. You have to be so well-informed about your policy.

*I know the prenatal costs don't begin to compare with NICU care, but they weren't small change either: I was CCed on most correspondence between healthcare providers and HMO, and saw things like ultrasounds billed at $1200 (excluding physician's time; I had 3 ultrasounds) and one particularly fancy blood test at $1600.

Originally Posted by Jerseygirl View Post
I'm not sure that you would not be covered by the NHS. If it was an emergency you would be...not sure about a straightforward birth...especially as your husband is British.
If she were legally in the UK and intended to reside there permanently, then she'd be covered for maternity care. If she were just visiting to have the baby, then no! I've just had to wheel out a lot of paperwork to convince the hospital here that I'm eligible for NHS treatment, and I'm a British citizen.

Last edited by MoshiMoshi; Apr 19th 2013 at 1:56 pm.
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Old Apr 19th 2013, 2:43 pm
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Default Re: Relocating whilst pregnant

Well my actual point was that I thought it might be better and less expensive for the OP to go ahead and have the baby in the UK if her family and support structure was there, and for her husband to visit for the birth, if that's a possible scenario. At least that was my opinion!
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Old Apr 19th 2013, 3:24 pm
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Default Re: Relocating whilst pregnant

Originally Posted by Speedwell View Post
Well my actual point was that I thought it might be better and less expensive for the OP to go ahead and have the baby in the UK if her family and support structure was there, and for her husband to visit for the birth, if that's a possible scenario. At least that was my opinion!
I suppose it depends on your personality but I would have found it far too stressful to deal with the move at 6 months pregnant, especially as I didn't want the degree of intervention they go in for here. Just too much to deal with.
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Old Apr 19th 2013, 3:46 pm
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Default Re: Relocating whilst pregnant

My vote goes for having your child in the UK with a health care system you are familiar with and understand.

We have been here 8+ years and I am still confused with how it works.

My youngest daughter broke her finger playing basketball in January, UK system would be go to hospital get an x-ray, simple break put a splint on it and come back in a few weeks and it will be fine.

US system go to emergency room see Dr. number one, calls in Dr number two for a second opinion, sent for x-ray, simple break but referral to Orthopedic Dr. Have to check orthopedic Dr is in network, go to see him the next day more x-rays. He applies splint. Arranges 4 follow up appointments over two months $40 co pay for each one. Wants to do another set of x-rays at third appointment I object hes fine with not doing them. Mean while daughters finger is fine she stopped wearing the splint after 2 weeks no pain. Total invoice of all x-rays emergency room and orthopedic Dr was over $3500 insurance paid all apart from the co pays.
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Old Apr 19th 2013, 3:52 pm
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Default Re: Relocating whilst pregnant

Maybe worth mentioning that there is usually an annual deductible...could be in the range of $500 or more...could be less. Co-pays seem to be in the region of 20% of the bill.

All the above depends on the policy. Generally you are sent for many more tests and procedures in the US than you would be in the UK...this applies not just to pregnancy. This can be a good or bad thing...depending on what (if anything) is found.

If you need to go to the ER...ask every person who attends to you if they are in network. A few months ago my husband went to the ER...the resident doctor wanted to introduce himself before we left. When the bills started to come in...the resident turned out to be not in network.

Last edited by Jerseygirl; Apr 19th 2013 at 5:19 pm.
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Old Apr 19th 2013, 5:09 pm
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Default Re: Relocating whilst pregnant

I moved here at 31 weeks pregnant. Had no major problems getting into the healthcare system. The doctor redid some tests (bloodwork / ultrasound etc) for their own peace of mind, and we had regular checkups in line with their requirements.

I know that some people prefer to deliver without intervention, which I respect. I had complications during labour which I don't think would have been picked up without continuous fetal monitoring (not standard in the UK). I am so grateful to have delivered in the US. The aftercare was amazing, and the staff were lovely.

Our care was 100% covered under insurance (military). Agree with previous posters that you need to check this out first!

I had an easy pregnancy which made the above possible. If I had been high risk or sick with it - I wouldn't have attempted the move until after the birth.

Congratulations on your pregnancy
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Old Apr 19th 2013, 5:30 pm
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Default Re: Relocating whilst pregnant

Congrats on the pregnancy. We moved here at about the same time, although reading my past posts I seem to have some confusion as to whether she was 6 or 7 months gone . Everything went fine, although there were a few added stresses (excluding the move!) as we did have trouble getting an OBGYN to take us on. It obviously depends on individual circumstances, so certainly one to check on before you get here if possible. It was also very expensive as we were coming without jobs, so had other insurance issues. I know people say that the service in the health system here is great (assuming you have decent insurance) but we had our first in Singapore, and the service there was significantly better than here. Not to mention significantly cheaper.

There was a thread on this last year here...
http://britishexpats.com/forum/showt...YN#post9994282
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