Some US Healthcare Insurance Questions!
 

My L1 thread, which you are welcome to read here for purpose of context started to lean strongly towards a discussion on US health insurance and so I thought it best to field my two most recent questions (there will probably be more once I've read the healthcare threads that one of the board mods has kindly pointed me in the direction of!) are listed below.

To summarise i am hoping to be successful in applying for a job with my current firm working for their US division for which they would process on my behalf the application for an L1 and associated L2 visas for me and my family.

They are a global corporation so (although I stand to ask these questions in great detail during the interview process) i anticipate a strong healthcare/dental plan to cover myself, my spouse and my dependants (of which there will soon be two! :D)

Questions:

As you can see from my prev. thread a fellow poster has told me of her scenario whereby her company healthcare costs her $380 a month in salary deductions for 2 adults. this seems reasonable but how much do we think is reeasonable for 2 children in addition?

Can anyway comment on the cost of healthcare for children? I'm going to assume it's either going to cheaper than for an adult, or on the flipside, more expensive due to things like the frequency of visits, with children being more likely to break an arm in the playpark or catch a flu etc...?

What are co-pays and deductables?

That's it for now...but probably more to follow! :o

Thanks,

R Harris

Re: Some US Healthcare Insurance Questions!
 

Deductibles are the monies you have to pay before the Group Health Plan kicks in. e.g. in my previous Group Plan I had to pay $250 dollars a year before my Plan paid anything apart from very specific "Wellness tests"

Out of pocket expenses are the total monies you pay per annum before the Plan pays 100% of your medical expenses. e.g. In my previous plan my total out of pocket expenses were $750 per annum. These costs were made up of deductibles, co-pays, co-insurance. etc.

Co-pay is where you pay a set amount to go to see your primary physician and/or specialist. Primary (GP in the UK) usually around 15 to 30 bucks a visit; specialist, couple of hundred.

Co-Insurance is where the plan pays its part of the costs and then you pay the rest - up to your Total Out of Pocket expenses.

All these items are detailed in your Plan summary. Read it VERY carefully.
Group plans usually give you a choice of co-pays, co-insurance and high or low deductibles.

Re: Some US Healthcare Insurance Questions!
 

The company might pay for everything, rare these days, or you might have the same monthly cost, or you might have to pay the full whack for additionals.

My last place, it was $65 for me and the wife, but kids added were no extra. The COBRA bill would have been $1500 a month just for basic cover for the missus and I when I got laid off though.

So really, you've just got to ask the company and see what you find reasonable.

Re: Some US Healthcare Insurance Questions!
 

In our case my husband pays $96 a month for all of us. Usually its grouped; employee, employee w/spouse, or employee with family....

BUT, we pay $96 a month for health insurance and our deductible is MASSIVE! We have a $2300 per person, per year, deductible. This means all doctor bills, tests, prescriptions, etc have to be paid for until we meet the deductible. After that we pay a co-pay for doctor visits, prescriptions and I believe its 90% covered at hospitals. My husband works for a big company, and I would have never thought that medical benefits could get this bad. Not sure what you're coverage looks like, but one thing for sure, you will be out of pocket on something.

In my opinion, save your adventure for after your new baby is born. Seriously, you have no idea what you're letting yourself in for should things go wrong, or even if they don't. What's the big rush? Florida isn't going anywhere.

I still don't get the big attraction to Florida.....

Re: Some US Healthcare Insurance Questions!
 

I like to look at the maximum annual cost where possible to calculate.

A couple of years ago I had a great plan where I paid $450 per month for PPO coverage for myself, spouse and 2 children. Our copays were $10 gp & specialist visit, $50 emergency room, $10 generic drug per month, $20 named drug per month and there was no annual deductible or co-insurance: annual cost $5400, not including copays or medicines.

We've also had High Deductible insurance where there was no monthly payment. The maximum exposure per year for self and spouse was $10k, with the possibility that we might need to find $10k in the first month. Luckily there was also an HSA (health savings plan) with tax advantages and yearly rollover of contributions where we saved on a regular basis.

Contrast those plans with my current employer: now paying $400 per month for just self and spouse (children have aged out and have own insurance), $20 doctor visit, $40 specialist visit, $100 emergency room, $15 generic drug, $35 named drug, $500 per person deductible and $2000 per person co-insurance: maximum annual exposure $10k, not including copays.

This gives you a few examples of different types of insurance and your possible cost but, as everyone else has said, plans and contributions are not equal. The HR dept. in the US should be able give you details and it would be a good idea to know the cost/maximum annual exposure before you negotiate your salary.

It can be difficult to get your head around at first and you will need to keep on top of your paperwork. Be prepared to occasionally do battle with the doctor's office when over charged (it does happen!) and the insurance company if they don't pay out. And keep on the right side of your HR dept. just in case you need them to weigh in on your behalf!:)

Re: Some US Healthcare Insurance Questions!
 

Never assume that. Some of the biggest companies in the world have the worst healthcare plans and some of the smallest have some of the best. On one hand they have to think about drawing quality people for a lot of big companies but on the other hand, they have to pay for it. A large company with a lot of employees spends hundreds of millions on healthcare insurance. They could take the option f offering great policies but not subsidizing it much but then you have the problem that you start to price employees out. It's a tough thing to get right. Also, dental (and vision) is not healthcare. A lot of companies don't even offer a dental program, a lot do but it is usually not very good considering the price of dental work here. You will usually get one eye check per year on your healthcare but if you need glasses of contacts then you will need vision insurance. Again, some companies don't offer it, some do and the levels are very varied.

The only thing you can do is talk to the employer and find out what they offer, what they charge you for it, what you will be responsible for and what it covers. The very best thing you can do is ask if there is an online demo portal. Since everything is policy driven, coverage options are usually hidden behind logins at the various insurance companies so it's tough to really get an idea of what is and isn't covered. It's become pretty common for the insurance companies to set up a demo login for people looking at a specific policy so you can go in, play with the online stuff, search which doctors and facilities are covered, see what co-pays are, run price checks for drugs and the like. It's a pretty useful tool. There is usually either printed or online material that will give some more specifics. Ask for open enrollment documentation. That's what the employees will have got during the last open enrollment period and will have good info in.

Just be aware that there are tens of thousands of insurance companies and they all offer hundreds of different policies. Each year you will be required to re-enroll in a plan and the plans frequently change in both coverage, provider and/or cost. This will be something you will have to do every year!

Re: Some US Healthcare Insurance Questions!
 

Lose the word "reasonable" in your discussion of healthcare premium costs.

The costs to you depends on the employer and what portion of the overall premium they pass on to you. We never paid for premiums under my husband's union coverage but now that he is retired, we pay $109 a month for my individual coverage. My share of the cost if I went with my employer's coverage would be nearly $500 a month for an individual and for a family it would be over $700 a month.

Fortunately for us, we have never had a deductible that had to have been met under any healthcare coverage. This is, of course, not the norm countrywide.

Also you have to note if your company is enrolled in a flex spending scheme which is when your premiums and out of pocket co-pays and miscellaneous healthcare purchases, i.e. glasses, aspirin, etc. are deducted from your salary before taxes and the purchase price (not premium) given back to you in taxfree money when you place an evidenced claim with the flex spending company.

Re: Some US Healthcare Insurance Questions!
 

It's worth taking note that whatever healthcare coverage your company quote you this year will probably change in January...for the worse! :frown:

Coverage is renewed at the beginning of each calendar year and each year the costs are more and the benefits are less.

Re: Some US Healthcare Insurance Questions!
 

Very true! Our deductible increases by $100 every year! :frown:

Re: Some US Healthcare Insurance Questions!
 

It is going to depend on the company and location. In the Silicon Valley, generally the plans offered are very good with low cost to the employee (although that is rising). In the Silicon Valley, usually the plans have a specific cost for the employee and an additional cost for the family with no additional cost for children.

Make sure that you notify your insurance plan within 3 months of having a baby since if you wait longer, you will have to wait for open enrollment (once a year period) to add the child.

Re: Some US Healthcare Insurance Questions!
 

That depends on the insurance company, and it's usually within 30 days of birth.

Re: Some US Healthcare Insurance Questions!
 

No it is apparently a federal government rule in order for the company to maintain its tax exempt status of the plan. My son and his wife just accidently waited too long and the company wouldn't allow coverage because of the federal laws.

According to the university (through which they were insured), if they allowed coverage, they would likely not be able to deduct the companies share of the cost as a deduction.

Re: Some US Healthcare Insurance Questions!
 

Hmmm...When I was with BlueCross, they needed a copy of babys birth cert and SSN within 30 days to be covered under the life changing events, other wise she'd have to wait till the next enrolement window.

The missus insurance at the moment, Atena is the same.

Very strange then.

Re: Some US Healthcare Insurance Questions!
 

Maybe some companies shorten the period. When my son called Atena, they said they didn't have a problem covering the baby (including the missed coverage) if the company said it was ok. But when he called the university, they told him in order to keep the plan tax exempt, they couldn't do it.

He didn't realize that the baby was not covered automatically until he started getting the bills about 3 months later.