Sound Boy

Hi,

I am shortly to emigrate to the USA and have only just shockingly discovered that most health insurance does not provide cover for pre-existing medical conditons and that I may have to pay for my insulin, other medicine and paraphanelia myself.

I won't have a job to start with but even so, a job is no guarantee that my medicine needs will be covered.

If there is anyone with insulin-dependent diabetes who has emigrated to the USA and who has found a solution to this problem, I would appreiciate your help if you can.

I will have some medicine with me for a few weeks or so, but after that I am on my own, or so it seems.

Jerseygirl

I'm sorry I can't help you with your question. You are correct health care insurance will only cover medical treatment...you will need separate insurance cover for meds. Even with insurance you will still have co-pays to pay for each medication...this will vary depending on the company/cover you choose.

Vimto

They are often looking for people to take part in medical trials for diabetes, these include medication and doctors visits and often are free and are not dependant on health insurance. Check on line to see if there is a free trial going on near where you will be moving to in the US. This may keep you going for a short while until you get yourself sorted out.

another bloody yank

I think Duncan Roberts http://britishexpats.com/forum/member.php?u=17190 was just diagnosed with diabetes, I don't know the specifics though.

Elvira

AFAIK, insurance companies have to cover pre-existing conditions if you have previously been insured. The NHS *does* count as previous insurance. But it seems you *have* to get insurance within 63 days of emigrating from the UK, so you most likely will have to get temporary individual cover before you are able to get a job that offers healthcare. This is likely to be very expensive.

This article and website should provide more information:

http://www.diabeteshealth.com/read/2006/05/01/4730.html

This may also have some useful information:

http://info.insure.com/health/budget.htm

The following is a comprehensive guide to health insurance for California, but I believe you can find similar guides for other states too:

http://www.healthinsuranceinfo.net/ca.pdf

Having said that, I personally would never move permanently to the US if I had a serious pre-existing condition. Getting and keeping health insurance will be an ongoing headache.

Bob

best advice, get a job quick smart and bring as much supplies as you can from the NHS.

BIL, without insurance rates would be on $900 for a 90 day prescription for the various stuff.

Tracym

What you're referring to is keeping HIPAA eligible status, so that an employer group insurance plan must immediately cover pre-existing conditions. Unfortunately, it is not simple for a new expat.

It seems there is debate if the NHS counts as previous insurance. I have had one state underwriter tell me it would for the state program, but others have said private insurance may not consider the NHS.

Secondly, while private individual insurance counts as HIPAA eligible, short-term policies generally do NOT. And the hitch is... most/all private individual policies will not cover an ex-pat until they've been in the country for 6 months. So... one gets a short term policy (which won't cover pre-existing anyway), then one loses HIPAA eligibility.

The state high-risk pools look to be the best solution, if they indeed count the NHS. Some visas and such are eligible, some may not be. I'm not sure, but I suspect they will cover diabetic drugs. The OP would have to check with the state they will be living in.

Sometimes drug companies may give discounts to those in need, but I'm not sure how that would work with a recent expat.

Perhaps supplies from Canada, if that still works? It appears to, but I'm not sure.

Before this touches off another nice big debate, let me go on record that this is the kind of stuff I'm in favour of insurance reform for.

Elvira

I think it's the long-term health insurance issue which should be the main concern for the OP. I'm sure a solution for funding insulin for a few months can be found, either by bringing supplies from the UK, or getting them from a discount pharmacy here or in Canada. In any event I don't think insulin is very expensive compared with some other drugs. (Indeed, I have heard of poor Type 2 diabetics actually choosing to go on to insulin because it is cheaper than oral antidiabetic medications.)

However, the problem about covering pre-existing conditions would really worry me. And it seems to be so difficult to get hard and fast information on this issue.

Jerseygirl

My doctor in the UK used to give me a prescription for 3 months...it is the maximum they can prescribe.

fatbrit

With no insurance or no coverage, solution is to pay directly. Visit to the GP should set you back less than a $100 -- look for 25% discount for cash payment. Make sure you get an Rx of them for a year's supply. Then order at the pharmacist, shopping about. Web order to Canada is usually cheapest and they'll send 3 months at a go.

However, on your insurance problem, the answer is a group policy, which cannot specifically exclude you. Either get employed or, if self-employed, look to join a professional organization that offers group health policies.

Tracym

There is hard and fast information available imo, except for the first bit as an expat. Pretty much, once you become HIPAA eligible, and stay that way, you should be ok.

The biggest (at least immediate) problem that I see is not being able to keep that HIPAA eligibility as a new expat, since then employers insurance does not HAVE to cover pre-existing for the first year. Unless they live in a state which affords extra protection.

My best friend is an insulin-dependent diabetic btw.

The risk of course, as we have often discussed, is if one loses the job, can't afford COBRA, etc. and somehow loses the insurance and HIPAA eligibility. This is really no different in the OPs case than anyone else living here though. And even if one doesn't have a pre-existing condition, they could acquire one the next day. So I guess that has to be part of their decision.

Tracym

The thing is, the employer's policy may not have to cover that pre-existing condition for up to a year. Of course, some employers choose to.

fatbrit

Yep -- US health care is a pile of total overpriced crap IMVHO!

Tracym

Yes we know you feel that way. I'm afraid I'm not going to get into that again myself. I am just trying to put up information that may be useful to the OP.

Sound Boy

What is "Rx" please?