US Medical Insurance...
 

Hi All

My USC wife and I are moving from UK to USA in the coming weeks and I had a quick question about medical insurance...if there even is such a thing as a quick question about medical insurance! ;)

For what I understand, US medical insurers often want to see proof of previous medical cover. How do I sufficiently demonstrate that I was covered for the entirety of my life under the NHS as a UKC?

Additionally; I figured US medical insurers might want a copy of my medical records before they provide me with coverage. Is this true? If US insurers do not need to see my records, then I'll save £40GBP [which is what my local doctor's office is quoting, to provide me with a copy of my own medical records] :blink:

Many Thanks,
Rich.

Re: US Medical Insurance...
 

£40 for medical records isnt bad, especially if you are of any age. Mine charges £1 a sheet!

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Hi CS,

Appreciate the input. Under the Data Protection Act 1998, organisations are obligated to provide you with copies of the records they hold about you upon request, in a timely fashion. For medical records however, they are legally allowed to charge up to £50.00 GBP.

Hopefully the below links and information is of help to you if your local doctor's office it trying to rip you off :thumbdown:
Cheers,

Rich.

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Rich, get a copy of your vaccinations but you're unlikely to need full medical reports. Apparently US medical organizations are wary of foreign records, and you'll most likely have a medical anyway - both physical and a massive questionnaire to fill in (the latter you might, might not).

As for proof, some insurers will understand the NHS and just take your word for it; others may need some help. The best is probably a letter from your GP to say you had coverage from such and such a date (mine refused to do it from birth, only from when we joined their surgery, but that was good enough as it was over 6 years). Again, they'll charge probably but at least mine put all 4 of us on the same letter for 28 quid (approx 50p per word...).

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Believe me paying out £50 is a drop in the ocean when it comes to paying for US healthcare. Have you or your wife got a job with healthcare benefits? If not it can be even more expensive. There are lots of threads about healthcare...if you use the search engine you should be able to find them. Go to 'Advanced Search' and make sure you highlight the US and Trailer Park forums. There is also information about US healthcare in the BE Wiki.

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Yes, get used to that feeling.

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50 Squid refers to cost of your records, they usually charge you a admin cost for printing them out though. Can be anything from nothing to a couple pounds a page.

You probably want just a brief over view and vaccine record, unless you've had a lot of illnesses and the like.

As for what you need for US insurance, different companies want different things. Can be a letter from your GP or local health authority, saying you've been living x years under the care of the NHS or words to that affect.

Need to get US cover within 62 days though for it to mean anything.

If you've got a job providing insurance, it won't matter.

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£50 is nothing--absolutely nothing compared to the costs you are about to experience.

I'm gathering you are probably pretty healthy--no major issues under treatment at this time so your doctor visits were probably for 'one off' things here or there. But even with that, a full copy of your medical records throughout your life is a good thing to have.

When you get older, and parts of you start to fail, there will be 'indicators'--measurements in blood tests and other things that will alert them as to possible situations. If you have a baseline of these numbers from when you are healthy it makes it easier to compare later in life. "I've always had a high such-and-such on this thing since I was in my 20s, so exploratory surgery because of a high indicator in the test might not be necessary when I'm in my 50s".

As Bob mentioned, it's rather important that your new cover start within 62 days of leaving NHS coverage in the UK. Most insurance agencies just assume since you were in the UK you had coverage, but some may request a letter or an NHS card or something. You medical records might also help for that.

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If you are getting a group plan from your employer there is usually no documentation of previous coverage required.

If you are buying the coverage yourself the insurer might require proof of previous coverage, at least until ObamaCare starts in 2014, but it will depend on where you live in the US. For example in Massachusetts the state requires you to have medical insurance and there are no previous coverage or prior conditions requirements. if you are an MA resident and you don't have employer insurance, Medicare or Medicaid etc you must buy a state approved insurance and the cost is determined by your age, gender and the level of coverage you choose.

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Despite the costs, I have to say I'm generally impressed with the service I get from my insurance. Yesterday (like previously) I had an email to let me know my lab results were ready, so I logged in to their website, and there are the results, barely 2 minutes after the lab had entered them into the system. Then, a couple of hours later, the doctor replies to my email with a phone call. He set a few things up and called me again to say they're ready. Excellent service. (Nothing serious)

Back at my GP in the UK if I wanted a result (usually 1 week after taking the sample) I would have to phone the surgery between 12noon and 1pm and wait in a telephone queue until the lone nurse would be able to give non-specific information about my result. If I missed that time slot then I'd have to wait until 12noon tomorrow.

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If you don't have employer provided health insurance, everything should be sorted out in January when the "Affordable Care Act" health care exchanges should be up and running. As a young person, the price is expected to be reasonable with no need for medical records. The following is the estimated cost of coverage for the "silver" plan in California. Cost may possibly be lower in other states.

http://www.coveredca.com/calculating_the_cost.html

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In the US, there as still some doctors that want to control everything 100% keeping the patent in the dark. In my case, my doctors were always very open providing me with a copy of the lab results but that wasn't the case for my maids doctor. He told her that she was pre-diabetic and put her on a strict diet but when I asked her about her glucose and AC1 readings, she didn't know and the doctor wouldn't give her the results even though she asked several times.

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I second that...even though we have spent a few thousand dollars on co-pays this year.

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I think the way the Kaiser system is set up, it'd be difficult to hide results. I guess it must be possible for various reasons, but those reasons would have to be justified. The wife, who works for Kindred, says that their system has similarities too, though not as "advanced" as Kaiser's. I notice that Kaiser's isn't entirely their own system either, but uses portions from some IT company's generic health IT system.

Meanwhile, how many billions has the NHS spent on a custom IT system which doesn't work. Not invented here.

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Yes, you certainly pay for it, and at hugely inflated costs. But then UK taxpayers each spent about £500 on that IT system which was scrapped.

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£500 is nothing compared to what you pay for healthcare here. It probably amounts to most people's monthly payment...not including co-pays etc.

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Usually it is the older private unaffiliated doctors that still may want to practice medicine the old way where the doctor controls the information and only gives out his diagnosis. That way he can keep in control and not have answer those pesky questions from people that get their information from the internet.

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£500 is two months premiums for our family. It's certainly not nothing - maybe it is to you on your Jersey mansion :p. My point is that the government effectively took £500 out of your pocket and burnt it in front of your eyes. I got nothing for that £500. At least here you'll get half a box of tissues for it.

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That's a strange argument. You could say US govt is taking x many dollars and burning them on defence, or whatever. It doesn't come out of your pocket like a premium or co-pay.

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Not sure what you mean. I simply meant that my 500 quid was completely wasted. At least with defence or whatever, something is happening with my money, be it a shiny new missile or whatever.:unsure: In both cases it's money that was taken out of my pay packet involuntarily. In the NHS case the UK government(s) chose to award an IT contract probably more based on backhanders than ability to achieve the contract (and there should probably be equal blame for the latter). Let's not forget the West Coast railway franchise which discovered more than just a little fraud going on, some of which we'll probably never know the full scale of. Government IT systems? Yeah... Time and time again they're massively over budget, over priced to begin with, fail to deliver, goalposts keep moving! Sorry, that ended up being a bit of a rant.

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Others might be able to provide details to or clarify what I'm about to add, as I have no direct experience with it.

As you have figured out, health is a business here, and there is no direct NHS equivalent. In the US, we have a law called HIPAA, which includes a concept called "creditable coverage". In effect, if you've had insurance within the last 62 days, then only pre-existing conditions that are less than six months old can be considered in the underwriting.

This is the part that I don't know, but which might help you: some insurers may accept your NHS coverage as a form of "creditable coverage." You would want to get some sort of certificate from NHS that proves that you have it, then hope for the best that it does you some good.

Also note that everything is going to change on January 1, assuming that the Republican lunatics in Congress don't repeal the new "Obamacare" healthcare bill (which they are unlikely to do.) At that point, health insurance coverage will be mandatory, and you cannot be denied a policy based upon preexisting conditions.

However, health insurance is essentially a state matter, and some of the right-wing states are not cooperating in setting up health care "exchanges" that would help you to get the insurance. It's also not clear yet how exactly this is going to work or whether it will result in lower prices. The US has the highest costs in the world, by far, and you'll probably suffer from sticker shock when you see how much that it costs.

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Plenty of defence programs have been cancelled without any return for the taxpayer investment in them.

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Thanks Everyone,

Your answers have been really helpful :thumb:

I've already collated my official vaccination records, since these were required for the UK medical as part of the visa process, and I'll be bringing them with me when I travel. I'm going to go with that, in hopes that it's sufficient without a signed letter from my GP.

I'm a healthy 28 year old with a healthier [and more attractive] 26 year old wife ;) Neither of us have any real medical history worth mentioning, and certainly nothing in the last two years, so hopefully acquiring insurance will be a relatively straightforward process.

I wasn't aware of the '62 days clause' but we'll be aiming to have insurance in place as soon as possible, if not before we even arrive in USA. Better to be safe than sorry I guess! Since haven't yet secured work in the US, we're going to be paying for this on our own dime. I think we'll just buy cover for the first six months, and by the time it expires we should be in work and able to leverage the coverage provided by our respective employers.

Happy to hear your thoughts if any of this sounds dumb though! :unsure:

Cheers,
Rich.

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Don't be tempted to use UK travel/holiday insurance for temp medical cover...because you are not tourists.;)

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Hi Jerseygirl,

This is a very good point! I was planning to do that until I had a lightbulb moment a few months ago and realised that at POE I would immediately become a Legal Permanent Resident of the United States, and therefore my insurance as a tourist would become void.

Very useful point to highlight for other readers though.

Cheers,
Rich.

Re: US Medical Insurance...
 

Vaccination record isn't proof of health cover at all.

Whilst you might not need a letter of proof, while you are still in the UK, get it.

Private medical insurance is far more sticky about these things and they will use anything to deny cover.

Might be worth getting a highlight of your medical history too, as mentioned, it makes a good baseline. Blood pressure and weight at the very least.

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For the benefit of those that might later be reading this thread; I contacted Knightsbridge Clinic here in London where I recently paid for a full medical examination as part of the CR-1 immigrant visa process.

I asked the receptionist if I could get a copy of my medical report, which they provided to the Visa Coordination Unit at the US Embassy. I was told that they were not authorized to provide me with a copy of my records, and upon request, they emailed me a copy of the attached letter. :thumbdown:

I had been hoping that since it was a recent medical examination, the records would have been available and helped me in terms of securing insurance in the States.

Cheers,
Rich.

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Have a look at the Wiki on health insurance - there are a couple of links at the bottom for temporary cover. But note that these do not count towards the 62 day continuous coverage and have very limited services available. But it's better than nothing IMHO.

Yeah, for the sake of a couple of tens of pounds, just do it. My incompetent GPs failed to do it before we left and I had to chase it up from the US. At least they acknowledged they did actually receive the request - if they hadn't, I doubt they would have written the letter after I left the UK.

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I strongly suggest that you watch a DVD (or download) the movie "Sicko" by Michael Moore (2.44 GBP with free supersaver delivery in the UK). He compares healthcare in the US, Canada, the UK, France and Cuba....it is a real eye-opener. :ohmy:

http://www.amazon.co.uk/Sicko-DVD/dp...+michael+moore

Actually you can get his other movies 'Bowling for Columbine', 'Fahrenheit 9/11' and 'Sicko' for just 8.44 GBP

http://www.amazon.co.uk/Michael-Moor...+michael+moore

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From your previous posts, it appears that you won't be arriving in the US until November. Normally insurance companies take at least a month before they approve insurance and they are usually a hassle. Since the exchanges should be operational January 1 and instantaneous approval is supposed to given, I'm not sure it is worth the effort to try to get health insurance prior to January 1 since you claim you are healthily. Health insurance companies using the exchanges have to accept you no matter what your medical condition so even if some medical condition props up in the month or two prior to the beginning of the year, you'll be covered at the beginning of the year.

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Hi Michael,

My wife and I are actually moving out to the States at the very beginning of July this year. Sorry for any confusion.

Cheers,
Rich.

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Hi All
UK NHS budget for 2012 was £104 billion
UK Total Income 2012 was £591.7 billion
Cost of NHS 17% of total UK Government income
Average wage in uk 2012 was £26,500
Average cost to fund uk NHS £4505 = £375.00 a month for average
wage earner

We all pay you just dont see it in the uk

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That isn't quite correct...people paying income tax pay for the NHS.

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The doctor probably didn't want to give her the results because they were under a baseline of 7.0. The American Diabetes Association says that an HbA1c under 7.0 is "controlled". The doctor probably thought that your maid wouldn't be motivated to stick to her diet if her numbers were "controlled." But it's not normal, let alone optimal. Normal is around 5. Your maid should be checking her blood sugar with a decent meter (I use the cheap one with the cheap strips from Wal-Mart) to make sure that her blood sugar stays as close to 90 as possible at all times and never spikes over 130 even after a high-carb meal. She does not need a prescription for the meter or the strips.

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Yes I totally understand that but it was just to indicate that the NHS is not free as a lot of people think. All Uk income tax payers pay a lot for the health service they receive and everybody pays for the NHS by paying tax in the form of VAT tax on petrol/ cigs/ insurance policies etc

All Uk tax revenue of whatever form goes into the general government treasury before it is dished out again to the various departments ie defence education.overseas aid (sore point) etc

What is important is that 17% of this (TAX) money goes to the NHS


Regards

Alan

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I know what you meant. ;)

The point is it is free at the point of service. If you need major surgery or have a major illness you need not worry about the cost. Of have to chose between meds or whether you can afford to eat that day.

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You get a better value for your money in the UK, and it better serves the goal of maintaining public health and welfare.

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6.5 is considered diabetic and below that along with higher than normal glucose readings is considered pre-diabetic. Time has long passed when the doctor was considered god which is what that doctor seems to think he is.

Those are her records and she has legal right to see them no matter what the doctor may think. He is breaking an important ethical rule in the profession.

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Medium family income was £26,500 and not average wage.

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http://www.bbc.co.uk/news/business-20442666

"The average annual earnings of full-time workers in the UK rose by 1.4% to £26,500 in the year to April 2012."