Health Insurance

[ajacks 3]

A useful way to compare non work private plans is to use www.healthcare.gov there is a insurance plan finder program that is compiled by state as a preliminary shopping mechanism for the aca. If SCOTUS does not overturn the law, there won't be any lifetime maximums for any health policy in any state.

[Darkmoonfaerie 19]

Also check into your state laws. In Massachusetts, I cannot purchase private health insurance unless my employer does not offer sponsored insurance. I'm self employed and the college where I teach part time does not sponsor insurance, so I have to purchase privately. If the school sponsored some, I'd have no choice but to take it and drop private pay. My current plan costs me about 50% more for private insurance than it would through an employer. I can't wait to have Alan here so he'll have insurance through his work and we can drop mine!

[gtoddv 1]

Hi all, thank you for reading and any advice you can give me!

I have not moved yet, still in K1 stage, but I am a planner, like I assume most of us here are.

My partner has health insurance through work, with Aetna Medical PPO, but in my opinion it is fairly mediocre coverage and I want him to change it and for us to have something in the works for when we get married once our K1 is approved (if we can).

I have not read anything good about this company and am so scared that if he gets sick (he has never been sick) he would not be covered and could not afford the out of pocket expenses for something costly like cancer.

My questions are:

1) Is it difficult to get coverage outside of work?

2) My partner pays $350 a month from his wages into his health insurance, does he lose that money if going off a work plan?

3) Can he even leave the work plan?

4) Coming from O/S (Australia) do I need to bring any medical records with me or will a company just cover me if I have nothing pre-existing?

4)a) What if something happened and or I had something pre-existing , would that mean I would have to join a high risk pool insurer?

4)b) Is there a time frame for pre-existing illnesses? IE/ If when I was 2, I had an illness and had it treated would I need to state that as a pre-existing condition ?

** Thanks already to Vanessa who has answered lots of my health insurance questions already! I am just sooo paranoid about health care in the US.

If most of what you have read about his insurance company has come from the Internet, you should probably take it with a grain of salt. People aren't going to bother reporting on things when they are going well, and they rarely report accurately enough to get the full picture. There is almost always a missing piece that would make their story less compelling. To hear people talk about my long term disability and health insurance companies, you'd think they were actively out to murder all their customers. I have never had a problem (worth mentioning) with either company. (and I have HUGE monthly treatment bills)

I wouldn't rock the boat as that can cause more trouble than it's worth. In most companies, health insurance is used to attract good employees. If the insurance is bad, it doesn't look good for the employer. (before I get flamed, I know that isn't the case for all employers)

Just try and relax and focus on getting through the immigration process. You will have plenty of time once you're together to PLAN away to your heart's content.

Good luck to both of you!

[Darkmoonfaerie 19]

I just thought of this...I get to see insurance companies from both the consumer and provider sides (I'm a Chiropractor). In my office, Aetna isn't my favorite plan to deal with/get payments from, but they are FAR from the worst company I deal with. They're good for customer service with me and my patients and fix errors quickly!

[momof1 205]

Be aware of mid year plan changes by some employers. Generally, you may have to have a qualifying even to change your coverage. That even could be : birth of a child, death or a family member, marriage, loss of coverage elsewhere etc... So, he may not be able to opt out of his current insurance until you are married.

Also, remember that most healthcare deductions through an employer are pre-tax deductions from your paycheck. This means that they decrease your tax liability which means you actually pay less in premiums. For example, adding my husband back to our healthcare when he returned to the US changed deduction from $80 to $195. However, the decrease in my paycheck was closer to $70(rather than the actual $115 increase) because of the decreased tax liability. Do your homework and figure out exactly what is included in his deductions because those may not be included in a private plan. Compare out of pocket costs as well to see what is really the best deal.

For my family, I pay approximately $285 every two weeks for a family of four. My employer contributes $515 every two weeks. It's very good insurance that I know I couldn't afford elsewhere. I work for a hospital and they want us to get service in our healthcare system so they reward us heavily for doing so. Basically, my plan includes: health insurance for two adults and two children, dental insurance for all of us, short term and long term disability, life insurance on myself, $3500 in a health savings account, and vision benefits. It's definitely not free but very reasonable in my opinion. I have a low family deductible($1200 max which is covered by the medical savings account), services covered at 100% and not subject to deductible in our healthcare system, $2000 out of pocket maximum per year, and a 10% coinsurance on procedures after the deductible.

[bigdog 376]

Stick with insurance via work, usually pretty standard without seeing the policy.

[AHandSD 1]

I suggest looking into a (tax deferred) medical savings account. It's pretty win-win, because you have money to supplement when the insurance falls short, you do not have to pay taxes on it, and, it stays with you even if your insurance changes.

In this way, you can keep the insurance--even though it might not be optimal--but at least your employer contributes to it, keep the money that you would have paid for a more expensive policy, and have the security of knowing that you're not just relying upon suboptimal insurance coverage.

You also have the option of using that money later for whatever you want (though at that point you will have to pay the taxes--that's the 'deferred' aspect, but you would have paid taxes on it anyway!).

Edited March 24, 2012 by AHandSD

[momof1 205]

Be careful bc there are differences between a medical savings acct and a health savings acct. The MSA doesn't roll over from year to year while the HSA does.

And, the MSA was previously called a flex spending acct and legislation forced changes to what's covered this year.

[Xanax 349]

Thanks everyone, it looks like we will keep our work insurance at least for now.

We may re-evaluate in 2014 when no one can be denied care under Obamacare.

We will open a health savings account if we can and if we ever need anything like IVF or anything we cannot get here in the US at a reasonable premium will we will travel to Australia.

[Amanda and Josh 12]

My husband has awesome health insurance and added us in open season. We are covered for pre-exsisting stuff (my daughter has cystic fibrosis) and they didn't question it, just sent a letter out confirming she is covered for it so i could take it if needed for our interview. I also am pregnant and they confirmed I am covered for the baby when I arrive. Apparently we will be out of pocket about $50 for having a baby. We are with Blue Cross

[Xanax 349]

I am really glad so many of you have "awesome" insurance, but we don't

[Amanda and Josh 12]

I am really glad so many of you have "awesome" insurance, but we don't

really? you were asking people about their insurance providers, pre exsisting conditions and having a baby. I am sorry your not happy with your insurance but I thought the point was you were asking who was happy to find out more information. would you prefer I not tell you who they are and their benefits when you specifically asked?

[Xanax 349]

really? you were asking people about their insurance providers, pre exsisting conditions and having a baby. I am sorry your not happy with your insurance but I thought the point was you were asking who was happy to find out more information. would you prefer I not tell you who they are and their benefits when you specifically asked?

Hi Amanda and Josh, firstly t hanks for your replies, but, actually no I didn't ask what you think I did.

I did not ask about having a baby, nor did I ask about anyone's insurance provider or if they were happy, I mentioned pre-existing conditions but I did not say I had any.

" My questions are:

1) Is it difficult to get coverage outside of work?

2) My partner pays $350 a month from his wages into his health insurance, does he lose that money if going off a work plan?

3) Can he even leave the work plan?

4) Coming from O/S (Australia) do I need to bring any medical records with me or will a company just cover me if I have nothing pre-existing?

4)a) What if something happened and or I had something pre-existing , would that mean I would have to join a high risk pool insurer?

4)b) Is there a time frame for pre-existing illnesses? IE/ If when I was 2, I had an illness and had it treated would I need to state that as a pre-existing condition ? "

Again, I really appreciate everyone's feedback, it has been especially helpful when people have explained how it all works, the links the the federal website, the explanation between HSA and MSA , the inbox messages I received re: how to get cover and with helpful info and when people have named companies with good policies and benefits ie/ bluecross.

Thank you , thank you, thank you

Edited April 4, 2012 by BrittandDan

[Amanda and Josh 12]

Your attitude was and is completely unnecessary. I was being chatty and friendly and merely telling you about our insurance. You did mention pre exsisting conditions and having a baby and I was telling you we managed to get insurance that covers ths without waiting times. I at no point pretended to answer all your questions but will be sure to not bother being friendly or engaging in friendly chatter with you ever again.

[Amanda and Josh 12]

I guess I just want protection against major things and good pregnancy cover.