Medical Insurance...SO Confused!

[VanessaTony 3,567]

The problem is one of demand/capacity and the cost of providing it rather than facilities, skill or equipment. Most UK hospitals are up to date in terms of buildings and kit but the endless growth in demand for more care and a wider range of medical services possible means rationing - much as it does in other healthcare models .

I've written and deleted more possible TOS violations in the last 15 mins than I have in a long time in response to that git you are responding to. So instead I will quote you and say - the same applies to Australia, not the statements he claims.

[VanessaTony 3,567]

Oh I see, what I meant was that I'll be there for about a month before we get married. It will then be about 3 months until my EAD comes through and I can then start to look for work. Im a qualified teacher so will hopefully be teaching, from what I've read the coverage for teachers is decent. The plan is to be put on my future husband's plan once we are married until I get a job, but I was unsure if I would be penalised for the month prior to marriage as I didn't realise that I could get temporary insurance during that time.

In terms of the NHS, I meant I was spoilt by not having to think about insurance, payment, complicated plans etc. the minuses you mention are definitely there, but I've never had to think about medical insurance which is probably why it's taking me a while to get my head around the US system.

Honestly there are still so many unknowns about how the Healthcare Reform will affect people that I don't think anyone can tell you anything for certain.

I CAN tell you that a K1 is a non-immigrant visa, and you could (successfully) argue that you are simply a visitor here until your legal status says otherwise, which is why travel insurance shouldn't be a problem.. I would confirm with the plan though. You are not legally authorised to remain in the US, technically, until you receive the GC. You are in a "period of authorised stay" when you file for AOS, but that simply means you don't HAVE to leave until the decision is given, it doesn't convey any legal status at all, it just removes your "illegal" status while it's pending.

The month difference, I wouldn't think you will need to ensure coverage for a time where you're not eligible for coverage. I could imagine that they'll most likely date your requirements for health insurance from your GC, as at that time you're a legal resident of the US and should have a SSN and all that's required to be enrolled. There would probably be some sort of test to determine whether you're required to have coverage. For example USC's are always required to file US tax returns (on worldwide income, no matter where they live), but I doubt they'd be penalised for not having insurance in the US, probably some sort of "presence" test.

Have you looked into how your qualifications translate to here in the US for your teaching? I know for nurses they need to take a qualifying exam. Is there something similar you need to do?

[rhirhi 35]

Honestly there are still so many unknowns about how the Healthcare Reform will affect people that I don't think anyone can tell you anything for certain.

I CAN tell you that a K1 is a non-immigrant visa, and you could (successfully) argue that you are simply a visitor here until your legal status says otherwise, which is why travel insurance shouldn't be a problem.. I would confirm with the plan though. You are not legally authorised to remain in the US, technically, until you receive the GC. You are in a "period of authorised stay" when you file for AOS, but that simply means you don't HAVE to leave until the decision is given, it doesn't convey any legal status at all, it just removes your "illegal" status while it's pending.

The month difference, I wouldn't think you will need to ensure coverage for a time where you're not eligible for coverage. I could imagine that they'll most likely date your requirements for health insurance from your GC, as at that time you're a legal resident of the US and should have a SSN and all that's required to be enrolled. There would probably be some sort of test to determine whether you're required to have coverage. For example USC's are always required to file US tax returns (on worldwide income, no matter where they live), but I doubt they'd be penalised for not having insurance in the US, probably some sort of "presence" test.

Have you looked into how your qualifications translate to here in the US for your teaching? I know for nurses they need to take a qualifying exam. Is there something similar you need to do?

That's fantastic, thank you so much. The picture is slowly becoming a little more clear!

In terms of teaching I'll just have to get my MA licensure. The only qualification they require is a bachelor's degree which I THINK is similar enough to not need translation. I was looking into having my GCSEs and A levels translated but it doesn't look like that will be necessary. I might end up doing TA work or something until my fiancé and I get on our feet cos I know the teaching license costs, in terms of study time as well as $$.

[Harpa Timsah 13,258]

Thanks for this and for those that might not know it is really important to understand how American healthcare insurance works. (and I am only just learning myself)

a) Coverage does not equal no big bills - you really really need to understand what is covered and how much is covered. Just look at the examples of the different bills a patient might get between fixed and comprehensive plans on that site

b) You really do need to make sure that *anyone* you see in a medical context is covered by your insurance(in network) otherwise a bill will arrive one day and it may well not be covered by your insurer.

I particularly love the attempts (often illegal) to bill for the difference between what your insurer pays the provider and the going rate from the provider. Balance billing

Just to explain, what you do is go to your insurers website and look for doctors there. They will find you all the doctors that are good for your insurance, pretty easy. Any decent insurance will have tons and tons of doctors to see. Once you find one you like you just keep going back to them, no big deal.

All emergency hospital visits are covered so you don't have to travel further to go to a "network" hospital when you are at risk of dying.

That fiance insurance link looked a little scammy to me...

[Ozz777 23]

She's probably concerned because she will most likely enter and marry her USC spouse before the end of 2012 and therefore be required to file her taxes here in the US (income or no). It's also more beneficial for her then husband to include her so that he gets a bigger tax break.

Last I checked, you don't have to file income tax if you make under roughly 10k. But I understand what you are saying.

[Ozz777 23]

I've written and deleted more possible TOS violations in the last 15 mins than I have in a long time in response to that git you are responding to. So instead I will quote you and say - the same applies to Australia, not the statements he claims.

I know, Australians love their medicare. Sorry my statements riled you up so much.

[VanessaTony 3,567]

Last I checked, you don't have to file income tax if you make under roughly 10k. But I understand what you are saying.

She doesn't *have* to no, but she is required to show proof of "co-mingling" of assets etc for AOS, ROC and later N-400, and tax returns are one of the main evidence. Whether she filed separate or joint (I filed 2009 - 2011 joint, 2012 separate) it doesn't matter but the joint address does.

It's pain but until an immigrant naturalises they pretty much have to consider the immigration ramifications of every decision. Ensuring they have joint bank accounts, update their drivers licenses if/when they move to show joint address, putting both names on health insurance, phone bills, lease etc... it makes for a much smoother process down the line... and a great bonfire after naturalisation!

[Protocol417 161]

Just to explain, what you do is go to your insurers website and look for doctors there. They will find you all the doctors that are good for your insurance, pretty easy. Any decent insurance will have tons and tons of doctors to see. Once you find one you like you just keep going back to them, no big deal.

To add one more thing, when you do a search for a doctor, make sure you call their office to verify they're accepting new patients.

When I switched to my current insurance, I had to go through a page and a half of doctors on the approved list before I found one that was accepting new patients.

[Harpa Timsah 13,258]

To add one more thing, when you do a search for a doctor, make sure you call their office to verify they're accepting new patients.

When I switched to my current insurance, I had to go through a page and a half of doctors on the approved list before I found one that was accepting new patients.

Oh wow, I've never been told an office is not accepting new patients. Interesting. (scary! )

[Nich-Nick 3,354]

Oh wow, I've never been told an office is not accepting new patients. Interesting. (scary! )

My hand surgeon told me when Obamacare gets rolling it is going to be hard to find a new doctor, especially for those approaching Medicare. He said it's not that we don't want to treat people, we just can't afford to. I am very worried.

[Protocol417 161]

Oh wow, I've never been told an office is not accepting new patients. Interesting. (scary! )

Nah, there were doctors available, it just took a bit of hunting. I only mentioned it because it wasn't something I wouldn't have thought to do, except that my insurer required that I select a doctor during my application process. That's when I discovered that many weren't accepting new patients. If I had waited until I was actually sick and in need of a doctor, it would've been a much bigger problem.

[Harpa Timsah 13,258]

My hand surgeon told me when Obamacare gets rolling it is going to be hard to find a new doctor, especially for those approaching Medicare. He said it's not that we don't want to treat people, we just can't afford to. I am very worried.

My father is a doctor, a very popular one at that, and I have never heard him say that he doesn't accept new patients. If he is busy someone else in the office can see the patient, no problem.

I don't see why Obamacare would change that. Each new patient they see is more money for them (unfortunately the system is profit driven). So any new patient is more money. If the whole practice is booked full then there will be a higher demand for more doctors, which is a good thing. But I don't see that happening. Do you think that once Obamacare gets going and everyone can afford hand surgery that suddenly millions of people will rush to get it and there will be no available doctors? Most anyone who needs hand surgery can get it, even in our current system.

It seems to me that the doctor was trying to spread ill will over Obamacare. His comments don't make sense to me.

[Nich-Nick 3,354]

My father is a doctor, a very popular one at that, and I have never heard him say that he doesn't accept new patients. If he is busy someone else in the office can see the patient, no problem.

I don't see why Obamacare would change that. Each new patient they see is more money for them (unfortunately the system is profit driven). So any new patient is more money. If the whole practice is booked full then there will be a higher demand for more doctors, which is a good thing. But I don't see that happening. Do you think that once Obamacare gets going and everyone can afford hand surgery that suddenly millions of people will rush to get it and there will be no available doctors? Most anyone who needs hand surgery can get it, even in our current system.

It seems to me that the doctor was trying to spread ill will over Obamacare. His comments don't make sense to me.

I know nothing about Obamacare so can't say. I believe his point was cuts coming to what Medicare will pay him means given a choice to fill his schedule with Medicare patients paying x and other insured paying y, many may not accept "new" Medicare patients to keep from going in the red. Yes, they would keep their current patients who age into Medicare. He gave me some number which I forgot, but basically said "It costs me $250/hr. just to unlock the door each day and pay for the office, staff, utilities, insurance, and if I have any left over at the end of the day I might get to pay off some of my education bills. I dunno. But I have had the fortune of excellent insurance since birth and the benefit of hand picking the best of the best in the largest medical center in the world. The idea of having to accept a ghetto clinic is scary and foreign to me. I'm sorry some people have no choice, and I realize I have been fortunate. I'm blessed that my father made good decisions and worked hard and taught me his values for saving. He was just a poor kid who picked cotton and didn't even finish high school. I hope I don't come across as sounding posh, because I'm not. I just don't want to be dumped as an elderly person. We shall see how it all plays out because I have no clue. It's a political football for sure and I just don't get into politics because I don't believe any of them.

[Harpa Timsah 13,258]

By that logic there would be no incentive for any doctor to keep any medicare patient, except by some sense of "loyalty." Any practice without a sense of loyalty would just chuck them all in favor of other patients, and I don't see that happening.

The thing with insurance is that they have artificially inflated the prices of medicine. So, say, a doctor's visit costs $50, but the insurance demands that the doctor bill it at $250. Then the insurance pays "$250" and the $50 it really costs goes to the practice, but on the bill it shows more. So insurance has this totally artificial means of increasing costs on paper while nothing in practice really changes. Then, before Obamacare, the insurance could say, "Hey! Mr. Patient! You reached your lifetime limit of a million so you are done!" (while of course that limit was reached by inflating the prices). Obamacare banned lifetime limits on insurance payout, but as far as I know didn't change this practice, unfortunately. That's also why the immigrants in this thread are shocked about the "cost" of things. A lot of those figures are artificial.

That's also why if you say you are paying in cash the doctor/hospital will quote you a figure at like a quarter the normal price. The "normal" price is what the insurance forces the place to "charge." When they don't have to go through insurance they can charge you the real price.

So, I don't know all the ins and outs either, but I don't think there is cause to worry. Early signs show a lot of good things happening. If anyone were to get left out and unable to get care, that would be contrary to the whole point of this thing, and I (and I am sure many others) will fight!

Edited July 25, 2013 by Harpa Timsah

[Owen_London 65]

By that logic there would be no incentive for any doctor to keep any medicare patient, except by some sense of "loyalty." Any practice without a sense of loyalty would just chuck them all in favor of other patients, and I don't see that happening.

Can you explain why you "don't see that happening"? A doctor's office in the US is a business just like any other.