# Medical Insurance



## chrissyG (Jun 17, 2009)

Hi everyone  new here, hoping to move to US on a fiance visa in 3 months time & trying to figure out how to get medical insurance. Got lots of quotes & then told that I won't be eligible to take out any insurance until have been in US for 12 months. Got quotes from here (BUPA) & 3x as expensive, so anyone know any way round this or any good companies/plans? :confused2:

Not too bothered about me since I'm A1 health-wise but really want my 14 year old covered.
Thanks
Chrissy (will definitely miss our NHS)


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## twostep (Apr 3, 2008)

Is your future husband isured? If so - through his employer or independent?


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## Fatbrit (May 8, 2008)

Is your future spouse employed with health insurance? If so, look at jumping on that ticket. Or are you going to get a job yourself? Look for one with health insurance. IMO, current individual policies are an expensive waste of time since they will happily exclude anything you're ill with. Expect this to change in the near future, though. A major health care bill is just around the corner.

Anyway, have a look here or similar sites.

Health insurance in the US is a whole new language. Expect to take time learning the terminology.


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## chrissyG (Jun 17, 2009)

twostep said:


> Is your future husband isured? If so - through his employer or independent?


Unfortunately no, otherwise that would have probably been the best way; he, like me, prefers alternative medicine & also works for himself so hasn't got employee cover, he hasn't been to a doctor for decades.


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## patusa (Jun 17, 2009)

chrissyG said:


> Unfortunately no, otherwise that would have probably been the best way; he, like me, prefers alternative medicine & also works for himself so hasn't got employee cover, he hasn't been to a doctor for decades.


hi i am an newbie i am soon to be an expat to i will miss nhs to dont know what you got til its gone has anyone said anything to you about medicare i am not sure how it works but maybe you can ask about that good luck in your new life


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## chrissyG (Jun 17, 2009)

patusa said:


> hi i am an newbie i am soon to be an expat to i will miss nhs to dont know what you got til its gone has anyone said anything to you about medicare i am not sure how it works but maybe you can ask about that good luck in your new life


As I said in my original post, I have already got lots of quotes - so have heard of medicare thanks.


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## patusa (Jun 17, 2009)

chrissyG said:


> As I said in my original post, I have already got lots of quotes - so have heard of medicare thanks.


ok all the best then hope all goes well for you


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## A8NNC (Sep 4, 2008)

*Insurance cover*

Hi
We are also moving to the States and wanted to get cover for at least the first year, if you call American Express they can off a one year policy it is called a Gap Year Policy - I think and it will cover you for emergencies dental etc there is an excess, but for us a family of 3 my daughter is 17 it is approx £675. My brother took something like this out for his first year and they have used it a few times, it is a good policy to start with....


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## chrissyG (Jun 17, 2009)

Thank you A8NNC 
I have just filled in an on-line form for American Express. I assume the £625 was per month, seems more expensive than the schemes I've been sent, but I've been looking at ones with a deductible of $3000+ a year, since we're both in very good health.


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## A8NNC (Sep 4, 2008)

chrissyG said:


> Thank you A8NNC
> I have just filled in an on-line form for American Express. I assume the £625 was per month, seems more expensive than the schemes I've been sent, but I've been looking at ones with a deductible of $3000+ a year, since we're both in very good health.


Hi 
No this is for a year, it is like a travel insurance policy but you can return back to the UK (not sure how many times) they have quite a few different policies, but it is mainly emergency cover - but with an excess on it. For the first year until you decide what to do it seems ok. As i said my brother and his family have it and have used it for dental emergency and calling out doctors and they paid up ok. Ring American Express and explain and they will tell you the best policy for a year. Bupa are thousands per year even if you are a member here, at least by taking this policy you are covered until you decide what to do. They will email you the quote and you can see exactly what it covers.


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## chrissyG (Jun 17, 2009)

A8NNC said:


> Hi
> No this is for a year, it is like a travel insurance policy but you can return back to the UK (not sure how many times) they have quite a few different policies, but it is mainly emergency cover - but with an excess on it. For the first year until you decide what to do it seems ok. As i said my brother and his family have it and have used it for dental emergency and calling out doctors and they paid up ok. Ring American Express and explain and they will tell you the best policy for a year. Bupa are thousands per year even if you are a member here, at least by taking this policy you are covered until you decide what to do. They will email you the quote and you can see exactly what it covers.


WOW!!! :clap2:Thank you so much  that is amazing :eyebrows:- I always have holiday insurance when I go abroad & last year got a year long insurance (with SAGA) but it only covers for being abroad up to 3 months at a time, I had asked if they could do one for a year & they said they couldn't.

That is going to save me so much money in the first year & we'll be coming back to UK for at least one holiday during that time anyway.
I had contacted BUPA first, before the american companies & was a bit shocked that there quote was over £9000 for me & 14 year old, even with good health, no smoking, no alcohol & not overweight - seemed far too much.


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## JohnSoCal (Sep 2, 2007)

patusa said:


> hi i am an newbie i am soon to be an expat to i will miss nhs to dont know what you got til its gone has anyone said anything to you about medicare i am not sure how it works but maybe you can ask about that good luck in your new life


You have to be 65 or older to receive medicare.


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## Bevdeforges (Nov 16, 2007)

JohnSoCal said:


> You have to be 65 or older to receive medicare.


And for someone who has not paid into the US social security system, you need to have been a permanent resident in the US for at least 5 years to qualify for Medicare.
Cheers,
Bev


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## JohnSoCal (Sep 2, 2007)

Bevdeforges said:


> And for someone who has not paid into the US social security system, you need to have been a permanent resident in the US for at least 5 years to qualify for Medicare.
> Cheers,
> Bev


Being a permanent resident for 5 years is NOT a requirement. Below is the list of requirements.

"Who qualifies for Medicare? All American citizens and permanent residents over age 65 qualify for Part A Medicare if they meet one of the following requirements:


Eligible for or receiving Social Security benefits
Eligible for or receiving Railroad Retirement benefits
You worked in a government job for a minimum amount of time during which payments were made into Medicare on your behalf.
Your living, diseased, or divorced spouse met any of the above criteria


If you are over 65 and don't meet one of those "who qualifies for Medicare" criteria, you can still access the health plan by paying a premium for it.

Additionally, there are people who qualifies for Medicare who are under 65. for instance, people with end stage renal disease or Lou Gehrig's disease also qualify.

Anyone who qualifies for Part A Medicare also automatically qualifies for Part B Medicare. You should be aware however that while Part A is free, there is a monthly premium for Part B. People who do not qualify for Part A can still pay for Part B under certain conditions.

Part A medicare is the original plan and is still operated by the government. It covers hospital services. Part B is medical insurance for seniors and covers doctor's visits, outpatient care and the like. 

If you qualify for Part A and Part B, you will also qualify for Parts C and D. Part C replaces parts A and B with a more comprehensive insurance plan including prescription drug benefits at a more expensive price. Part D provides prescription drug benefits to people on Parts A and B."

My mother was a permanent resident ( GC ) but did not qualify. She was able to get medicare by paying for part A ( normally free ). She paid about $300 /mo but that was 9 years ago. I am sure it is much higher now. She paid the regular premium for part B that everybody pays. Parts C and D did not exist then.

I have a Medicare Advantage Plan from Healthnet. I pay zero premium and zero co-pays and it also includes Part D ( prescriptions ) at no cost to me. It also includes free gym membership and a lot of other things. I have my choice of more than 15 different Medicare Advantage plans from various companies.


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## Bevdeforges (Nov 16, 2007)

JohnSoCal said:


> Being a permanent resident for 5 years is NOT a requirement. Below is the list of requirements.
> 
> "Who qualifies for Medicare? *All American citizens and permanent residents over age 65 *qualify for Part A Medicare if they meet one of the following requirements:


From the Medicare website: 

_>>If you are not a U.S. citizen or a lawfully admitted alien who has lived in the U.S. continuously for a five-year period, please contact Social Security at 1-800-772-1213 for your Medicare enrollment and eligibility. <<_

If you are not a citizen or lawfully admitted alien, the qualification criteria are different. Practically speaking, if you haven't contributed to the US Social Security system due to your immigration status, the five year residence rule usually applies. It's only logical that you have to have contributed to be eligible.
Cheers,
Bev


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## Fatbrit (May 8, 2008)

JohnSoCal said:


> Being a permanent resident for 5 years is NOT a requirement. Below is the list of requirements.


What Bev said.


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## JohnSoCal (Sep 2, 2007)

Bevdeforges said:


> From the Medicare website:
> 
> _>>If you are not a U.S. citizen or a lawfully admitted alien who has lived in the U.S. continuously for a five-year period, please contact Social Security at 1-800-772-1213 for your Medicare enrollment and eligibility. <<_
> 
> ...


I agree that you must be a US citizen or legal resident. However, the 5 years does not apply if you are a legal resident of 65 and pay for part A and B. My mother turned 65 just 2 years after entering the US and enrolled in Medicare but she had to pay for part A. In fact if she had waited, she would have had to pay a penalty for every month she waited past being eligible.

The Medicare rules that you have cited does not say you can't get Medicare. It just says that you have to contact SS.


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## Bevdeforges (Nov 16, 2007)

JohnSoCal said:


> I agree that you must be a US citizen or legal resident. However, the 5 years does not apply if you are a legal resident of 65 and pay for part A and B. My mother turned 65 just 2 years after entering the US and enrolled in Medicare but she had to pay for part A. In fact if she had waited, she would have had to pay a penalty for every month she waited past being eligible.
> 
> The Medicare rules that you have cited does not say you can't get Medicare. It just says that you have to contact SS.


John, the OP was asking about health insurance for a UK national coming to the US on a fiancé visa - where her future husband does not have employer-provided health insurance in the US. Under the circumstances, it's highly doubtful that Medicare is an option for her at this time. 
Cheers,
Bev


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## chrissyG (Jun 17, 2009)

Bevdeforges said:


> John, the OP was asking about health insurance for a UK national coming to the US on a fiancé visa - where her future husband does not have employer-provided health insurance in the US. Under the circumstances, it's highly doubtful that Medicare is an option for her at this time.
> Cheers,
> Bev


Thanks for all the advice :cheer2:
I don't see the difference between getting medicare by paying the monthly premium & getting any other medical insurance, is it just that it's state(country)-owned? 
I have enough unearned income so won't be in a position of having insufficient funds & wouldn't want to qualify on that basis anyway, but is there an advantage to being with the medicare scheme rather than another provider?

Sorry still confused :confused2:


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## JohnSoCal (Sep 2, 2007)

Bevdeforges said:


> John, the OP was asking about health insurance for a UK national coming to the US on a fiancé visa - where her future husband does not have employer-provided health insurance in the US. Under the circumstances, it's highly doubtful that Medicare is an option for her at this time.
> Cheers,
> Bev


This is not about the OP but was in reply to the person that mentioned medicare in their post.


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## JohnSoCal (Sep 2, 2007)

chrissyG said:


> Thanks for all the advice :cheer2:
> I don't see the difference between getting medicare by paying the monthly premium & getting any other medical insurance, is it just that it's state(country)-owned?
> I have enough unearned income so won't be in a position of having insufficient funds & wouldn't want to qualify on that basis anyway, but is there an advantage to being with the medicare scheme rather than another provider?
> 
> Sorry still confused :confused2:


There is a big difference but Medicare is not an option unless you are 65 and a legal resident of the US. There are not many options for people over 65 other than straight Medicare or Medicare approved private insurance such as the Medicare Advantage plans like I have. The Medicare web site lists the private plans available in your locality. Most people who have straight Medicare also buy a Medigap policy that covers the deductibles, etc. that Medicare doesn't. The premiums are pretty cheap. My mother switched to a Medicare Advantage plan a year after having regular Medicare. She had the option to continue paying the government for Part A and B or to pay the insurance company directly which was cheaper. I handled all her financial affairs so am very familiar with it.

All private Medicare Advantage plans have to be approved by Medicare and meet their standards. They have to accept everybody that qualifies for Medicare and lives in a locality where the plan is offered. The insurance companies offering Medicare Advantage plans are paid a monthly fee ( $1000+ /month ) from the US government for each subscriber. The private companies compete with each other on service and cost. Some are very good and some are not so good. This can easily be checked out by looking at their ratings. Many of them do not charge any premiums and offer much more extensive coverage than regular Medicare. These private plans are not available in all parts of the country. They are very strong in California. There are currently 10 million subscribers to the the Medicare Advantage plans.


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## Fatbrit (May 8, 2008)

chrissyG said:


> Sorry still confused :confused2:


Forget the Medicare talk on this thread. If you have a 14-year-old, I'm guessing Medicare's not going to be a factor in your life for some time to come.


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## JohnSoCal (Sep 2, 2007)

I agree that Medicare is most likely not applicable to the OP. As I said. I only mentioned it because of another post. However the discussion about Medicare has been very useful to others. I received a Private Message thanking me for the Medicare info as it affects them directly. I am a member and moderator of forums on other web sites. Most threads regarding a general topic like Healthcare go off in different directions as more people post about their questions and experiences. This is NOT a bad thing as the whole purpose is to provide information to all who want it and not just the OP.


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## chrissyG (Jun 17, 2009)

I'll be 57 when I go so not far off retirement


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## chrissyG (Jun 17, 2009)

but why wouldn't it be applicable? because I won't be working full-time there? - I'll be buying property to rent out & getting my private pension in 3 years time


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## Fatbrit (May 8, 2008)

JohnSoCal said:


> I agree that Medicare is most likely not applicable to the OP. As I said. I only mentioned it because of another post. However the discussion about Medicare has been very useful to others. I received a Private Message thanking me for the Medicare info as it affects them directly. I am a member and moderator of forums on other web sites. Most threads regarding a general topic like Healthcare go off in different directions as more people post about their questions and experiences. This is NOT a bad thing as the whole purpose is to provide information to all who want it and not just the OP.


I have no problem with threads wandering. Sometimes I try and split them if it's possible. If not and a poster is getting confused, we'll try and tell them what to ignore.


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## JohnSoCal (Sep 2, 2007)

chrissyG said:


> but why wouldn't it be applicable? because I won't be working full-time there? - I'll be buying property to rent out & getting my private pension in 3 years time


It may be applicable. Buying property for rental and receiving a private pension does not affect qualifying for Medicare. If your husband qualifies for Medicare than you will also qualify the same as any American when you reach 65. My wife has never worked but she receives the same benefits as I do by virtue of being my spouse.


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## chrissyG (Jun 17, 2009)

That is very useful info, thanks a lot to everyone, things are certainly becoming clearer. Now I just need to get a good accountant to talk me through the tax structure when I'm there.


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## Bevdeforges (Nov 16, 2007)

chrissyG said:


> That is very useful info, thanks a lot to everyone, things are certainly becoming clearer. Now I just need to get a good accountant to talk me through the tax structure when I'm there.


Here's a money-saving hint: rather than an accountant, try and find an "enrolled agent." EAs are specialists in taxation, tested and certified by the IRS. They normally are considerably less expensive to consult than accountants (CPAs), and very often are more oriented toward personal taxes and small businesses.

There are also tons and tons of books on the market about US taxes. One of the best starting points is Publication 17 from the IRS - which is basically "Everything you Ever Wanted to Know About Federal Income Taxes" and is available for free on the IRS website or from a local IRS office.

State taxes very often start from your completed Federal income tax form.
Cheers,
Bev


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## chrissyG (Jun 17, 2009)

JohnSoCal said:


> There is a big difference but Medicare is not an option unless you are 65 and a legal resident of the US. There are not many options for people over 65 other than straight Medicare or Medicare approved private insurance such as the Medicare Advantage plans like I have. The Medicare web site lists the private plans available in your locality. Most people who have straight Medicare also buy a Medigap policy that covers the deductibles, etc. that Medicare doesn't. The premiums are pretty cheap. My mother switched to a Medicare Advantage plan a year after having regular Medicare. She had the option to continue paying the government for Part A and B or to pay the insurance company directly which was cheaper. I handled all her financial affairs so am very familiar with it.
> 
> All private Medicare Advantage plans have to be approved by Medicare and meet their standards. They have to accept everybody that qualifies for Medicare and lives in a locality where the plan is offered. The insurance companies offering Medicare Advantage plans are paid a monthly fee ( $1000+ /month ) from the US government for each subscriber. The private companies compete with each other on service and cost. Some are very good and some are not so good. This can easily be checked out by looking at their ratings. Many of them do not charge any premiums and offer much more extensive coverage than regular Medicare. These private plans are not available in all parts of the country. They are very strong in California. There are currently 10 million subscribers to the the Medicare Advantage plans.


(Silly of me but I only just saw this post.) 

I find this info amazing :shocked: am I right in thinking you are saying that effectively the government does cover medical costs for everyone over 65, if they can't themselves, so that there is a state medical system of sorts. Also seems like you're saying the premiums are subsidized so aren't as high as I'd assumed  since I was extrapolating & thinking as I got older they would rocket up. I was assuming a starting premium of about $3/4000 a year with a deductible of about $3/4000 which might go up to about $10000 a year & I'll be very happy if this isn't the case since I'm certainly not rich.
Thanks


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## chrissyG (Jun 17, 2009)

Bevdeforges said:


> Here's a money-saving hint: rather than an accountant, try and find an "enrolled agent." EAs are specialists in taxation, tested and certified by the IRS. They normally are considerably less expensive to consult than accountants (CPAs), and very often are more oriented toward personal taxes and small businesses.
> 
> There are also tons and tons of books on the market about US taxes. One of the best starting points is Publication 17 from the IRS - which is basically "Everything you Ever Wanted to Know About Federal Income Taxes" and is available for free on the IRS website or from a local IRS office.
> 
> ...


I did think about getting a book on US taxation when I got there, but felt it might be too complex for me,:noidea: although years ago I did my own book-keeping to trial balance so maybe I should have more confidence. It's generally better to do stuff yourself anyway & you obviously learn more that way & become self-reliant - cheaper too. I have made a note of the publication & it'll be a good starting point & will also look for an EA for when I feel I need some extra advice. 

Thank you so much for taking the trouble to reply to me :thumb: I felt I was going into an adventure on my own and although eager, was also considering that I'd have quite a bit of research & adjusting to do, but I can see I've hit gold with this website. :grouphug:


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## JohnSoCal (Sep 2, 2007)

chrissyG said:


> (Silly of me but I only just saw this post.)
> 
> I find this info amazing :shocked: am I right in thinking you are saying that effectively the government does cover medical costs for everyone over 65, if they can't themselves, so that there is a state medical system of sorts. Also seems like you're saying the premiums are subsidized so aren't as high as I'd assumed  since I was extrapolating & thinking as I got older they would rocket up. I was assuming a starting premium of about $3/4000 a year with a deductible of about $3/4000 which might go up to about $10000 a year & I'll be very happy if this isn't the case since I'm certainly not rich.
> Thanks


No, the premiums are not subsidized. No, not everyone over 65 is covered. Every US citizen and legal resident is covered if they met the requirements. Rather than reiterate everything, I am giving you the link to the official Medicare web site for the qualifications. It is interactive.

Medicare.gov - Medicare Eligibility Tool (Eligibility Questions)

By the way, it is not automatic. You do have to apply for it.

The Medicare Advantage plans are offered by private insurance companies and must be approved by Medicare and follow their rules. They are not offered in all localities. Basically the government pays them $1000+ /month for each subscriber that qualifies for free Part A Medicare and is enrolled in part B. Medicare part B is optional and costs $96 /mo for everybody. The premium is higher for high income people ( $170,000 /yr for a couple ). The insurance company can offer whatever additions they want and can add additional premiums if they want. You can also check them out on the official Medicare web site. Many do not charge any premium. Whether they charge a premium or not is not an indicator of the quality. Most of the highest rated ones do not charge any premium.

Personally, I have had one of Health Net's Medicare advantage plans for 4 years. I pay no premiums, zero co-pays for any doctor ( general or specialist ), zero for labs or diagnostics etc. I do not pay any premium for prescription drug coverage. It even includes free gym membership. Each plan has a network of doctors, hospitals, etc. that you go to within your locality. The size of their network is an important factor to consider. My plan has 5000 doctors in its network. Other plans may only have 500. You do have coverage worldwide for any illness or injury requiring treatment.

Doctors, labs, etc. have a free choice whether they wish to belong to an insurance plan's network or Medicare. Most of them do.

If you don't meet qualifications for free Medicare part A then you can still enroll in it or a Medicare Advantage plan by paying a premium for it. This premium is not subsidized and won't be cheap. Most people that have regular Medicare and not an Advantage plan also buy a Medi-gap policy from an insurance company. It basically fills in the gaps not covered by regular Medicare and has a low premium.

Some of the medical insurance offered is from non-profit organizations. Also some states have their own health insurance.

I have only given you the basics. It by no means is a complete explanation. You can do your own research on the Internet by searching for "Medicare", "Health Insurance", or some other related term.


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## chrissyG (Jun 17, 2009)

JohnSoCal said:


> No, the premiums are not subsidized. No, not everyone over 65 is covered. Every US citizen and legal resident is covered if they met the requirements. Rather than reiterate everything, I am giving you the link to the official Medicare web site for the qualifications. It is interactive.
> 
> Medicare.gov - Medicare Eligibility Tool (Eligibility Questions)
> 
> ...



I only meant subsidised in the sense that the health scheme is, because the government pays them $1000 for each subscriber. Thank you so much, I understand the system now & have just checked out the site, I've made notes & a reminder for me to apply when I'm 65, I'll have been in US the 5 year qualifying period by then.

Thanks again :usa2:


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## chrissyG (Jun 17, 2009)

A8NNC said:


> Hi
> No this is for a year, it is like a travel insurance policy but you can return back to the UK (not sure how many times) they have quite a few different policies, but it is mainly emergency cover - but with an excess on it. For the first year until you decide what to do it seems ok. As i said my brother and his family have it and have used it for dental emergency and calling out doctors and they paid up ok. Ring American Express and explain and they will tell you the best policy for a year. Bupa are thousands per year even if you are a member here, at least by taking this policy you are covered until you decide what to do. They will email you the quote and you can see exactly what it covers.


Thanks again for suggesting this, it would have been a brilliant idea, unfortunately there is an age cut-off of 49  & I am 56, so they wouldn't let me do this. I may get this for my children though. Am still looking at policies.....


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## Elphaba (Jan 24, 2008)

I have an unrelated question regarding US medical insurance and would appreciate some information.

I have an American client, currently resident in the UAE, for whom I am arranging medical insurance. The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.

My question therefore, is would he be likely able to obtain some sort of continuous cover upon his return? Full claims history would be available for medical underwiting, but he would want a plan where any existing conditions would be covered on what is called 'no worse terms'. I simply require an 'in principle' answer, not recommendations.

Many thanks for your assistance.

-


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## Bevdeforges (Nov 16, 2007)

Elphaba said:


> The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.
> 
> My question therefore, is would he be likely able to obtain some sort of continuous cover upon his return? Full claims history would be available for medical underwiting, but he would want a plan where any existing conditions would be covered on what is called 'no worse terms'.
> -


Medical insurance in the US is a highly charged (at this moment) and very complicated matter. Basically, nothing regarding his prior claims history is going to help him on his return to the US. 

Under normal circumstances, medical insurance is a benefit offered by your employer - with the premiums either covered or split between employer and employee. You do everything in your power to avoid having to buy medical insurance on your own because it's just too darned expensive that way, even if you're perfectly healthy and have no bad habits (i.e. smoking, sky diving or other "dangerous pursuits").

Short of having an employer who offers insurance, some people are able to insure through a club, church or professional association. But single policies are to be avoided like the plague unless you have lots of money to throw around.
Cheers,
Bev


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## Fatbrit (May 8, 2008)

Elphaba said:


> I have an unrelated question regarding US medical insurance and would appreciate some information.
> 
> I have an American client, currently resident in the UAE, for whom I am arranging medical insurance. The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.
> 
> ...


The first thing to note is that there is a major health care bill in the air at the moment that could change everything or nothing. So future planning is generally difficult at the present time.

There are two sorts of healthcare insurance: group and individual plans. Group plans are commonly offered by employers or associations.

For the group, conditions are either covered for everyone or excluded for everyone, whereas for individual plans the insurer can exclude conditions for individuals. The continuous coverage comes in with both of these in the period where there is a delay before coverage starts. A foreign policy should be good, and I can, for example, tell you that the UK's NHS coverage usually counts.

Health insurance in the US is currently tails you lose and heads they win. And given my fellow Americans susceptibility to the insidious lobbying by the insurance companies, I really can't see it changing this time around.


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