# UK to Houston



## Gem586 (Jun 5, 2015)

Hey 

Me and my husband should be moving to Houston shortly but I have a few questions . I'm worrying about such minor things! It's totally ridiculous! 

As we are married should I be covered under his health insurance ? And how does it work? If I need to go to the doctors ? Or if I fall pregnant while we are over there ? Do you claim from it ? I just don't understand how it all works ?

Also we looked at living on energy corridor but I heard it is more expensive and there are other complex 's / housing just as good in other areas , can anyone recommend any to have a look at (we are bringing our pet cat) which reminds me is there any good Catterys around Houston for when we would like to come home it's a worry leaving him. 

Thanks 

Gemma


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## twostep (Apr 3, 2008)

Nobody can answer questions regarding your medical coverage. Go through the information your husband got from HR and contact HR with your specific questions.

Houston is not a small town. Commutes can be cruel. Where you live depends on your needs/wants and often budget.

Are you talking about boarding a cat? Vets offer such services. There are bonded/insured pet sitting services. We always have someone move in for the duration.


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## Gem586 (Jun 5, 2015)

Thanks for the reply . 

Ok I will ask my husbands work. But I meant what you Americans normally fm do about healthcare ? We have the NHS so I'm not clued up on how the system works over there. 

Do you pay every time you go to a doctor etc?


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## Gem586 (Jun 5, 2015)

Also just to ask how much approx does it cost you for a week for a pet sitter?


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## Crawford (Jan 23, 2011)

Gem586 said:


> Thanks for the reply .
> 
> Ok I will ask my husbands work. But I meant what you Americans normally fm do about healthcare ? We have the NHS so I'm not clued up on how the system works over there.
> 
> Do you pay every time you go to a doctor etc?


The way that it usually works with a group company scheme, such as your hubby will probably have, is that the monthly premiums for you and him will be taken from his salary; the scheme will have a list of doctors that you can visit (this in known as in network); you visit the doctor and depending on your scheme you may have to pay a smallish charge per visit (say 20 to 30 bucks) or the bill goes straight to your insurance company and they pay a certain percentage of the bill and you then pay the rest when the doctor bills you. Note that everything gets charged for : doctor visit , tests, vaccinations, x rays etc.

All schemes have different options. You should find out all the details about your particular scheme because it is probably not just monthly premiums you will have to pay; there are deductibles (what you have to pay before the company will pay for anything), co pays or coinsurance.

Also check to see if it will pay for maternity costs - some schemes don't


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## Gem586 (Jun 5, 2015)

That's a great help thank you. How do people cope if they can't pay? Obviously we will be able to pay but it's crazy. And how do people afford children if they can't afford the bills ? It must cost a fortune with all the health checks , scans etc. 

I guess that's why a lot of expats go home to use the NHS !


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## Crawford (Jan 23, 2011)

Gem586 said:


> That's a great help thank you. How do people cope if they can't pay? Obviously we will be able to pay but it's crazy. And how do people afford children if they can't afford the bills ? It must cost a fortune with all the health checks , scans etc.
> 
> I guess that's why a lot of expats go home to use the NHS !


Ex-pats can't now go home and use the NHS (with some exceptions).

Which is why when folks say they are moving to the US with job offers we tell them to check out the health insurance policy being offered - so a) they won't end up with huge medical costs if he policy is not a good one and b) they know that there will be some medical costs to budget for no matter how good the policy is.


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## twostep (Apr 3, 2008)

Gem586 said:


> Thanks for the reply .
> 
> Ok I will ask my husbands work. But I meant what you Americans normally fm do about healthcare ? We have the NHS so I'm not clued up on how the system works over there.
> 
> Do you pay every time you go to a doctor etc?



As there is no centralized system there is no telling what your husband's medical plan covers, what your copays and deductibles are or even your selection of physicians.

Personally I am covers door everything from preventive procedures, emergencies and whatever comes along.


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## ddang (Jun 21, 2012)

Sorry but the NHS is absolutely horrible and the worst system in the world! I don't understand how anyone would like it. I am more than excited about going back to the states and getting health insurance and pay my health care. Sorry that was my two bits!


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## twostep (Apr 3, 2008)

Gem586 said:


> Also just to ask how much approx does it cost you for a week for a pet sitter?


I pay50 cash/day plus a full fridge/bar, use of pool, ... Mini vacation for someone who likes a cat. Feeding twice a day, litter box cleaned daily, human in the house, open account at the vet.


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## twostep (Apr 3, 2008)

Gem586 said:


> That's a great help thank you. How do people cope if they can't pay? Obviously we will be able to pay but it's crazy. And how do people afford children if they can't afford the bills ? It must cost a fortune with all the health checks , scans etc.
> 
> I guess that's why a lot of expats go home to use the NHS !


The same way they do in the UK - milk the system. Let others pay.

If you are an expat without decent medical coverage included in your contract there is more not right.

There is no NHS services for expats.


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## Crawford (Jan 23, 2011)

ddang said:


> Sorry but the NHS is absolutely horrible and the worst system in the world! I don't understand how anyone would like it. I am more than excited about going back to the states and getting health insurance and pay my health care. Sorry that was my two bits!



The US medical system is great ....... as long as you have the money to pay the premiums and bills.

Up until Obamacare came along you could not have guaranteed that upon return you would have been able to obtain health insurance unless you had a Group scheme.


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## Gem586 (Jun 5, 2015)

I never actually said I liked the NHS in previous messages. Or asked if anyone did . 

For all other constructive replies thank you so much you've really helped  this is all very new to me and now I feel I understand how it works


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## Gem586 (Jun 5, 2015)

Just to confirm I will not be coming over to the U.S. To milk the system ... That is not what I am asking . I have worked full time since I left college 12 years ago and I plan to do the same once I come to the U.S. And apply for my own working visa. My husbands company needs us soon so me going over on his speeds the process. I have always paid my way and very independent . I'm just worried as if I fell poorly or if I was pregnant in the future I wondered what the process is. I want to be sure we can pay for it if need be. 

People can moan all they want about the NHS but I personally have never had any issues with it luckily. 

I just wanted to know how it all works , it's all new to me and I feel slightly attacked from a few comments.


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## Bevdeforges (Nov 16, 2007)

Try not to take random comments too personally. The US health care system is somewhat unique (if only for the fact that there is no "national coverage" other than the requirement that one have coverage) and takes a bit of getting used to. However, if you're on an employer plan through your spouse, the one big "gotcha" may be that may be a waiting period before pregnancy is covered. (Usually a year.) Though that may or may not have been eliminated with the Obamacare requirements.
Cheers,
Bev


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## Newyorkaise (Nov 30, 2010)

Please don't feel attacked. I sincerely doubt the remark was actually meant for you personally. 

Some people simply believe that vast numbers of people are "milk[ing] the system" and "let[ting] others pay"...despite the fact that most hospitals and their debt collection agencies will hound a patient literally into the ground before writing off a debt. It's also worth noting that most bankruptcies in the US are the result of a family's experiencing a catastrophic medical event, so being uninsured or underinsured is no picnic. The ACA ("Obamacare") is helping somewhat, but the system is still based on a for-profit model, open to greed on the part of the insurers and riddled with claim denials intended (and, yes, this is my personal opinion, although I'm not alone in thinking it) purely to protect profits - in short, it's far from the universal care that the NHS provides.

So although any employer willing to bring you and your family to the US will probably provide a comprehensive health care program (by US standards), it is perfectly normal to ask a few basic questions of the HR folks - they should be able to give you the appropriate brochures for whichever programs they offer. Be sure to check the waiting times for various coverrages, particularly for pregnancy. And if they don't offer a comprehensive health care program, you may (as has been pointed out earlier) want to make a reassessment of the job offer.

Best of luck to you as you make this exciting move.


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## BBCWatcher (Dec 28, 2012)

Bevdeforges said:


> (if only for the fact that there is no "national coverage" other than the requirement that one have coverage)


An important correction here. The U.S. doesn't actually have a requirement to carry medical insurance. The U.S. only imposes a higher income tax on a particular defined _subset_ of individuals who do not have adequate medical insurance (called "Minimum Essential Coverage," which has a particular definition), but there is no actual _requirement_ to have medical insurance. (And if you are subject to the higher income tax rate that higher income tax doesn't buy any medical insurance coverage.)

If there were an actual requirement the U.S. Supreme Court might have ruled differently in its previous Obamacare-related case. But there isn't, and it didn't.

That said, it is usually quite foolish not to have adequate medical insurance, regardless of your income tax rate. But this is still a choice.



> However, if you're on an employer plan through your spouse, the one big "gotcha" may be that may be a waiting period before pregnancy is covered. (Usually a year.) Though that may or may not have been eliminated with the Obamacare requirements.


It has been eliminated, so you can set aside everything you just wrote as obsolete information. The whole U.S. system changed quite significantly, especially starting on January 1, 2014.

All "Obamacare" qualified plans, whether sold in the exchanges or elsewhere (e.g. provided via your employer), deem maternity care and childbirth essential health benefits. They must be covered, and there are no preexisting condition limits. The only hypothetical exception is if you still have a "grandfathered" pre-Obamacare medical insurance plan.


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## Bevdeforges (Nov 16, 2007)

OK, good to know that Obamacare eliminated that one "gotcha" as it was a particular issue for corporate transfers back when I still lived there.

However, there is still a "breaking in period" when it comes to the change from one health care system, particularly a Europe-style national health system, to another. There is also a long-standing fear in the US of anything described as "socialist" (which is how many folks in the US describe European style national medical systems). It also doesn't help that the NHS has long been held up as the "nightmare that awaits" should the US succumb to a "socialist medical system" so expect a whole lot of misunderstanding of how the NHS works. (Actually, just try to avoid the topic of "back home it works like this" - you'll be glad you did.)

It's sort of the bane of all expats' existence. And yes, I had a French woman one time ask if I had come to France "to soak up the benefits here." Told her, no, I came to France to live with my French husband. They have 'em everywhere these days!
Cheers,
Bev


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## Gem586 (Jun 5, 2015)

Thank you everyone for being so helpful ! Much appreciated . I'm sure I will have more questions soon haha 

Gem


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## Bellthorpe (Jun 23, 2013)

Bevdeforges said:


> (Actually, just try to avoid the topic of "back home it works like this" - you'll be glad you did.)


That is one of the golden expat rules - in all countries and on all subjects!


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## Gem586 (Jun 5, 2015)

Thank you for the advice guys


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