# Continuing health monitoring in the US



## CurlyGirl (May 29, 2015)

Hi,

I suspect this will be a two part answer but i'm in my research phase while saving for our wedding Stateside (Still debating K1/CR1)

My partner is in a very good job with a good level of healthcare, when we marry I can be put onto his cover at an additional cost as I understand it. In the 4 years i've been with him, it seems comprehensive, hes always seen quickly and even his dentist sounds amazing. He's not a very sickly person though and will generally avoid seeing a GP unless he's literally dying. (Hates medication) me however....i have no option. 

The first question is around contraception, I have 3 monthly depo injections and will need to find somewhere to do this consistently. I assume this will incur a fee as well hopefully theough the insurance?

The more important side of things is that I need regular 3 monthly blood tests. In the UK my GP does both on the same day and is very convenient. I have crohns disease so the bloods are for monitoring my disease but do the NHS provide your history over to your chosen US provider for consistent care? I have 15 years of records since diagnosis which I guess are very important but I'm concerned how you get your medical history to follow you over. I am very well at the moment, never had surgery and never had more than a few weeks off work at most many years back but I have had some adverse reactions to past medications and would like ideally to see a consistent person for continued monitoring. Do you get to see the same medical professionals in the same way we do GPs in the UK?

Thanks for any feedback.


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## twostep (Apr 3, 2008)

Why does your future spouse not contact his insurance with those questions? Without knowing the details about his coverage there is no guessing what the answer might be.


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## CurlyGirl (May 29, 2015)

:spit:


twostep said:


> Why does your future spouse not contact his insurance with those questions? Without knowing the details about his coverage there is no guessing what the answer might be.


Is everything specific to the insurer?


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## Crawford (Jan 23, 2011)

What usually happens in the US is that insurance companies have a list of in network doctors - primary physicians (GP's), specialists, surgeons etc etc. This is the list of doctors that have contracted with the insurance company and have agreed a payment schedule. You will be able to search this list on your husband's insurance's web site.

_Going out of network will cost you lots of extra dollars._

You don't _need_ to register upfront with a primary physician (GP). Again, usually, when one falls ill and wants to see a primary you pick one from your list and go see him/her. From there on in, if you like the person you continue to see them.

In your case, as you have a health history, I *WOULD* go and see a primary, explain your situation, and then he can 'order' your three monthly blood tests and make appointments for your depo injections. (You'll need to check up on your insurance policy to make sure these injections are covered). If your primary needs to refer you to a specialist he will also do this for you.

For ongoing care, yes, you usually see the same doctors.

I would not bank on your medical notes following you over........ get them before you go.


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## CurlyGirl (May 29, 2015)

Crawford said:


> What usually happens in the US is that insurance companies have a list of in network doctors - primary physicians (GP's), specialists, surgeons etc etc. This is the list of doctors that have contracted with the insurance company and have agreed a payment schedule. You will be able to search this list on your husband's insurance's web site.
> 
> _Going out of network will cost you lots of extra dollars._
> 
> ...


Thanks so much for the reply, thats reassuring and a lot clearer than I thought.

I was going to ask my Gastro consultant about transfering copies of my notes over. My health worries are the reasons we haven't rushed the process through. I want enough savings as reassurance as knowing my luck i'll get ill with the stress of the whole process! 

Which begs another question actually. I did 90 days in the US last year and travel insurance was a fortune. As Brits moving over...do we need insurance until we adjust status or get bank accounts to pay for such things from UK providers?


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## Crawford (Jan 23, 2011)

I thought you said your husband to be has US company health insurance?

If so, not sure why you are saying "do we need insurance until we adjust status?" His insurance continues prior to and following your marriage - unless he is quitting his job.

Yes, you would be added to his insurance at additional cost.

You need to find out if his insurance will take you on immediately you enter the US as his wife. Some companies do, some companies don't - some have a one/two/three month waiting period. If so you would need to find short term insurance. 

Check on the healthcare.gov site or your state's exchange site to see which companies can offer this to you. Travel insurance won't usually cover you once you are resident in the UK - apart from emergency treatment and maybe getting you back to the UK.

Think the following company offers short term policies:

Travel Medical Insurance: Patriot Travel Medical Insurance


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## CurlyGirl (May 29, 2015)

Crawford said:


> I thought you said your husband to be has US company health insurance?
> 
> If so, not sure why you are saying "do we need insurance until we adjust status?" His insurance continues prior to and following your marriage - unless he is quitting his job.
> 
> ...


Great thank you. I am swaying towards the CR1 which would mean yes i'd be his wife to access his policy as soon as i'm able. If we do the K1 though, the void is my worry as I may need my injections and bloods while still a fiance. Something else to add to my list of pros and cons of the visa route!

Its all exciting until you get to the nitty gritty we take for granted here!


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## BBCWatcher (Dec 28, 2012)

The insurance carrier has to take a legal spouse on board (at the specified premium), so yes, that's another argument in favor of a CR1. (Unless you get married literally the day you arrive on a K1. That can be done, and your husband can then immediately add you to his policy with immediate effect. As it happens my wife had a claim three days after we were married. Fortunately I added her to my policy the day after we married -- on that occasion I was smart.)

Depo injections have to be covered ("in network" at least) if the policy is PPACA-compliant. (Very few U.S. policies are not.)

You are entitled to your own medical records. Bring a copy of them from the U.K. and share them with your new provider -- nothing really more complicated than that. Try to schedule your trip the day after you've had your regular tests so that you have another 30 days until your next set.


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## CurlyGirl (May 29, 2015)

BBCWatcher said:


> The insurance carrier has to take a legal spouse on board (at the specified premium), so yes, that's another argument in favor of a CR1. (Unless you get married literally the day you arrive on a K1. That can be done, and your husband can then immediately add you to his policy with immediate effect. As it happens my wife had a claim three days after we were married. Fortunately I added her to my policy the day after we married -- on that occasion I was smart.)
> 
> Depo injections have to be covered ("in network" at least) if the policy is PPACA-compliant. (Very few U.S. policies are not.)
> 
> You are entitled to your own medical records. Bring a copy of them from the U.K. and share them with your new provider -- nothing really more complicated than that. Try to schedule your trip the day after you've had your regular tests so that you have another 30 days until your next set.


Great advice, thank you


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## BBCWatcher (Dec 28, 2012)

Note that he can add you to his policy as soon as you're married even if you're not yet in the U.S. Sometimes that makes sense.

U.S. states vary in how quickly you can get married, but there are some that have no waiting period. Legal marriage is not the same thing as a wedding. A wedding is a celebration, a party, sometimes with religious ceremony. That party can be scheduled months or even years later. A relative I know got legally married (quietly) then, a couple years later, had a wedding. That all worked perfectly fine, and everybody was/is happy.


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## BBCWatcher (Dec 28, 2012)

One further point. Doctors sometimes shift from "in network" to "out of network" as insurance carriers renegotiate pricing. While you can never guarantee a particular favorite doctor in any medical system -- doctors are mortal, retire to France, etc. -- just be prepared for the possibility you'll have to switch to another "in network" doctor in order to maintain the higher level of insurance coverage. Also watch out for tests and other procedures, and ask questions. It's possible to visit an "in network" doctor who then orders a test from an "out of network" lab. (Some would call that a scam. I would.) Stay "in network" for everything if at all possible. Keep track of your medical records.

There are still a few medical insurance policies that don't have network distinctions and just cover every provider's services, but that's rare and getting less common.

If you have a prescription drug requirement, and it can be self-administered, nowadays your initial supply can come from an "in network" retail pharmacy but a lot of carriers then want you to shift over to mail order. Not a problem generally, but that's a popular part of coverage rules as well.


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## EuroBob (Feb 23, 2015)

When checking insurance coverage, wouldn't CurlyGirl need to make sure that she does not fall victim to a clause stating that "existing and previous conditions are not covered"?


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## BBCWatcher (Dec 28, 2012)

EuroBob said:


> When checking insurance coverage, wouldn't CurlyGirl need to make sure that she does not fall victim to a clause stating that "existing and previous conditions are not covered"?


No. There is no such clause in legal, U.S. domestically underwritten medical insurance policies. The U.S. Patient Protection and Affordable Care Act ("Obamacare") abolished pre-existing condition limitations.

The U.S. medical system changed quite significantly on January 1, 2014, when the full effect of the PPACA came into force.


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