health insurance experiences

It is highly likely that my husband and I (both American) will move back to the States this coming summer.  I anticipate that we will be unemployed for at least a few months and will need to pay for insurance.  In addition, we may start our own business and have to pay for our own insurance then, anyway.  And to add just one more complication, we want to have a baby pretty quickly after getting there and don't know if it is a bad idea to be pregnant already when we arrive  - pre-existing condition and all that.

I have looked up the costs of individual plans in Maine, NY and Mass and have been shocked to see premiums over $1000/mo.  I understand that many self-employed people go through a bargaining group, such as the chamber of commerce for a better rate.

What I am really asking is to hear about some of your experiences getting healthcare if you were not covered by an employer when you got to the States.

Thanks.

I was self employed for ten years and had Healthnet for my insurance.  Years prior I had Kaiser.  My premium was $240 a month, that was until January 2006.

I was just talking to my dad about health insurance in Mass at Thanksgiving.  My mother wants to stop working at her part time job, as they don't really need the income, but that's where they get health insurance.  My dad is self-employed.  He said that to go private would caost them about $10,000 a year, so your quotes around $1000 a month sound about right for Mass.  He wasn't more specific than that, but it was clear that for two older people (50-55) the cost of insurance is pretty high.  

Good luck.

I lived in NY and while working in a crappy job that didn't offer health insurance I qualified for a state subsidized plan (Healthy NY).  I think my premiums were around $300 a month.  My english husband wasn't working and didn't qualify - his premiums were really high, maybe $650 a month. 

Later, when he was out of work again and I couldn't get him onto my plan we were paying $458 and fees were promptly raised to $550 after he'd been on the plan for 3 months.

Many health insurance plans have special rules regarding pregnancy - it won't be covered until you've been a member of the plan for 6 months before you conceive (conception usually defined as the first day of your last period).  I think you can get around it with the continuous cover clauses, but you wouldn't qualify for that. 

Hi... I can only speak of my own extremely biased experience, and I was in Texas.

Basically, I was seeking individual coverage because it was going to cost $600 to add me and 2 kids to my husband's employer's plan, and then a $1500 deductible on top of that. I could not find any maternity coverage whatsoever on an individual plan. I found a basic plan that was $200 per month for me & my kids, with a $2000 deductible, which allowed 3 office visits ($40 each) that were not subject to the deductible. When I got pg I was added to DH's plan; it was $600 per month plus $30 copay for each appt., and when the baby came there was a $1500 deductible for me, plus a $1500 deductible for baby, then they would pay 80 % with a $1000 out of pocket limit (for each person) which was met by both me and baby! When I added it all up including the premiums it turned out to be about 10 or 12k. Anyway, that was a big chunk of our income and it was not easy to pay for all that up front. I just thought it was scandalous that all that was with insurance.

Ummmm, I dunno but if you have NHS now, maybe you should just get pg now and postpone your move 6 months or so. I had a baby on NHS, and privately through the above scenario– a C section both times, and interestingly enough in my NHS experience they seemed much more cautious about my health. Just my experience.

It really is a crisis

sorry this isn't what you're going to hear.  health insurance really is a big problem in the US. 

my sister was working in Mass, USA.  she had health insurance through them.  she became pregnant.  During her 3rd month or so they moved to Cali, where her husband was starting school.  They had ASSUMED that his school health insurance would cover them.  NOPE.  doesn't cover dependents.

my sister went without health insurance for months 3-6.  she tried to do cobra, tried to get on medical, etc... big big big stressful mess.

finally, my parents who own a business in NJ put her on their health insurance. 

i'm sorry i don't have a rosy story to tell.

Something else to think about is that most insurances have waiting periods for people who were not covered when the new insurance coverage begins.

I don't know if they would look at NHS as insurance coverage, so you may have a waiting period for some things.

New York State has state health insurance plans for people who are not covered by an employer.

http://www.nyshmoguide.org/SpecialHealthPrograms.asp


They are means-tested, but for working people with higher incomes than required for Medicaid.


There are other states with similar plans, but I don't know which one.

I haven't had insurance in almost three years....sigh. I've looked into student insurance, but they all want the entire year paid at once...no payment plans. Good luck!

There are other states with similar plans, but I don't know which one.

Maine has a similar arrangement called Maine-Care, I think.  I have friends who were on it for a very brief period, but as I understand, you more or less have to qualify for public benefits (food stamps, etc) or be low-income elderly to be eligible for it.

The New York State one is specifically for people who can't afford to purchase their own health insurance and don't have a job that provides health insurance, but earn too much money to qualify for federal benefits.

My ex was on it when she was single with no kids, in her 40s, and working as a temp without insurance coverage through employment.

I don't know if there's a residency requirement, though.

For Healthy NY you have to be a NYS resident, but I don't think you have to have been there for any particular time.  The upper income limit is quite low, not much above minimum wage, if I remember correctly.  If you qualify it is definitely a good deal though.

Pennsylvaqnia has a good plan for low income, but not medicare eligiable, for 35.00/month.  Of course there is a two year waiting list to get on it.  In the meantime, residents can pay 375.00/mnth to buy in until your name comes up.  Which is very helpful if you are at a job that pays enough for you to do that, you don't qualify for the plan. 

I was on the West Coast.  Had Kaiser and it was FAB!  About $200/month, though, for just me.