When my wife arrives in the USA, my insurance company will want some sort of "proof of prior medical insurance coverage" in order to cover any potentially preexisting conditions.

I imagine some of you married folks have encountered the same issue. My understanding is that everyone in Russia get medical services (of not very good quality, but in principle) from the government. How did you prove "prior medical insurance coverage" for your spouse?

Thanks.

By "proof of prior insurance," they usually mean in the US. In my experience, any policy asking for this will also ask for 6 months of prior US residency.

For most (all?) group polices, getting married will usually allow your spouse to be covered, including pre-existing conditions.

Medically-underwritten policies are more of a pain. Enough so, that it is probably better to get on a group policy if a t all possible.

Seems I read of one the Canadian members using their provincial health plan card as proof of previous insurance in a similar situation......may vary by insurance companies tho too.

So does your insurance company not extend coverage to your spouse if she has had no insurance in the past, be it in Russia or the US? What is their policy for such people?
In terms of the Russian policy, it just a small piece of paper that is renewed each year. It is not given to everyone. Only official employees, pensioners, and students have them. I'm not sure what a Russian hospital does for someone who is neither of these three. But the Russian citizen pays for just about everything in a Russian hospital anyways, because of lack of state funding. For example you must bring your own medicine and syringe, and then a medical professional will administer it to you. Russia is cool in terms of all their medications can be bought at a pharmacy and is not restricted like in the US to prescription only on most useful medications.
But to answer your question, I guess you can take a copy of it, translated it and attach it as support for your insurance company, as if it really means anything to them.

My mother-in-law is a doctor in Russia (Radiology). It really is quite different there. Russia has 4 times as many doctors as the US per capita. Shortages of everything else, though.

My impression of Russian medicine is totally different from what we see in Western Europe and the US. There seemed to be much less emphasis on science, and much more emphasis on more traditional treatments. Routine checkups and tests do not seem to be normal in Russia.

For example, the usual yearly pap test doesn't exist in Russia. While it is fairly rare for anyone to die from this in the west, it is quite common in Russia.

My insurance company does want to see continuity in medical insurance, but apparently does not require 6 months of insurance coverage in the US, as Russ indicated. Such a requirement may be illegal under Colorado law.

I am very aware of big differences between the realities of Russian and US health care delivery. That isn't quite the point here. I need to demonstrate that she, in fact, has enjoyed medical coverage. I work in a start-up, currently small, but rapidly expanding, and we don't have the HR infrastructure I used to enjoy. I've given the my interface with the health insurance company the following text from the Russian Federal Constitution and am asking what, beyond that and a copy of my wife's passport, demonstrating her Russian citizenship, I can do to demonstrate that she does, in fact, have medical insurance coverage. Here is Article 41:
"Article 41.

1. Everyone shall have the right to health care and medical assistance. Medical assistance shall be made available by state and municipal health care institutions to citizens free of charge, with the money from the relevant budget, insurance payments and other revenues.
2. The Russian Federation shall finance federal health care and health-building programs, take measures to develop state, municipal and private health care systems, encourage activities contributing to the strengthening of the man's health, to the development of physical
culture and sport, and to ecological, sanitary and epidemiologic welfare.
3. Concealment by officials of facts and circumstances posing hazards to human life and health shall involve liability in conformity with the federal law."

Aren't those nice words? Now, this doesn't show that quality of coverage is good -- but, really, often Medicaid coverage in this country isn't good, either ...

I'll ask my wife questions about just what her medical passport is.

If others have more ideas, or concrete experience on this point, please chime in.

There is really no such thing, unless you are refering to the medical file itself.
But otherwise the state insurance policy is called a "полис". Ask your wife about that. It's a small blue paper with a seal.

When I lived in Russia, everyone I knew was covered by private insurance, and no one ever used state-funded medical care. Also, annual pap tests are more than common (well, I would know, I had them myself ). Also, health insurance that I was accustomed to back there, worked pretty much like a typical US HMO plan. Well, I guess, maybe not everywhere.


I think you may not be 100% right here - everyone has this health coverage thing. But the one I had was not a blue paper with a seal, but a plastic green card Gee, I don't know anything any more I never used it in my life, cause I was always a dependent on my father's policy, and it was private.

I suppose, it may be different in different regions. I am from Moscow, and I was told that other places in the Russian Federation were very different from Moscow in terms of medical care and everything else. Anyways, I'm aware that health insurance here may ask for proof of continuous coverage, but if you can't provide it, they should be able to administer a medical exam to determine if pre-existing conditions exist.

I hope you will be able to resolve that! Best of luck to you!

What you may have to do is sign a waiver saying there are no pre-existing conditions or something like that. I had to do something similar when I joined my employer's medical plan. I had no medical records to transfer over or proof of medical care (I'm sure it was out there somewhere, just didn't have it with me.) to show my H/R guy or the new insurance company. They sent me a form saying something to the effect of "I certify that I have no previous medical conditions that will affect my insurance premiums" or something like that. Then there was another line that said "I have been under the care of physician XXXXX and he/she states that I'm of a healthy standard in accordance with company XXXXX policy."

Something like that. There's got to be a way that if she's generally of good health (which she must be... she passed the medical check) they can add her on without a problem. If you haven't already called, call the new policy people at the insurance company directly instead of dealing with your "company guy."


OK, I see that you've already "interfaced" with the insurance people, and my question now is, why do they need proof that she had prior coverage? Can't she be added on? Or, does that cost more? Either way, they should have a waiver or something of that nature for those without prior coverage.

You should go visit the other regions. Go see where the 25% of the poverty stricken population lives. Moscow is truly a "country" within a country. It is so much better there than say parts of Siberia where my wife lived. Day and night on some fronts. For example private insurance is just starting up over there, but I am not aware of any private clinics that exists except the dental ones. Only the "new Russians" who are regarded that the "thieves" by the rest of population enjoy any kind of decent way of life. The transparent companies are hard to find but do exists. But corruption at the state level is rampant. The stories I here from my father in law are just amazing.

Slim,
I'm not quite sure what is going on. In order to be accepted for full coverage without rejection of coverage for pre-existing conditions, I had to show that I did not have a gap in medical insurance. I think this is something regulated under the COBRA law and also under State law here. (I now live in Colorado. -- Yippee!)

She's in reasonably good health and as a fine woman my age (and I'm nearly 50) she probably has some conditions that a new doc would say are "pre-existing". I don't want to mess with any restrictions. I want to get her US-quality (i.e. much better quality) health care from the get-go once I get her here later this year. It appears that under Colorado law, if she can show prior coverage without a gap, than she is fully insurable as she is. Given my reading of the Russian Constitution, I think I can make a case that she in fact has benefited from insurance coverage from birth.

We'll see. I don't have to sort this out urgently, since she won't be here for awhile. After all, I don't even have NOA1 for the K3. As I get it figured out, since it may be relevant to others with Russian beneficiaries.

I think as long as she brings a copy of her "полис" with her (or her card, or whatever it is that shows she had insurance) you should be fine with that.

I was actually looking at my wife's "полис" just a couple of hours ago; she was going through some old papers, and she had the "old" style, just a piece of paper that said "health system coverage policy for XXXX XXXXXXXX" or something to that effect.

If your wife could bring a copy of her policy (not just the card, but maybe the card and a printout of the policy.... with translations) that should be more than enough to establish proof of prior coverage.

A clever insurance company employee can also say that the Russian constitution was written in 1991 and has not covered her since birth Pull out the Soviet one after that, I am sure it has a similar provision.
In my opinion the whole prior insurance without a gap rule is probably referring to US insurance and might have the company scrambling since they didn't consider foreigners.

Satellite Posted Today, 07:42 AM

QUOTE(novotul @ Mar 4 2007, 11:53 AM) *
Given my reading of the Russian Constitution, I think I can make a case that she in fact has benefited from insurance coverage from birth.
QUOTE(novotul @ Mar 4 2007, 11:53 AM) *
A clever insurance company employee can also say that the Russian constitution was written in 1991 and has not covered her since birth tongue.gif Pull out the Soviet one after that, I am sure it has a similar provision.
In my opinion the whole prior insurance without a gap rule is probably referring to US insurance and might have the company scrambling since they didn't consider foreigners.



I actually thought about that -- but them seem to be looking for proof of insurance only for the past three years

Jumping in her, but similar principal, I just showed my NHS Card.

I am sure the question is for those in the US system, they just need to tick the box.

While in Moscow in 2002, I've got flu and came to the hospital. As Russian is my first language they did not ask my documents, just asked me whether I live in their district. I said "no" and gave them the address where I rented an apartment in the other part of the city. They said, as I am not from their district, but want to see a doctor here, I must purchase the insurance. I agreed, paid around $10 equivalent, and got some kind of basic insurance for 6 months. I did not bother to read the paper and in 20 minutes was in doctor's office.

By the way, while waiting outside of the office, together with other patients, I was hearing one old woman complaining about how long she had to wait for this appointment (4 or 5 days, likely did not have extra $10): "In America people can see their doctor immediately". I dissapointed her a bit by revealing that I live in US and how long I have to wait for appointment with my doc if there is no big emergency ;-) But I also said, that my dad was treated for heart attack quickly and effectively, stayed in the hospital for 3 days and paid nothing out of his pocket ( bill would be around $15000).

My wife and I now joke about the "freedoms" that we enjoy here in America. How, even though it's nice to know that you will be cared for with the best equipment in the event of a life-threatening event, like a heart attack, you still must go through the pain-in-the-@$$ process of filling out all the forms, paying insurance, talking to this adjuster or that receptionist, etc.

Everything here in America requires a long, drawn-out process, to enjoy the benefits. Overseas, most places you can just pay the $10 equivalent, and whatever you want.... you got it.

Who's really free?

I think you are talking about Russia, cause I traveled all over Europe (and unfortunately) had to visit some medical locations. None were so eager to take me, and no $10 insurance or visit charge applied either. I can tell you from experience in Poland, they wait 2+ weeks to see the doc, and the average price is 100PLN ($33)... and that's a lot considering most only make $300 a month! To get an x-ray is a 3 week wait. Can you imagine breaking something and sitting in pain for almost a month to get care?! crazy! In Spain, I paid medical insurance for $30, and the doc visit cost another 25euro.

I'm happy I have insurance in the US

It is possible to pay for services overseas that can't be paid for here. 100PLN may not have gotten you expedited service, but maybe 100USD would've. Try dropping an extra C-Note in your dr.'s office here, see what happens. Do it overseas, and you're going to be a superstar.

My insurance through my employer didn't require anything as proof of prior insurance to support preexisting conditions.

I consulted at a major US insurer and can say that policies underwritten vary by state, underwriter, and company if through employer.
Your provider will have requirements that differ from others.
If you're getting push back with your initial contact, try asking for a supervisor to get clarity.
I've asked my wife for written items for things I need to supply for her and she says Russians don't have this; the US culture and society is different.

I know it's very frustrating to deal with US entities that do not understand there's some other culture and society outside that's somehow existed for a long time without our structure. I hope you get it resolved with the least stress!

The problem has solved itself. There are advantages for working for a small, well-funded startup.

After we hired a HR manager, I talked with her about this situation. She thought about it, and while I was travelling last week on business she emailed me with her decision: she decided to start covering my wife as of the start of my employment. It turns out that the insurance company doesn't use SSN as ID trackers, so they can add my wife to the policy with a SSN. So her insurance is effective on 1 March 2007, just like mine. Since we are early in the process, she will for sure have been covered by this company for more than six months before she enters the USA and, therefore, before she has her first opportunity to see an American doctor.

One more issue taken care of!