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floggers

Getting health insurance ASAP in US?

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Hi everyone,

 

So my K1 process went smoothly and I'm moving to the US in about ten days to be with my fiance in Baltimore. I'm excited but also starting to get really nervous about how to get health insurance. Coming from Canada, I am used to simply having a health card that lets me walk into any doctor's office, hospital, walk-in clinic or even dermatologist without ever having to worry about fees. I just had a bad bike accident here in Toronto, which really got me thinking about what I will do if something like that happens in the US. 

 

Can anyone tell me their plan or how they immediately got themselves covered in the US? My fiance's job doesn't cover dependents so I gotta find something on my own. 

 

Thank you!

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Be prepared to spend around $400 per month for poor insurance with a high deductible.  I have decided to not have health insurance for me or my spouse

 

I pay cash what they call Self-Pay in USA, you will get a great discount on service and usually be moved to the head of line when needed services especially for a doctors appointment.

 

 

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Many people choose to get health insurance through work.  You can also go to the marketplace. 

 

I also had a hard time trying to figure out health insurance.  I cant say im anything close to a  expert, but we have a high deductible health savings plan. Basically we have a deductible that needs to be paid out of pocket before the insurance covers our costs. They can, however, change that amount we're billed.  For instance, I had to go to urgent care (like a walk in) and the insurance disallowed them charging us over $700 and changed the bill to only  $150.  

 

How the health savings works is my husbands employer pays 1500 a year into a savings plan we can only use for medical expenses.

 

All preventative care is covered 100%. We don't go to the dr unless we are really sick or something is broken.  

 

So you have to sift through and figure out if you want co-pays, to be referred to specialists, or if you can afford something without a high deductible.  Some plans have some vision and dental built in, and some do not.  Basically I figured that you pay the most to have to pay the least when health care issues arise. 

 

I hoped some of that helped.

 

Edited by NikLR

You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose.  - Dr. Seuss

 

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If you'd like an all-inclusive plan in Maryland, you might want to look into Kaiser Permanente. You must exclusively use their providers and services, as it's an HMO, but it's a one-stop-shop plan. They offer the bronze, silver or gold plans per the Affordable Care Act (Obamacare).

 

https://my.kp.org/maryland/

 

 

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12 hours ago, floggers said:

Hi everyone,

 

So my K1 process went smoothly and I'm moving to the US in about ten days to be with my fiance in Baltimore. I'm excited but also starting to get really nervous about how to get health insurance. Coming from Canada, I am used to simply having a health card that lets me walk into any doctor's office, hospital, walk-in clinic or even dermatologist without ever having to worry about fees. I just had a bad bike accident here in Toronto, which really got me thinking about what I will do if something like that happens in the US. 

 

Can anyone tell me their plan or how they immediately got themselves covered in the US? My fiance's job doesn't cover dependents so I gotta find something on my own. 

 

Thank you!

Welcome to B'more.

 

You have a few options available.

  • Buy insurance privately, using any insurer that offers in the state of MD. We use Blue Cross Blue Shield. They only required to see proof of marriage, though if you're not buying a plan jointly, I don't see that as being a requirement. From a personal standpoint for various reasons I am not a fan of Kaiser but it works for some. And I'd strongly suggest staying away from Evergreen.
  • Use the state or federal exchange. We have a state exchange, so you'd have to go through that. Most of what you see on the exchange can all be found via private plans these days though. The subsidy discount will only apply in certain situations. The cons of this is that most likely you'd need to wait until after marriage and after filing for AOS (with an NOA1) as your earliest proof of residency, and baring that your EAD, and or green card.
  • Wait until you are work authorized (after filing for AOS) and receiving your EAD, find an employer that offers insurance for you.
  • The next option is going on your spouse's insurance, but unfortunately you say this is not an option for you at this time.
  • Go without and pay the penalty. With or without insurance, you can always seek medical treatment and will not be refused. There are plenty of clinics all over the state. Carefirst offers immediate care for walk-ins for all sorts of problems, so long as you don't need emergency care (though they can handle sprains and simple xrays). They can prescribe medication in-house, are generally good and well-trained doctors. Out of pocket costs with no insurance can be somewhere between $100-200 + the cost of whatever medication. My insurance cuts this down to a simple copay of $60 + lower cost of drug (on occasion no cost at all). If you have a primary care doctor set up though, your standard copay is usually between $25-30. Higher for specialists. Of course the decision to go without insurance, must be considered carefully. Is the risk worth it vs being bled dry with a monthly premium?

Some finer points for other options: temporary insurances, travel insurances, and short term insurances marketed towards immigrants do not comply with federal law. The feds consider this substandard insurance, and therefore the penalty will apply come tax time (depending on the specifics of your situation). All persons are required to purchase health insurance or if they do not, must pay a penalty in taxes. There are exemptions and gaps depending on the timing. The penalty is $600+ and expected to increase. As you might be aware, this yearly payment is considerably cheaper than paying a monthly premium. With BCBS, we pay about $700 per month and a 5k deductible. Most insurances are unfortunately yanking their lower tier/slightly cheaper plans from the market, because they are unable to cope... and some may leave the market altogether. Evergreen for instance, is having big problems with that right now.

Typically you will need to decide on if you want an open access plan (you may go anywhere without a referral so long as the doctor participates with your provider) or if you need to stay within network (must see only a select group of doctors and may need a referral/prior authorization for specialists). The higher the deductible the 'lower' the premium, and the lower the deductible, the higher the premium. These days, most people are suffering from sticker shock. It's not cheap. And I'd have to say, this state has very high costs in that regard. My only other tip for you is to search the options carefully and compare costs if you can. Absolutely try to get an SSN as soon as possible, because this will assist applying for insurance along without any hassle.


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8 hours ago, NikLR said:

How the health savings works is my husbands employer pays 1500 a year into a savings plan we can only use for medical expenses.

 

I have been out of the corporate world for 20 plus year.  Back when I worked for a company like in your case the $1,500 would be put in a reserve style account and no taxes taken out from payroll, we used to call that a cafeteria plan.

 

And at the time like in your example, if you didn't use the $1500 during the year then you lost the money.   Is this still the same way it works now of days?

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6 hours ago, MarkPerry said:

I have been out of the corporate world for 20 plus year.  Back when I worked for a company like in your case the $1,500 would be put in a reserve style account and no taxes taken out from payroll, we used to call that a cafeteria plan.

 

And at the time like in your example, if you didn't use the $1500 during the year then you lost the money.   Is this still the same way it works now of days?

Depends on the health savings plan, there are two types.  Some do, but ours does not.  Hubs works for the FAA so not exactly corporate world. 


You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose.  - Dr. Seuss

 

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