Relocating to the US, health insurance advice needed!

October 1, 2009 8:12 AM

I'm relocating to the US (from the UK) in a couple of weeks and having concerns about health insurance. My husband's employer covers health insurance for him, but to cover me as well we must take out the 'family policy' for $500 per month (if we had 4 kids this would be a great deal, but apparently it's the same price for the whole 'family' even if that's just me. This seems crazy to me, not sure if it is normal!). Is my alternative plan crazy? Health insurance companies confuse and scare me!

To simplify things, assume that I'll be there for a year, and I will not have a job that includes insurance. I'm on the H4 (nonimmigrant) visa. However the year will be split into chunks where I'll be back in the UK - for example a month from mid-Dec to mid-Jan, a couple of weeks in April, and a few weeks in June/July. So the chunks of time when I'll be in the US will be 2-3 months each.

My idea is to get premier single trip travel insurance through my regular provider STA Travel, for £134 (2 months) to £172 (3 months). The coverage is outlined on the link above and is all quite standard as far as travel insurance goes. The policy is single entry, so I'd buy a policy with each return flight to be covered for all the time I am in the US. This is clearly much better value than the $500/month policy offered through husband's employer. I assume the travel insurance wouldn't cover routine checkups etc and I'm ok with that; I can get those done when I'm back in the UK every few months courtesy of our wonderful NHS. Worst case scenario, the savings we'd make from not going with the $500/month policy would easily cover a flight home for a non-emergency, non-covered but necessary medical consultation. The travel insurance has other benefits too, such as emergency dental treatment (dental isn't covered at all in the employer's policy), legal costs, theft, etc. But I'm also totally paranoid about the US healthcare system, and don't want to be caught out or bend the rules to such an extent that the travel insurance policy wouldn't pay up in an emergency because I'm classed as being a US resident or something, because if insurance companies can find a way not to pay out, they usually do in my experience! So mefites, is this a sensible plan of action or am I missing something?

posted by hibbersk to health & fitness (14 comments total)

Do read all conditions related to the travel policy. They sometimes exclude people who have lived outside of their 'home' country for a certain number of days (in the case I saw, 45 days). Otherwise I dont see a flaw in the system.
posted by london302 at 8:20 AM on October 1

I'm not sure if this applies to your case, but will the NHS still consider you a UK resident with that much time spent in the U.S.? If it works like travel insurance does here in B.C., the travel insurance policy will require you to be covered by your government health plan (MSP in our case). Worth double checking if you haven't already.
posted by Emanuel at 8:27 AM on October 1

apparently it's the same price for the whole 'family' even if that's just me. This seems crazy to me, not sure if it is normal!

I'm not sure if your scheme will work or not, but let me assure you, this is indeed normal. Some employers have special 2-person family plans, but these are the exception and not the norm. Even my extremely generous employer does this and it pisses me off beyond imagining. It's another way that the burden for community health care is shifted unfairly onto the backs of the young, healthy and relatively impoverished.
posted by felix betachat at 8:35 AM on October 1

To take out UK travel insurance, you need to be a "UK resident." You need to find out how your policy defines who is and isn't a UK resident. If they chose to investigate a claim, the insurance company probably wouldn't look favorably on you having an H4 visa for the US in your passport. Will you be maintaining a home in the UK? That would help.

It might be an idea to make a few anonymous calls to some insurance companies asking how they define "UK resident."

Alternatively, you may be able to get a catastrophic policy specifically for non-immigrant visa holders that's (way) cheaper than $500/month. After googling non-immigrant US health insurance, I just got some quick-n-dirty quotes that were around $900 for 12 months. This is more expensive than UK travel insurance, but may afford you a bit more peace of mind.
posted by peanut butter milkshake at 9:03 AM on October 1

You'll find that most travel insurance coverage is limited to 14-day trips.

There is backpacker insurance for people who are going overseas for longer periods...

There might be better info at the UK-based Moneysavingexpert.com
posted by almostwitty at 9:12 AM on October 1

I'd be wary of the travel insurance - READ ALL THE SMALL PRINT. Also - if you can - try and find out which doctors / dentists etc. you'll want to see routinely in the US. Call them and ask what Health Insurance Plans they take - possibly they may not accept the STA travel policy.
posted by momentofmagnus at 9:38 AM on October 1 [1 favorite]

Oops. Sorry, forgot you said routine checkups you'd do in UK.
posted by momentofmagnus at 9:39 AM on October 1

Thanks for the comments so far! to address some of the issues raised:

The NHS technically doesn't cover treatment to folk living outside the UK for more than 3 months [link]... but since I'll still be registered with my UK doctor under my parents home address, the general consensus among expats is nobody ever checks, and there isn't really a way for them them to check anyway (no need to get into the morals of this!)

The UK resident requirement is something I hadn't thought of, so thanks peanut for mentioning it. I think the employer actually offers a 'catastrophic policy' as an alternative to the family plan so I'll look into the costs of that.

Almostwitty, STA provides policies for single trips up to 24 months so that's not a problem. But, coupled with the UK resident requirement issue I'll definitely look at backpacker/study That should be safer as I'd have been a UK resident for long enough before taking out the policy.

Thanks again so far. You guys are so much more helpful than the STA salesperson who was like, 'yeah sure you'll be fine!!'
posted by hibbersk at 9:56 AM on October 1

oops that should have been 'backpacker/study abroad insurance'
posted by hibbersk at 9:57 AM on October 1

and there isn't really a way for them them to check anyway

In the post 9/11 and 07/05 world of connected databases I seriously doubt that's true.
posted by Neiltupper at 10:42 AM on October 1

In theory yes, but the NHS, despite all its awesomeness, is pretty inefficient and uninterested in that kind of thing, especially since the new NHS database is 4 years overdue.
posted by hibbersk at 11:09 AM on October 1

you might want ot look at these people: www.patriotamericainsurance.net, they specialize in this sort of situation. I haven't used them but they have come redoomended on Visa Journey which is normally a pretty relaible source of advice.
posted by tallus at 11:39 AM on October 1

Are you going to remain a UK resident for tax purposes as well? You should look into the tax advantages to being a US resident/taking US tax breaks/paying US health premium versus paying UK taxes and enjoying the NHS's services.

There are many other subtle savings available to you if you are a US resident. If you get a US driver's license, you save money on your auto insurance. I think H4 visa holders are eligible for in state tuition fees in some states now. When you file taxes jointly with your husband, you can then get your ITIN and start trying to build a credit history.

If I were you, I would be most afraid of the UK taxman and tax fraud. US taxes are unbelievably cheap and you may well in the end get a good deal by sucking it up and paying for the health insurance. Play also with the long term in mind. Although you say you'll stay for a year, blink and you'll be here for five. I keep swearing up and down I'll go home soon but never go ...
posted by crazycanuck at 10:31 PM on October 1

Thanks tallus, that actually looks like a pretty good option...
Crazycanuck thanks for the suggestions, we definitely still have lots to investigate!!
posted by hibbersk at 4:18 PM on October 4