[kim_johnson]

Anyone a visiting student in the US such that you don't qualify for health insurance that requires you to be enrolled as a student at a US institution?

Any thoughts on a decent health insurance provider for people in that situation?

Maybe it varies by state...

I've been given information - but turns out that puts me onto insurance 'brokers' rather than directly in touch with insurance policies (where policy details matter to me as much as price of the policy).

Can anyone reccommend a comparatively 'good' health insurance provider in the US (in terms of good value for $$ and reasonable turnaround time with reimbursement and not too many tedious forms)?

In particular:

- Getting glasses would be nice (optometry)
- Don't care about dental
- Mental health would be nice (limited no of visits ok cause I'm only going for 9 months)
- Would really like 100% of GP visits on Campus to be covered and minimal contribution for prescriptions from my end (if possible) including (perhaps significantly) birth control pills.

Thanks.

[doubtful]

An insurance broker is the way to go. They have relationships with many insurance providers. They will sit down with you and go over options and find out what your needs are -- be prepared to answer questions about past and present health/medical concerns.

They don't charge you anything for their services and they get a similar commission from each provider so they have no incentive to 'sell' you a particular plan. (They clearly have an incentive to sell you a plan, but it's going to be the plan that is best for you given a whole slew of factors including your needs, health, and price).

I was really skeptical of this option, but in my limited experience found it to be really helpful.

Happy Travels.

[kim_johnson]

Ah. Okay... Not sure why I was hoping to avoid that... (I much prefer to book my own flights rather than dealing with travel agencies, too, but that got a little too complicated in this instance). Guess I should email them, then... I'm a little annoyed because I just assumed I'd be eligible for the health insurance available to students at the institution I'm visiting... And their rates were expensive enough (by my standards) whereas the non-students health insurance rates are MUCH more prohibitive. And... I have so many pre-existings it really isn't funny... (Though haven't had treatment for them in the last couple years they could crop up at any time incl if I land on my ankle funny I might never be able to walk again given the screws and plates holding it together at present etc).

Thanks for that.

[Kiya]

Can you say where you'll be going? Things differ around here from place to place.
Kiya

[kim_johnson]

sorry - paranoia kicked in. i'd rather not (no offense).

[kim_johnson]

Okay....

Does a once off $150 deductable (per person per term of issuance rather than per condition) together with a 20% co-pay of medical expenses up to $5,000 (then they cover 100%) sound reasonable?

Pre-existings not treated in the last 6 months are covered (that is all of my pre-existings).

NO provision for in patient or outpatient mental health services (i'll live).

How much is it likely to cost to see a GP (so I can figure what my 20% is likely to be)? I guess prescription charges are likely to vary... How much is generic birth control likely to be (I'm guessing that won't be covered at all)... How about generic antibiotics (like if i get the flu or something)??

Some other plans have a fixed rate per condition - I'm not not clear on whether $50-$100 contribution from me is likely to be more or less than a 20% co-pay from me, however. Those plans often cover 100% of prescription costs...

Sorry to be so full of questions but I really have no idea. Can't believe how expensive it is to get what is essentially free (or very minimally charged) back home... I mean... I get it since I'm not a citizen... But if I was...

[314159pi]

if you are under 25 years and are a full time student you should be able to buy into the group health plan at your university for a cheap rate. it is not the best plan but good enough. you can contact the office of the dean of students of the college you wish to attend for more info.
generic anti-biotics are very cheap in america. it's the brand label prescription drugs here that bust the bank honey. expect to spend a lot on blood test when you see a gp for a full exam here. you may want good insurance to cover that.
pi

[kim_johnson]

I'm 29. Thanks. Had a massive hunt and I think... This looks like the plan.

[(JD)]

A good co-pay is $20 or less for an office visit with MD.

[kim_johnson]

Most of the plans I've been looking at say that you have a $100 premium per condition. Or a $50 premium if you go to a student clinic - but I found out I'm not eligible to do that since I'm not paying the health levy by way of paying fees at that institution. I'm guessing... That is per doctors visit really (in the sense of getting sick and going to the doc). That looked fairly expensive to me...

This one has a 20% co-pay - I've just noticed up to a maximum co-pay of $5,000 of medical expenses (so worst case I pay up to $1,000 of medical costs) then I'm 100% covered until I hit the maximum payouts.

I was trying to figure around how much a 20% co-pay would be to see a GP... How much does it cost to see a GP (family doc) in the US? Less than one hundred? If so... Then a 20% co-pay would be less than $20...

(It is hard to figure whether 'fixed premium' or 'co-pay' plans are better since I don't know the cost of things to figure out whether the premium or the co-pay amounts are comperable... E.g., would you rather pay 20% of an inpatient visit or have up to $750 per day of an inpatient visit covered? Depends on the cost of an in-patient visit, I guess...)

[MyBestKids2]

Wow, so many things to mill around. Regarding your 20% co pay question Alex, in my experience, generally you will pay between $20-$40 co pay. However, the intake (1st appointment) usually costs much more, reflecting in a higher one time co-payment. Of course, co pays are subject to reflect the economic status in the area you are moving to. Good luck on your search, I can't even fathom what you are going through!

[sunrise]

Kim, my insurance plan is a fee for service plan, meaning there is no co-pay (which is a set fee per visit), rather the insurance just pays a straight 90% of the cost and I pay 10%. This is for providers in the network only, out of network, insurance reimburses for a lower percentage. There is a $200 deductible per person, and well-care visits are not subject to the deductible. So an intake appointment with a GP would be considered well-care and so would not apply to the deductible and would simply be paid for at the 90% rate. I consider this a good plan.

Here are some recent charges for services. These costs are network provider costs, they would charge more to people who aren't part of this plan or another that hasn't contracted for a lower rate (the power of a group insurance plan).

Clinic visit with family doc, $86
In-office surgery by family doc (to remove a plantar wart), $147
In-office surgery by family doc (attempt #2 to remove the wart), $124
Assistant gyno-surgeon at in-hospital surgery, $134
HPV vaccine, $135
Nurse charge to administer vaccine, $34
Routine vision exam by opthamologist, $131

Those are just some of the charges from my most recent statements. Hope that gives you an idea of what things might cost. I would have to pay 10% of these costs once my deductible was met. My insurance pays $150 every 2 years for glasses. That's not much as glasses cost quite a bit more. I would recommend getting your eyeglasses prescription filled before you come to the U.S.

I pay about $50 a month in insurance premiums to cover me and my 2 girls on a family plan. This is considered very reasonable here (it is insurance through my employer).

Antibiotics are very cheap, if generic. Less than $5 on my plan. I'm not sure about birth control pills. If you don't have an insurance plan that covers prescriptions, you can get some sort of generic discount prescription card. I had never heard of these, but someone posted about them in the Drugs forum a couple of months ago. Apparently they are legit and anyone can use them at preferred pharmacies.

Hope this helps!

[ECHOES]

Re: Prescriptions.
There are a few places that offer common generic Rx's at $4.00 for a 30 day supply and $10-$12 for a 60 day supply.
Check out Walmart, KMart, CVS, Walgreens, Target, Publix, Albertsons... those are in my area but not necessarily in all areas of the U.S. At their respective websites (their name.com) they will have a list of the generics they offer at $4. (When my insurance changed, I had my doctor change my meds so I could take advantage of this.)

Some plans are a discount type of plan and the discount is applied at the time of service, then you pay your share right then and there is no paperwork to be filed. If a claim has to be filed, most doctors offices file insurance claims for the patient. Most claims here are filed electronically by the physician's office.

Some of the major companies here (doesn't mean best prices or greatest coverage, as all companies sell all kinds of plans) : Blue Cross/Blue Shield, Aetna, United Healthcare, Kaiser--but there are many more.

Here's a Google link: Individual Health Insurance . If you add the state you will be in after 'insurance' it will be state specific.

You know what you want; that's good to know so you can compare that to what's offered.
Is anything offered through the university? If you haven't already, contact the university for their help, as I would imagine they have helped others with this.

I hope this helps

[kim_johnson]

Thanks very much to everyone on this thread (and to the people who PM'd me).

I'm not eligible for student health insurance (or to use the student health service on campus) because I'm not paying fees which include a health levy - that is why they have me down as a 'visiting scholar' and I've been told I need to arrange my own health insurance.

There is a student / RA/TA plan with Smith Chesson and Woody (a subsidery of BlueCross / BlueShield). I'm not eligible for that because of the not paying fees thing. I emailed them, though, and they sent me a link to 'Gateway International' which offers health insurance to visiting people (with repatriation of remains etc which is required for J1 visa entry - which is what I need to meet).

So... I'm thinking 'Gateway International' will be a subsidary of BlueCross / BlueShield - since those people recommended their plan. I compared that plan to others... But I'm thinking that one has the most extensive coverage.

One thing that concerned me was that there was no mention on their website of providers who bulk bill to them directly (no 'in network' providers) and there were also no claims forms online. I emailed them about that and they said I can go to anyone and there is no 'in network / out of network' distinction - but they don't have a list of providers who bill them directly.

Which leads me to believe... That nobody will?????

They said you get a claims form once you have purchased the insurance - but they emailed me one. About 5 pages of crap in order to make a claim... I'm thinking that is probably standard...

I know of one university teaching hospital nearby that has 'family doctors' / GPs. I'm thinking... I might email them and ask about whether they bill 'Gateway International' directly. They say on the hospital website that they directly bill BlueCross / Blueshield so it would be weird if Gateway International was a subsidary of them and yet they didn't bill Gateway International directly - wouldn't it?

Or is that how they screw international peoples over... Make up some subsidary for them that isn't so well known so nobody will bill them directly and they can take a year or so to pay out claims?????

There wouldn't be much point in purchasing insurance from them if I needed to pay all my medical expenses upfront and then had to wait up to one year (for example) for the claim to be processed...

I had a look at the fairly standard BlueCross / BlueShield plans and they are more extensive - but then they are around 3X the price...

[kim_johnson]

http://www.gatewayplans.com/pdf/usabro.pdf

Actually... I take the BlueCross / BlueShield subsidary thing back... I have no idea who the hell these people are...

Sorry... I'm just worried about this... Insurance is going to cost me around $1,000 from these people (which is significantly more than some of the other plans out there) - but I wonder if they might be a rip-off with respect to the 'impossible to actually get your claim paid out' issue... I'd feel a hell of a lot happier if I knew there were places willing to bill them direct... Is it appropriate to email hospitals and ask???

[kim_johnson]

I mean otherwise... How am I supposed to know that they aren't some made up internet site trying to scam me out of money? Aside from the Smith Chesson and Woody people providing a link to their plan, I guess... And the professional looking website / brochures...

[kim_johnson]

Oh, here we go...

>The Gateway Plans are underwritten by the Insurance Company of the State
of Pennsylvania, a Pennsylvania insurance company, with its principal place
of business at 70 Pine Street, New York, New York 10270. It is currently
authorized to transact business in all states and the District of Columbia.
NAIC No. 19429. The Insurance Company of the State of Pennsylvania is a
member of the American International Group of Companies (AIG).