Health insurance between moving and registration

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What is the best thing to do about health insurance during that awkward time between moving to the US and the beginning of term, or whenever health insurance kicks in? Presumably if you're on a J1/F1 visa, there might be complications if you try to claim on regular traveller's insurance. Hopefully nobody would ever need it, but I'm thinking it would be wise to know the best plan of action for those three weeks, just in case. 

[TakeruK]

How much time are we talking about? Also, check that your school's health insurance terms actually lines up with the academic term. For my current school, the health insurance term is Sept 1 to Aug 31, but the academic year is approximately Oct 1 to Sept 30. My school purposely offsets these months for the exact reason you mention--orientation happens in September (and mandatory for F1/J1 I think) so they make the insurance begin earlier to avoid the lapse of coverage.

 

If it's less than 30 days, I think you should be okay with Traveller's insurance. Usually, these plans only cover catastrophic stuff / emergencies right? With traveller's insurance for the big stuff, you might be able to wait up to 30 days before you see your doctors for small stuff like vaccinations, checkups, etc. 

 

Some other options if waiting for student plan to kick in doesn't work:

- You can contact private health insurance providers and sign up for an individual plan. It would be a bit pricey but if you need it, you need it. These plans are generally month to month so you can cancel them when your plan begins. However, watch out for deductibles and consider how much it would cost to just pay for whatever you have to get done before your school plan kicks in. A visit to a walkin clinic here will cost about $100-$200 depending on what you need. Many US providers have discounts for uninsured people too. It might turn out that just paying for care (other than hospitalization, which would be covered by traveller's insurance) could be cheaper than getting insurance for just 1 or 2 months.

 

- If you are arriving extremely early, you can ask the school whether you can enroll in the health plan early. In my field, when students arrive and start work early (over the summer instead of waiting until September), they usually get paid for the summer months and also get benefits. Although most student health plans have limited dates per year that you can enroll, most plans have exceptions for "life events" like new school, new child, new marriage etc.

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Thanks Takeru Turns out I am insured from Sept 1 (yay). But some great ideas for anyone else who doesn't get pre-term insurance.

[MathCat]

Does anyone have specific suggestions for short term private coverage in Southern California? I'm Canadian, and I'm moving 3 weeks before my university health care kicks in. Blue Cross won't provide travel insurance unless I buy for the period until I next return to Canada, which would be very expensive and far more than I need. I only want/need catastrophic coverage, but I'm really overwhelmed trying to figure out the options. I won't hold it against you if your suggestion isn't the very best option or anything - just somewhere to start looking would be good. My university hasn't been helpful.

[rising_star]

MathCat, my suggestion would be to go without. Unless you slip, fall, and break a limb, the costs won't be severe, assuming you're generally in good health. I say this as someone that has had continuous health insurance for the past two years and has only gone to the doctor for routine physicals in that time (and as someone that lived without health insurance for over a year of their life). 

[TakeruK]

I'll have to give an update to my previous post since health insurance laws have changed!

 

In California, you will technically qualify for CoveredCA (aka "Obama care" or "health insurance marketplace/exchange plans") for those 3 weeks. Normally you can only enroll during the regular enrollment period (Nov 15 to Feb 15) but special "qualifying life event" such as new F1 or J1 status allows you to enroll at a special time. You won't qualify for the plans once your school's plan kicks in but you are eligible for the first month. You can get out of the plan at any time so you can get out of it after one month (they will actually kick you out once you dutifully report your new school coverage).

 

However, I'm not sure this is worth the hassle. You can't enroll until you actually get to California, and then by the time you get it set up, you would be just a few days away from your school's plan starting and you will have to go through the whole process of cancelling your plan. In addition, unlike Canadian health insurance, the deductibles on these plans are quite high so it's unlikely you will incur so many medical expenses in those 3 weeks that you will need your insurance. The only possibility is that you get hit by a car or some other emergency that sends you to the hospital.

 

So I would second rising_star's suggestion to go without insurance, if you are willing to take the risk that something catastrophic might happen. But even if you have insurance, something like a hospital visit will still cost you a ton of money. If you get sick or face some non-emergency, I'd wait until your school insurance kicks in. But if it's serious then go to a walk in clinic anyways and ask if they have discounted rates for uninsured people. One time, I made a mistake of going to a clinic not covered by the plan and they ended up reducing the fees by a fairly large fraction (so that it was just a little more expensive than if I had gone to the right clinic). 

 

Alternatively, you can schedule an early visit back to Canada (maybe for Canadian Thanksgiving? or during the US 4-day Thanksgiving holiday) so that your Blue Cross insurance period will be shorter.

 

Or, when you book your flights, sometimes the airline offers travel insurance that includes both catastrophic insurance for ~30 days as well as trip cancellations. Maybe opting into that program is the best way to get what you need.

 

Or....change your moving plans so you arrive closer to the date that your insurance starts!

[TakeruK]

Oh I forgot to repeat this from my earlier post. I think it is probably what you should do first:

 

Contact your new school and ask about this. Sometimes the student plan will let you enroll early/late because of special circumstances like students arriving before/after the insurance registration date. Our school does this as we have many students that start in June or July but our insurance does not begin until September 1. Our school lets these early arrivers get paid and get benefits as soon as they begin, no need to wait!

[MathCat]

I did ask the school about it, and they were quite unhelpful. They just told me to look into private short term plans.

 

My main concern is to have coverage in case of catastrophe. I wouldn't plan on going to the doctor except for an emergency, but I don't want to risk thousands of dollars in expenses if something does happen.

[TakeruK]

Okay, a very good provider in California is Anthem Blue Cross. I don't personally use it (my school's insurance is a different one) but my spouse has been on this through both the "Marketplace" as well as off-marketplace plans (through her work). 

 

I searched their plans for a catastrophic coverage and I found this one: https://shop.anthem.com/sales/eox/abc/ca/en/shop/plans/details/snq?execution=e1s19. This is the only catastrophic plan they provide because this type of insurance is now not very popular given that the marketplace makes better plans a lot more affordable. Also, most other companies will offer similar plans. This plan costs about $160 per month.

 

It's good because it's an "off marketplace" plan so it will be a little easier to get onto and off. However, read the plan carefully. For things like an emergency, it says you pay 0% after the deductible. The deductible for this plan (and many such plans) is $6600. So, even with this plan, you will have to pay $6600. However, this is better than having to pay over $100,000 for a serious emergency. 

 

Another option is to just go for a better plan. If you go to the other extreme (Platinum), your deductible is $0 and your out of pocket maximum is $4000/year (so, no matter what happens, you will not pay more than $4000 for covered services). With this plan, your copay for the hospital is $150. If you stay overnight, it's $250/day up to $1250. If you incur other costs, you will pay the listed copays (flat rate) or coinsurance (percentage of total cost) until you reach the $4000 out of pocket maximum. This plan will cost you $320 per month. Info for this plan: https://shop.anthem.com/sales/eox/abc/ca/en/shop/plans/details/snq?execution=e1s24

 

To summarize, I know shopping for insurance is complicated and confusing (my wife and I have been through this so many times already). Here are some things you should keep in mind:

 

1. Almost all the companies are the same in terms of cost. Anthem Blue Cross is a major one. Other big companies are Aetna, United HealthCare, and Kaiser.

 

2. There are two types of plans "HMO" and "PPO" (or sometimes EPO). HMOs require you to use a doctor in their limited network. PPO and EPO plans cover different amounts based on whether you use their (wider than HMO) network vs. out of network. For your purposes, you should just make sure the nearest hospital is covered by the plan you choose. I'd say to pick a PPO plan over a HMO plan for this purpose.

 

3. There are 5 level of plans: Catastrophic (hard to find now), Bronze, Silver, Gold, Platinum. Premiums range from $160 to $350, ish. With the Marketplace making the market more even, these labels are pretty consistent across all companies. Better plans will have lower copays, lower deductibles, and lower out of pocket maximums.

 

4. When you choose a plan, read the benefit (or ask the agent on the phone) carefully. Deductibles are pretty high (with the lower plans) and if a benefit says "after the deductible is met" then it will likely be useless to you. These deductibles are meant to be met over the course of the year, which means you pay pretty much full cost for the first visit or two (or three or more!). Since you are just worried about the super expensive costs, it might be better to go for Platinum coverage. It will cost you an extra $200 but given that you will only use this plan if you get into the hospital, you are basically choosing between:

- Get no insurance and have a very low risk of paying thousands of dollars for help

- Pay $160 for minimal insurance and have a very low risk of paying $6600

- Pay $320 for maximum insurance and have a very low risk of paying $4000

 

So it's up to you to decide what level of risk you are willing to take! Hope this helps!

[rising_star]

MathCat, I'd consider what your personal health history is. If by "something catastrophic," you mean get hit by a car while walking down the street, then the person who hits you would be paying your medical bills using their car insurance. If you mean slip, fall, and break your wrist, then I can honestly say that if you use low-cost clinics and county health departments, you would pay significantly less than $4-6K out of pocket to have that treated. County health departments typically work on a sliding scale so, as a graduate student with little income, you'd be paying a few hundred or less for most things. 

[MathCat]

@rising_star I have had medical experiences that could have financially ruined my family if I'd been in the US without insurance, so I'm not willing to risk it. I can afford to pay for insurance I probably won't use, and I could manage to pay the deductible on a cheap plan, but definitely not hospitalization costs if it did happen.

 

@TakeruK Thanks a lot, this is very helpful information. I'll look into these plans!

[St Andrews Lynx]

I got travel health insurance from the Post Office (UK) to cover the gap. I think I was advised to have proof of health insurance to show at border control when I arrived. As I recall, it wasn't too costly, and I didn't need to use it.

[PoliticalOrder]

Why not travel insurance from something like CAA?

[MathCat]

Why not travel insurance from something like CAA?

Well, every single travel insurance option I've looked into has the same issue as Blue Cross - they want me to buy coverage until I will return to Canada next. That is much longer than the 3 weeks I need coverage for, but I might end up going that route anyway. I'm not completely positive that there's no other issues with it though - e.g. I will have told MSP I'm going to the US for school. I'm not sure if that affects my eligibility for travel insurance. I will call and ask for clarification on these potential issues tomorrow.

[PoliticalOrder]

It shouldn't matter what you are doing or when you go back. For BCAA for example (not Ontario but should be comparable), you just have to put in that you are going to the USA and how long you want coverage for; three weeks shouldn't cost more than $150, even less with a high deductible. You can also buy it online.

[have2thinkboutit]

While it's true that it's usually possible to pay for only the time you're abroad the insurance company might not pay for you if you cannot prove that you've completed your journey. That's what my provider told me when I needed health insurance for a month last winter. That seems to be the standard for travel insurance. I'd recommend going with one of Takeruk's options. And being able to visit your friends and family for thanksgiving doesn't sound like a bad trade off to me

[PoliticalOrder]

^

 

Not where I am from. The only important date is your departure date. Because the time you purchase for travel insurance has nothing to do with how long or when you return home it has to do with how long you purchase coverage for. In other words, if you only purchase coverage for a week of your month long trip, that's your prerogative. Similarly, if you don't ever return home, that has no difference whether or not you are covered for the period that you purchased the plan for.

 

Here is the official policy from Ontario's CAA:

 

http://www.caasco.com/Insurance/Travel-Insurance/~/media/insurance/documents/TI_Policy_Guide.ashx

 

There should be no reason you cannot purchase travel insurance for 3 weeks for your time in the US despite not returning after those three weeks. That is exactly what travel insurance is for.  

[MathCat]

Well, I'm not coming from Ontario, and the Blue Cross rules here seem to state I must actually be returning to my province on the end date of my travel insurance. The rep I spoke to on the phone told me I would need to purchase travel insurance until I am back in Canada next. I saw the same language in the other travel plans I looked at (it's a return date, not an "end date", and they specifically state in the terms that you must return to your home province), but I will call again to make sure. I may just plan a trip home earlier and get travel insurance, if that's the only barrier. I'm not sure if MSP will be an issue.

[PoliticalOrder]

There are plenty of other travel insurance options out there besides Blue Cross.

 

One for example, http://www.worldnomads.com/doesn't state anything about needing to return anywhere. 

[TakeruK]

In general, medical travel insurance is only intended for emergency services that you cannot wait until a return trip home. Once you are well enough to return home, you will be expected to return to Canada and complete any necessary treatment there. Insurers like BCAA and CAA seem like they will be okay without proof of return trip (at least, to get a quote) and they also have "annual" plans for frequent travelers. So maybe it will work out that you can tell BCAA that you have not yet determined when you will return, and they will be okay with that. Then, if you do get injured you can book a flight home and finish up the treatment in Canada (as the travel insurance only covers emergency costs that you cannot wait until you get home). Maybe this will satisfy the insurance companies, but maybe it won't -- we're not experts here. Again, up to you to determine the amount of risk you'd want to take.

 

In my opinion, if you do choose to get insurance, you would be much better off getting it from a US provider instead of the travel insurance because you aren't really in the US for just those 3 weeks. If an unfortunate accident or emergency does happen, you may want to be able to get treatment and plan for recovery while in remaining in the US and minimizing the disruption to your studies. But this would just be my personal choice if I were to be in the same situation

[MathCat]

I looked into a fair number of things and ended up getting student travel insurance from Scotiabank. They sell a student travel plan that is pretty much exactly for this purpose - you can buy emergency medical coverage for up to 30 days prior to the start of your program. No issue about return dates or anything like that.

[TakeruK]

Yay, glad to hear you found a solution