Relocating: Europe to US / health care confusion

[everyDollarIsGreen]

Hi everyone,

We are a family of 4 (my wife, two kids, and me) and moving to the US/Oregon. I will be starting a job at Oregonstate University. Their medical plans are explained here [1,2]. Previously, we had universal health care and never had to think a second about health care plans. Now, I keep on reading about this topic and end up being more confused than before. These are the problems I'm facing:

1) Coverage by any medical plan through Oregonstate only seems to start the month after start of employment, e.g., if I would start Dec 16 then coverage would only be available starting by Jan 1. We will be arriving some weeks prior to the anticipated job start date so either way, we would need some kind of short-term health care plan (6-8 weeks) to have us covered in case of emergency, COVID, etc. It is absolutely no option to not have some kind of coverage during that time. What are our best options for this kind of short-term medical insurance? Any recommendations?
2) To further complicate matters, my wife is pregnant, so while I expect that delivery of the baby will happen under coverage of the 'final' health care plan, I'm not sure if that insurance policy is going to cover for the cost of the delivery, since that pregnancy would be a kind of pre-existing condition? Ideally, the short-term medical insurance we need to bridge the gap would take that into account, e.g., for 1 or 2 check-ups.
3) It seems to me that based on [2] Oregonstate employer contribution is 95% (!?!) to the monthly premium so it kind of does not matter which plan I choose from [3] since the monthly premium is pretty much covered by Oregonstate anyway? Any recommendations by the MMM-experts?

We are otherwise 'reasonably' healthy and in our 30s. The only major health issue I had so far was severe reflux as a result of a hiatus hernia. Luckily, this could be solved by a surgery but I will require a gastroscopy every 2 or 3 years as a check-up to ensure early detection of esophageal cancer (the risk is small but not zero; so I do not want to take any chances).

While we are otherwise financially responsible people (more focused on the 'FI' part of FIRE), when it comes to health care we are mostly interested in a convenient, 'European-style' all-around-protection choice that has us covered. So we are not necessarily looking for the cheapest option with too many strings attached.

Any thoughts or suggestions are highly appreciated!

Thank you.

everyDollarisGreen

[1] https://hr.oregonstate.edu/benefits/current-employees/insurance/core-benefits-health-vision-dental-basic-life/medical-plans
[2] https://hr.oregonstate.edu/benefits/current-employees/insurance/cost-health-plans
[3] https://www.oregon.gov/oha/PEBB/Documents/OE-2021/Summary-Benefits-2021.pdf

[reeshau]

Regarding #2, that will only apply for your "final" plan, the one sponsored by your employer.  That does not apply to just any plan you might find.

Do you have any foreign medical coverage from your home country?  My Irish coverage included global healthcare, when "Irish options are not available." While the language was there to apply to specialists, it would also apply if you were not in the country.

Are you working with a relocation company?  I would ask this question to your contact there for assistance.

The other potential would be to look for medical travel insurance for the gap period.

There are short-term health insurance plans available, but they aren't subject to the standards of the Affordable Care Act, so that leaves them open to any level of coverage. (Or lack of coverage)

[Abe]

You can go to healthcare.gov and sign up for a health insurance plan for the family that is ACA (affordable care act, the current US government regulations for health insurance). You can then cancel the policy once your employer-paid policy starts. The policies will cover things you would need in the short interval for emergencies, and probably be equivalent to what you’d get from the employer plan long-term.

It’s common for government jobs to cover most, if not all, of your insurance premiums. You’d just pay for the temporary coverage and then for a percentage of bills afterwards (usually 10-20% depending on specifics of your insurance).

When you sign up (both for employer and through healthcare.gov , don’t get the cheapest option as that leaves much to be desired usually).

[Paul der Krake]

You can go to healthcare.gov and sign up for a health insurance plan for the family that is ACA (affordable care act, the current US government regulations for health insurance). You can then cancel the policy once your employer-paid policy starts. The policies will cover things you would need in the short interval for emergencies, and probably be equivalent to what you’d get from the employer plan long-term.

It’s common for government jobs to cover most, if not all, of your insurance premiums. You’d just pay for the temporary coverage and then for a percentage of bills afterwards (usually 10-20% depending on specifics of your insurance).

When you sign up (both for employer and through healthcare.gov , don’t get the cheapest option as that leaves much to be desired usually).

This will never work for people who are new to the country and won't even have Social Security numbers for a at least a couple of weeks.

The bridge plans that are available off-exchange likely won't cut it for a pregnancy. Realistically, OP should move his employment start date to be well before or well after the expected delivery date.

[Abe]

You can go to healthcare.gov and sign up for a health insurance plan for the family that is ACA (affordable care act, the current US government regulations for health insurance). You can then cancel the policy once your employer-paid policy starts. The policies will cover things you would need in the short interval for emergencies, and probably be equivalent to what you’d get from the employer plan long-term.

It’s common for government jobs to cover most, if not all, of your insurance premiums. You’d just pay for the temporary coverage and then for a percentage of bills afterwards (usually 10-20% depending on specifics of your insurance).

When you sign up (both for employer and through healthcare.gov , don’t get the cheapest option as that leaves much to be desired usually).

This will never work for people who are new to the country and won't even have Social Security numbers for a at least a couple of weeks.

The bridge plans that are available off-exchange likely won't cut it for a pregnancy. Realistically, OP should move his employment start date to be well before or well after the expected delivery date.

You don't need a social security number for ACA healthcare plans. Two of my colleague (one from Tokyo, another from London) did exactly this when they moved here last year.

[Paul der Krake]

You can go to healthcare.gov and sign up for a health insurance plan for the family that is ACA (affordable care act, the current US government regulations for health insurance). You can then cancel the policy once your employer-paid policy starts. The policies will cover things you would need in the short interval for emergencies, and probably be equivalent to what you’d get from the employer plan long-term.

It’s common for government jobs to cover most, if not all, of your insurance premiums. You’d just pay for the temporary coverage and then for a percentage of bills afterwards (usually 10-20% depending on specifics of your insurance).

When you sign up (both for employer and through healthcare.gov , don’t get the cheapest option as that leaves much to be desired usually).

This will never work for people who are new to the country and won't even have Social Security numbers for a at least a couple of weeks.

The bridge plans that are available off-exchange likely won't cut it for a pregnancy. Realistically, OP should move his employment start date to be well before or well after the expected delivery date.

You don't need a social security number for ACA healthcare plans. Two of my colleague (one from Tokyo, another from London) did exactly this when they moved here last year.

Were they able to get to start promptly upon arrival? If so, that's great news.

[Dollar Slice]

It varies by state, unfortunately, so it is hard for people in the rest of the country to answer - but I would guess that Oregon has pretty good ACA healthcare options and you would be able to sign up for it. You definitely would be able to here in NYC, they have special plans designed for non-citizen new immigrants. There's no benefit to society to having people arriving here with a job and no access to health care.

FYI - finding doctors who are "in network" is key to American healthcare. You'll notice most of the plans list different benefits for "in network" and "out of network"; you might pay $10 to see a doctor in network but you'll be billed 30% of the cost if they're out of network (which might be hundreds of dollars if it's a high-end specialist). What you could do to simplify things for yourself is to sign up for (for example) a Kaiser ACA plan and then sign up for a Kaiser plan with your employer, and then all of your doctors will be in the Kaiser network for both plans.

I do think the Kaiser Traditional plan looks like the best one if the premium cost isn't a factor, although I only glanced through them for about five minutes, so someone else can feel free to point out anything I missed.

[Abe]

That’s a good point. I would recommend the Kaiser plan for you based on coverage and medical quality of care.

[Dicey]

That’s a good point. I would recommend the Kaiser plan for you based on coverage and medical quality of care.

Kaiser has strengths and weaknesses, but there's no chance of getting caught in the in/out of network maelstrom, so for that reason alone I second @Abe's recommendation. Since he's a non-Kaiser MD, his recommendation means a lot. I'm just a Kaiser member.

Given that you and your spouse will be dealing with all manner of new experiences on top of being pregnant, Kaiser's one stop shop approach will definitely remove some of the stress.