I broke down tonight — the stress suddenly took hold of me and I couldn’t climb over it. My husband didn’t know what to do with me, and I just sat and sobbed. It’s not like me — I handle stress by doing things — but tonight I didn’t have the strength and so the panic took hold of me and rendered me powerless.
M received a formal offer yesterday from a company he liked and would be very happy to work for. It’s a good offer — we should take it. So why am I feeling like I want to go upstairs and crawl under the duvet, never to leave Britain — never to leave my bed — again?
Health insurance is scaring the hell out of me, for one thing. This offer includes family health cover — paid 100% by the company and with a very good provider — which is excellent, but the are so many grey areas which I find that I either don’t understand or which infuriate me, or both. Take the exclusion period for instance: there’s a 60-day exclusion period before the health cover kicks in, during which we are uninsured. What is the purpose of this exclusion period, and how people in the US normally go about getting coverage during this time? I asked two people in States — a dear friend of mine who is an insurance agent in another state and my mother’s boss, who handles the health provision for her employees — and the answers have made me see red. The reason there is an exclusion period is because it’s standard practice for employers to not extend benefits to new employees until they are sure their new hires are going to work out. Well, I can understand that when it comes to nice-but-unnecessary benefits such as retirement plans, bonuses, gym memberships, even vacation allowances, but not something as day-to-day essential as health coverage. You can live without the others for a few months with no real adversity, but being without health cover for even a day has the potential to bankrupt people and wreck lives. To withhold something that basic is like withholding an employee’s pay. Who would find it acceptable if employers said, “We think you’re great and we want you to come and work for us, but we want you to work for us for several months with no pay until we’ve seen if you’re going to work out.” Unthinkable! So why is it acceptable to do that with something so essential as health cover?
But it was the answer to my second question that really made my blood boil. No, to be more accurate, it was the apathy in the response: you could hear the shrug of her shoulders as my mother’s boss said, “Well, I guess it might be possible to get temporary cover… I don’t really know. I think most people just gamble for those couple of months. You know, a lot of young people just don’t worry about it because they’re young and healthy.” She said this as if it were perfectly reasonable and — I thought — she might have been implying that it was an option for us, as if we were a couple of happy-go-lucky kids deluded in a belief of our own invincibility rather than the fully-grown, adult parents of two small children that we are. “I mean, it’s not like any of you are going to get sick.” She was talking about us, and almost saying out loud that I was being silly and paranoid to worry that we might need health care in those first couple of months. I came over all hot with indignity and was suddenly having trouble keeping my voice calm and pleasant as I blurted out, “No, but there’s a real possibility that we will all four be in a head-on collision as we learn to drive on the other side of the road!” Her response? She laughed and started chatting about some film she’d seen recently with a similar scene. As if I cared.
I also asked about E2′s recent troubles and the blood tests they are running: if they turn out to be positive and they diagnose her with coeliac disease (or something else) in the next few weeks, will that affect her coverage for it when we get there? My friend said probably not, as it’s group cover; my mother’s boss said it may. Either way, we don’t know for sure. And somehow, that’s what really shook me. The other stuff made me angry — really angry — but this frightened me to my mother-core. The idea that my child might be diagnosed with something and then hung out to dry just made me feel sick. It made me feel sick then and it makes me feel sick again now as I’m typing this. Everyone in the States that I talk to about this says it’s just how the system works, but it’s just not something that I can be that laid back about. Maybe I’m over the top and paranoid — or maybe I’m just a mother.
And that was what did me in. There are just too many unknowns with this move and my brain can’t handle it anymore. Everything feels right on the edge: the base pay is nearly enough to live on, but not quite; there’s commission on top that might make up the difference, but we can’t know how much money that will actually be until we take the plunge — will it be enough or not quite?; there’s the very meagre vacation provision (this job gives 5 days — which is better than others — but that still seems so mean when it’s M’s only chance for the entire year to travel around the world to see his kids); there’s the evening classes he’ll have to take, which means I’ll be alone with the kids several evenings a week as well as all day every day; there’s the whole health cover issue… So many things right on the edge — not one of them positioned well within the comfort-zone. If there were only one or two that were on the edge but lots of others that were sure-things, I think I could live with it. I’m ok with taking chances… just not with chancing everything.
And so it all overwhelmed me tonight, and I broke down in uncontrolled sobbing. I told M I don’t want to go. I want to stay here, I wailed. He was taken aback and said, “But how can we? We’ve gone over it time and again and there’s no way to make it work.” And that bit of truth sent me into new despair and I couldn’t control my crying.
We have to give this company an answer by Monday. But I feel like we’re back to square one — still completely unsure whether or not we should even go at all. I have no idea if it will work if we go, but equally no idea how to make it work so we can stay. I feel drained, exhausted, angry, frustrated, and frightened frightened frightened. I just don’t know what to do.
Stumble it!
Oh, hon, what a heavy weight to bear. This was our number one concern when we moved back, also. T was coming back to a job – but I wasn’t, I had no prospects and no idea what I would be doing. I knew I could always do nannying to pay the bills, but it was likely to be under the table and would certainly not provide health coverage. We were incredibly lucky to be covered by T’s company from day 1.
Failing that – I had gathered information about short-term catastrophic policies. They do exist! They are perfect for just the situation you mention – being in a collision, or some other completely unpredictable, and urgent, situation. I can try to dig up the information I found for you if you would like. I figured – and I think it is safe for you to assume this as well – that any issues that I would want to see a doctor about could wait a few months, or could be addressed at an urgent care clinic with a sliding scale for fees. If your child has an ear infection for example, the clinic will be fine. If you would like to discuss an ongoing health issue, it can probably wait 60 days. What I *do* recommend, however, is finding out exactly what your coverage will be so that you can phone and make appointments with (a) new doctor(s) asap, since some of them have waiting lists of a couple of months for non-urgent new patient appointments.
In the US, if you are transferring from one employer to another, with a gap in insurance (or are fired and don’t have a new job yet), you are offered the chance to purchase COBRA insurance which is for situations just like that – but there is really nothing equivalent for us returning expats.
As for E2′s situation – I am 99% sure that a group plan such as the one you will be covered by MUST cover her care. The other thing to do – if you are worried – is to just not present all of her records, and have them retest and rediagnose (not telling them you already have a dx, if you do).
Finally, I wanted to mention just one more niggling thing to think about: start planning now to request your records from your GP in the UK if you plan to bring them across with you, as it can take up to 30 days and they will likely balk at mailing them to the US :-/
If you have more questions or anything, let me know – I didn’t make the move with kids, but I did make it with T and I both having chronic health issues that require follow up and so health insurance was my #1 priority.
Oh – and 100% employer-paid insurance is FABULOUS. We used to have this but starting in 2008 we have to pay premiums and I am not amused.
Most auto insurance covers hospital bills up to a certain amount if you were to get into an accident. Look into that.
Also, what about moving up north in the UK where cost of living is lower? Have you looked into that?
I understand your anger and your frustration. Health insurrance and the new drug plans in the US are not working out well at all. Here’s a quote from a friend of mine who looks after her mother full time who had a stroke and requires a lengthy period of therapy.
“…being stressed out over insurance issues…
I don’t often write about the “trials” of caregiving and long term care issues (maybe because I doubt many will actually “get” it and mostly because I dislike having that be my whole identity….probably I should write about it more…might be cathartic) but let’s just say I was greeted with a huge dose of reality when I arrived home from European fairyland. We have been expecting it for awhile but received the firm information that our particular insurance company will now cap All Physical Therapy at £1,220 ($2500) per year! If you don’t understand what that means…it means about 10 sessions…maybe enough to actually help you if you break a toe or something. For longterm stroke/brain injury rehabilitation issues, this amount is a joke. But it’s completely legal…no real recourse. Not based on medical research, doctor’s orders, or individual needs. (Umm, folks we already have socialized health care!) The fact that Mom sees one of the leading stroke rehab. specialists in the world who certainly prescribes a different plan of treatment makes no difference whatsoever. And while we will certainly make some noise & some complaints, we are well aware that any real trouble could jeopardize Dad’s job, so we mainly are powerless. (btw, your insurance is probably similar, you just don’t realize it….alot of people have had this almost unbelievably low cap for awhile…and the whole system is contingent on whatever Medicare dictates…regardless if you’re actually eligible for Medicare or not.)”
Health Insurance is one big reason why I won’t live in the US again.
Courage! It’s OK to be stressed and sad – you’ve got a lot to deal with.
I know nothing about US health provision, but if E2 does have coeliac disease, once she is on a strict gluten free diet she will be as healthy as any other child. It might take a few weeks for her digestion and energy levels to settle – and a bit longer for her bone age and size to catch up with the average child, but she stands a good chance of being just as fit and healthy as the others. I’m keeping my fingers crossed that it is ‘only’ coeliac disease …
That is stressful S! One of the reasons I was happy to move to Canada was the universal healthcare. That said, you should be able to pick up a catastrophic policy for a reasonable amount, and it’s true there are clinics that can help you as well, like Abigail said. But coming from the UK as you are, I understand your anger about the US healthcare system, and I share it. Health is too precious to gamble with! Anyway, it sounds like a good policy other than that. Sorry you’re feeling so stressed–it’s understandable though, although I have a feeling everything will work out fine if you do take theplunge.
We did it. We were quite lucky to easily slide into jobs after making the move across, but once we wanted to move from that easy space, we were faced with many of the same concerns as you.
We got jobs that were okay, not great, but made the transition doable, and gave us what we needed to get a house.
We then took the time to search for our real jobs, not what-will-get-us-moved jobs.
I cobbled together part time work, my husband commuted huge distances for little pay, but slowly, surely, with a few years of patience and hard work, we’re where we want to be.
All the planning in the world won’t make you hit the states in a place you wanted to get to. You have to do what gets you across–pay the high bills, work the not-so-perfect jobs in the not-so-great ways, and feel satisfaction that you work WILL pay off in the end, unlike the situation you are describing being in now.
My advice would be to move the target from the time you land to, say, a year or so after you get there. Grit your teeth, give it one last surge, and then enjoy the spoils.
Oh gosh, what a day. That’s frustrating I’m sure. I don’t know how health coverage is across the Atlantic (I like in Florida) but I know how frustrating it is here. I heard that the US is actually ranked one of the worst countries for health care but the best in emergency response care. Isn’t that just ridiculous. It makes me embarrassed for my country. After I got married, I didn’t have health care for about a month and I was so terrified. Because if you do get sick or hurt (or pregnant) while you are uninsured, they won’t cover you for it when you do get insured calling it a “previously existing condition” Yeah. Sucks. Luckily, I didn’t get sick or pregnant and now I’m covered. But not by my employer, they don’t offer it to me (sucks right?) but I’m under my hubby’s insurance which is pretty good. Ugh. Health insurance makes my blood boil too. We’ve joked about moving to Europe or Canada just so we have healthcare.
I hope that it doesn’t stress you out too much. I’m sure it will work out. PS. I’m addicted to your blog.
I just want to thank you all for your responses — there’s a wealth of info in there that is really helpful and I really appreciate.
Abigail, thank you for all that — a lot of food for thought. My mum and I have started looking into short-term policies to cover the gap. $700 a month (!!!!!), but we can do that if it’s only a couple of months.
Do you happen to know what would happen if any one of us was diagnosed with something (something big or big-ish) whilst on that temporary cover? Would it then be covered or excluded when we switch to the employer’s cover? Just something I suddenly wondered…
NS, interesting point about the auto insurance! I didn’t know that.
Moving north… we have considered relocating within the UK, but I’m not sure it would make up the difference… very hard to live on one salary, though I am determined to do it if we can while the girls are so little, especially with E2 being such a sensitive little thing (both physically and emotionally *rolls eyes*). When we first considered it, it made moving to the US all the more logical — why move to a part of the UK where we’re only *just* financially better off and are totally isolated from everyone we know, when we could move to the US and be more better off and surrounded by family. But… as we get closer to the move and also start looking into the scary details, nothing seems so darned logical anymore…
Oh NCMrsD! Thanks for that, but you’ve just scared me to death AGAIN!!!!! :-X
Lucy, thank you thank you thank you — those few words settled me right down. If she does turn out to have coeliac, it’s a real relief to hear that she can be as healthy as anyone else with a managed diet. Reading that made me feel quite positive again.
Erin, if it all goes wrong, we’re coming up north to move in with you in Canada, ok?
It’s funny, isn’t it, how only a few years away living in a system of universal healthcare really changes your view of the US health system? I don’t want to see a UK-style NHS in the US, but I really do think the US system needs to be changed.
Sedders, well said! You reminded me of what my father says and I so often forget, “It’s not your last house, it’s not your last job.” It’s so easy to get all tied up trying to get *everything* absolutely *perfect* first time, and to forget that you do it in stages, take step to where you want to be instead of one great big leap. Thanks for that.
Miss-Mrs, I think that’s it *exactly*: when Americans — normal, hard-working, Joe-Average Americans — feel like that have to move countries in order to have something as *basic* as decent healthcare, then you know there’s something wrong with the current set up. As I said, I don’t want to see the US adopt a UK-style NHS, but there are ways that the system can be vastly improved in order to provide cover to all.
Hey, and thanks for the compliment. You’ve made my day!
It does vary but in general a group plan (through an employer) cannot exclude preexisting conditions. With private plans, I think they can for SOME things but not for all things, and I also believe that they WILL cover the conditions after a certain amount of time (up to 12 months, if I recall correctly). It is so variable from place to place though.
For your girls, here is information on the CHIP program for PA: http://www.chipcoverspakids.com/ This is a federal requirement that all states provide health insurance for kids, there are different income requirements/pay scales etc but it does give you an idea of what is available in a worst-case situation for the girls. It looks like the income cut-off for free coverage for your family is $41,300/year, with graduated pay scales after that (http://www.chipcoverspakids.com/upload/admin/File/CAK_Premiums_2007.pdf).
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