Need Health Insurance Help

[kdavid3]

While this forum may be an odd place to ask this question, the Candle for Love community has been one I've been a part of for awhile now, and one I've found to be educated, open-minded, and extremely helpful. Thus I bring my issue here:

 

I've just within the last hour been diagnosed with an issue which requires somewhat serious surgery.

 

I'm looking into all my options right now, and one is returning to America for the operation. (I live in China.)

 

Obviously, the biggest problem here is that I don't have health insurance. So, what are my options? Do I have any?

 

I'd appreciate any help anyone could provide. Thanks!

[Guest ExChinaExpat]

While this forum may be an odd place to ask this question, the Candle for Love community has been one I've been a part of for awhile now, and one I've found to be educated, open-minded, and extremely helpful. Thus I bring my issue here:

 

I've just within the last hour been diagnosed with an issue which requires somewhat serious surgery.

 

I'm looking into all my options right now, and one is returning to America for the operation. (I live in China.)

 

Obviously, the biggest problem here is that I don't have health insurance. So, what are my options? Do I have any?

 

I'd appreciate any help anyone could provide. Thanks!

 

A few thoughts come to mind:

 

1. If recently diagnosed, it's important to get an independent second opinion. Especially if you were diagnosed by a Chinese doctor. I suggest you contact the International SOS by telephone and speak to them. They have offices in most major cities of China, including Beijing and Nanjing.

 

2. You mentioned you live in China. Are you working here? The reason I ask is that if you are working in China that all Chinese employers are required to provide social medical insurance. This will cover your medical expenses in most cases.

 

3. After several bad experiences with Chinese hospitals, I am not at all confident of medical training and facilities here. However, there are exceptions, but not many.

 

4. You now have a pre-existing medical condition given that you were diagnosed before having medical insurance in the USA. This means you are not insurable there. Not sure about any new laws going on as it's been too much of a mess there. Also, I think most international medical insurance companies also consider that you have a pre-existing condition.

 

In short, I again suggest you search and call the International SOS office nearest you.

 

https://www.internationalsos.com/en/

Edited January 3, 2014 by GuangDongExpat (see edit history)

[kdavid3]

Thanks for the quick reply.

 

A second opinion is a good idea, and one I'll seek on Monday.

 

I do work in China. My company provides insurance, and they'll cover procedural costs, but not medicine.

 

I've also had several bad experiences with my son. I really don't want to do anything major here, hence my search for information about returning to the States.

 

I've been researching this all day, and it seems under the new laws that I cannot be denied insurance for a pre-existing condition. I'm still looking into this.

[Steve in USA]

Another option to surgery in China or returning to the US, is to look into medical tourism in India. Some facilities cater to Westerners with US trained doctors and nurses, and offer a resort experience for after surgery recovery. Cost is substantially less than in the US, and quality of health care is several magnitudes above China. Maybe your employer provided insurance would cover this?

 

http://www.medical-tourism.com

Edited January 3, 2014 by Steve in USA (see edit history)

[Dennis143]

 

 

4. You now have a pre-existing medical condition given that you were diagnosed before having medical insurance in the USA. This means you are not insurable there. Not sure about any new laws going on as it's been too much of a mess there.

 

 

Not true. It is illegal to deny anyone healthcare due to a pre-existing condition under the Affordable Care Act.

Edited January 3, 2014 by Dennis143 (see edit history)

[amberjack1234]

 

 

 

4. You now have a pre-existing medical condition given that you were diagnosed before having medical insurance in the USA. This means you are not insurable there. Not sure about any new laws going on as it's been too much of a mess there.

 

 

Totally false. It is illegal to deny anyone healthcare due to a pre-existing condition under the Affordable Care Act.

 

Dennis is absolutely correct on this issue. It has just come on line and I would suppose that many American citizens in other countries don't know about it or know very little about it. You can come back to the US and sign up with any insurance company that you wish to and they CAN NOT reject you for pre-existing conditions. Blue Cross/Blue Shield is one of them. As a matter of fact if you are in the US and don't sign up with an insurance provider you will be fined come income tax time. That cutoff was 24 Dec 2013 but even so I am sure that you would not mind paying a small fine to get signed up under your circumstances. The fine might not even apply to you being that you have been out of the country.

 

Larry

 

Edit to say: I am sorry about your problems. I wish you well.

Edited January 3, 2014 by amberjack1234 (see edit history)

[credzba]

While this forum may be an odd place to ask this question, the Candle for Love community has been one I've been a part of for awhile now, and one I've found to be educated, open-minded, and extremely helpful. Thus I bring my issue here:

 

I've just within the last hour been diagnosed with an issue which requires somewhat serious surgery.

 

I'm looking into all my options right now, and one is returning to America for the operation. (I live in China.)

 

Obviously, the biggest problem here is that I don't have health insurance. So, what are my options? Do I have any?

 

I'd appreciate any help anyone could provide. Thanks!

 

Many of us who want to retire in China have considered medical choices.

In my investigation I found that Thailand has excellent America level hospitals, and the cost is cheap enough that your cost without insurance wont be insurmountable.

 

I have not checked any more than that, but it is a consideration.

[Steve in USA]

It is illegal to deny anyone healthcare due to a pre-existing condition under the Affordable Care Act.

Very true, provided the insured can afford to pay for the plan. Rates are taking off like a Saturn V. Edited January 3, 2014 by Steve in USA (see edit history)

[Guest ExChinaExpat]

Thanks for the quick reply.

 

A second opinion is a good idea, and one I'll seek on Monday.

 

I do work in China. My company provides insurance, and they'll cover procedural costs, but not medicine.

 

I've also had several bad experiences with my son. I really don't want to do anything major here, hence my search for information about returning to the States.

 

I've been researching this all day, and it seems under the new laws that I cannot be denied insurance for a pre-existing condition. I'm still looking into this.

 

You say your company provides medical insurance. Are they providing an international plan that allows you to be treated outside the China mainland? Or, do you work for a Chinese company that is only providing "Chinese Social Insurance?" Chinese social insurance only allows you to choose from a limited list of hospitals and doctors who would NOT be considered top tier by any measure. Further, Chinese social insurance only allows for treatment within the China mainland. Hong Kong is excluded from Chinese social insurance.

Edited January 4, 2014 by GuangDongExpat (see edit history)

[amberjack1234]

Yeah, that is true Steve but when you consider one night in the hospital can cost $47,000 dollars to sign up with an insurance company would be a wise decision. I had a cardiac stent placed in one of my heart artery 7 years ago and stayed in the hospital less than 20 hours and the cost to the hospital alone was $47,000. Of course that was for the use of the operating room for less than one hour. I have a good friend that is an operating room nurse and she says that the hospital administration is constantly on their a** to count even the seconds that a patient is in the OR. That $47,000 did not cover the anesthesiologist or the doctors fee.

 

Larry

[Randy W]

The last I've heard about the Obamacare expat exclusion was that the test would be along the lines of that of the Foreign Earned Income Exclusion. That is, as long as you qualify for THAT (regardless of whether you actually had any excludable income), you are also exempt from Obamacare.

 

I don't know what has actually taken effect on that front.

 

Any fines he has incurred would be paid through the IRS at tax time, not related to actually signing up.

[dan1984]

The last I've heard about the Obamacare expat exclusion was that the test would be along the lines of that of the Foreign Earned Income Exclusion. That is, as long as you qualify for THAT (regardless of whether you actually had any excludable income), you are also exempt from Obamacare.

 

I don't know what has actually taken effect on that front.

 

Any fines he has incurred would be paid through the IRS at tax time, not related to actually signing up.

 

Hmmm, I'm all of a sudden rather confused. I've been living here in China and have travel medical insurance (nothing great, but covers the big things if I should run into a health problem). Do I need to sign up for Obamacare/something else or risk getting fined?

 

Also, let me get this straight, when it comes time to return to the U.S., upon arriving we can sign up for medical insurance and move forward with no string attached, ie, not be rejected for a preexisting condition?

[Randy W]

 

The last I've heard about the Obamacare expat exclusion was that the test would be along the lines of that of the Foreign Earned Income Exclusion. That is, as long as you qualify for THAT (regardless of whether you actually had any excludable income), you are also exempt from Obamacare.

 

I don't know what has actually taken effect on that front.

 

Any fines he has incurred would be paid through the IRS at tax time, not related to actually signing up.

 

Hmmm, I'm all of a sudden rather confused. I've been living here in China and have travel medical insurance (nothing great, but covers the big things if I should run into a health problem). Do I need to sign up for Obamacare/something else or risk getting fined?

 

Also, let me get this straight, when it comes time to return to the U.S., upon arriving we can sign up for medical insurance and move forward with no string attached, ie, not be rejected for a preexisting condition?

 

 

 

Again, my understanding is that as long as you qualify for the Foreign Earned Income Exclusion, you are exempt from the provisions of Obamacare, regardless of whether you are actually reporting any Foreign Earned Income. Check the Form 2555 for details of THAT exclusion.

 

The proof of the pudding will come in the tax returns for 2014. Check these instructions and forms (once they are issued) to see what boxes you will need to check or forms you will need to fill out in order to avoid the fine. I have every expectation that it will not be an issue for us expats.

 

Any fines that you or he DO incur are handled through the IRS.

[Steve in USA]

Yeah, that is true Steve but when you consider one night in the hospital can cost $47,000 dollars to sign up with an insurance company would be a wise decision. I had a cardiac stent placed in one of my heart artery 7 years ago and stayed in the hospital less than 20 hours and the cost to the hospital alone was $47,000. Of course that was for the use of the operating room for less than one hour. I have a good friend that is an operating room nurse and she says that the hospital administration is constantly on their a** to count even the seconds that a patient is in the OR. That $47,000 did not cover the anesthesiologist or the doctors fee.

 

Larry

My intent was only in cautioning the OP although he could not be now denied insurance coverage for a pre-existing condition, that insurance coverage is going to cost a lot more than others. The whole health care system is up in the air right now and not to expect premiums and proceedures today to be the same as in the past.

 

I had my galbladder removed last year and the 2 day ordeal was billed at over $23,000 to my insurance. I had to pay only a $150 for the ambulance. I like insurance too.

[Dennis143]

I just phoned and was able to speak with an ACA Healthcare.gov representative immediately. She told me that a person must be currently residing in the US to receive healthcare coverage through the ACA marketplace.