Although we feel our travel insurance would be adequate while
traveling, what happens if one of us needs medical attention and we are sent back
to the States? Unfortunately, travel
insurance typically ends as soon as you land on U.S. soil. A more likely scenario is upon our return
where there is a vulnerable period where the travel insurance will no longer
protect us, yet we may not be employed in order to qualify for
employer-provided-healthcare. Even if we
did find employment, there may be a pre-existing condition clause with a
waiting period on that policy. Either
way, we would be uninsured when we return to our “real” lives – something that
makes us very nervous.
One way to avoid being uninsured when we return is to maintain
continuous coverage in the States during our absence. Sounds easy enough, but apparently it’s very
complicated. A couple of excellent blogs
have helped highlight some of the complexities with health insurance in the
States. Both blogs are available through
the Meet, Plan, Go website. They are
both, a “must read”: TravelHealth Insurance Providing Creditable Coverage and HealthInsurance for American Travelers. Frankly,
we hadn’t even thought about needing to maintain health insurance in the States
while we travel, but after reading these blogs, we definitely think that is the
way to go.
COBRA:
If you have read these articles, you would know that we do not qualify for COBRA
because we are voluntarily leaving our jobs instead of getting laid off.
CREDITABLE
COVERAGE AND PRE-EXISTING CONDITIONS: In the articles, you would also learn
the difference between creditable coverage versus non-creditable coverage, and the
problems caused by that pesky pre-existing condition clause.
Basically, creditable coverage
means that you have had “credible” health insurance coverage (most group plans,
Medicare, Medicaid, state health plans, some individual health insurance, etc.),
which may positively influence the pre-existing condition exclusion period in
your new health plan, as long as there was no lapse between creditable
coverages past 63 days. In other words, even if we are lucky enough
to get a job with a group health plan as soon as we return; the plan may have a
pre-existing condition exclusion for up to 18 months. Anything that we have sought treatment or
consultation within 6 months prior to applying for the new health insurance is
considered a pre-existing condition and may be excluded under the new health
plan for a period of time. However,
this exclusion may be waived or shortened by proof of having prior creditable
coverage within the last 63 days.
You ask, how easy or difficult
is it to obtain creditable coverage, privately or individually? Reading the blogs, it seems like a difficult
process. For starters, there aren’t a
lot of companies that underwrite individual, creditable coverage. Even if we find one, we may not be
eligible. In the Health Insurance for Americans, they explain how they had to change
their residence to New Jersey – in order to take advantage of some of the
consumer-friendly insurance laws. So, we will continue to do some research and
report back!
NON-CREDITABLE
COVERAGE: Travel insurance is non-creditable coverage. Many short-term health insurances are
non-creditable. The eligibility process
is less rigorous, and it costs less than creditable coverage. Earlier, we mentioned that once we hit U.S.
soil, travel insurance coverage typically ends.
Therefore, it may be prudent to maintain some kind of short-term health
policy in the U.S., “just in case” we need coverage upon our return. Although it may help with medical bills
initially, it will do nothing to help with the pre-existing condition exclusion
clause, as mentioned above. In addition,
the short-term policies we have reviewed provide insurance for up to 6 months,
at which point, they can opt to non-renew.
Since we are gone for over 6 months, we risk non-renewal; thereby, being
left uninsured anyway.
·
MAINTAIN
EMPLOYMENT/SECURE LEAVE OF ABSENCE: Many
people seek certain employment for its benefits. This is no different. One huge benefit of securing a leave of
absence instead of having to terminate employment, is the ability to maintain
benefits during our absence. The group
health plan is creditable, and because there will be no lapse in coverage, we
have nothing to worry about, except to pay the premiums during our
absence.
Bottom line: there is a lot to think about. Should we seek expensive, individual,
creditable coverage during our absence? Will
we even qualify? This will minimize the
risk of being excluded for pre-existing conditions upon our return. Or, should we maintain a short-term, less
expensive, non-creditable U.S. policy instead?
At least we will be insured, but risk non-renewal when we need it most,
and does not help with the pre-existing condition clause. The riskiest option is to simply go with
travel insurance only. Or, could we
secure a leave-of-absence, where creditable health insurance coverage can be
maintained? Next steps: research the
options, including cost, and report back!
