Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Health Insurance

Hi Guys,

I have a question for some of the Americans on the forum.

I will likely have the opportunity to move to the US in the next 5 years. If I do make the move, I will likely be working as an ICU specialist in a hospital. I come from a country where I have universal coverage.

Will I be able to get health insurance with my diagnosis of AS?

Yes, you should be able to get health insurance. The vast majority of US residents do have health insurance. The very small minority that do not are getting a lot of media and political attention at the moment.

The majority of US residents have employer sponsored group health insurance. Since 1996, it has been against the law for group health plans to refuse coverage or impose pre-existing condition clauses. Group plans are also prohibited from canceling coverage due to illness or health history. It sounds like you will be working for a hospital or a medical employment agency. You would be entitled to the same health insurance options at the same price that they provide to any other employee.

If you will be self employed, under the system still in existence today, you would either need to purchase private coverage of join some other group plan. Private coverage could be problematic - however if you can get your Canadian coverage classified as "creditable coverage" private health insurance is not impossible (just expensive.) The Patient Protection Act (Obamacare) as it is currently written will open up access to medical exchanges through which all residents - regardless of health status - can purchase health insurance. Obamacare is controversial. It may, or may not, survive much past the next Presidential Inauguration. If it ends up being repealed, it will most likely be replaced by some other optional health program.

Reports of masses of uninsured Americans dying due to lack of health insurance are greatly exaggerated by the media and the politicians. Hospitals in the US that participate in the Medicaid program (most of them) are required to treat emergency patients regardless of ability to pay. (Note, emergency does not mean a minor flu.) As a financial officer for a major health care corporation, I can tell you that we spend a significant amount of our annual budget on uncompensated care.

Single payer will come to the US at some point. Probably not next week though.

I wouldn't be so sure. The members of the American Public who have health insurance (the vast majority) are not going to be happy with the restrictions inherent in single payor plans. (There is no single payor plan in the world that I am aware of that allows TNF therapy for spondylitis without radiological evidence, but it is a common practice in the US. All those without radiological evidence will not be happy to have TNFs taken away.) There will most likely be a single payor option (government run health care) for those who want it. The problem is that there is a segment of the population that don't want it if they have to take any financial responsibility at all (taxes, fees, co-pays, coinsurance, premiums, etc.) The poorest of the poor have insurance - or at least have access to it. Many of the uninsured choose to be uninsured. There is a small number who do not have insurance because they do not work for a company that offers it and they have a pre-existing condition that makes it too difficult and too expensive. They will opt for the eventual single payor plan.

Stormy is right. California has a special MediCal program for women in the low or middle income group who have no insurance and have breast or cervical cancer, perhaps it covers other cancers also. My daughter, Sandy, works where they have no insurance and after she was Dx with breast cancer, was told about that program by her doctor's office. They have been wonderful to her. She has had excellent care. Mammograms every 6 months, great doctors, chemo, hospitalization, you would never guess that she was covered by MediCal instead of the best insurance. The Cancer Center nearby treats everyone regardless of their ability to pay.

My husband and I have insurance provided by the company he retired from. The most we pay is 10% for some services and many services have no charge. I get 3 months of Humira for $50.

Hi Stormy,

I certainly didn't mean to imply that Americans are dying on the streets without coverage. Everyone I know in the States has good coverage. I just have never had to deal with this sort of thing before. It is good to know I have some options. If I can't get coverage, there is no way I can make the move

No worries. I did not think you were implying that at all. It was just an honest question from someone thinking ahead. You are wise to know what you could be getting into.