My wife is pregnant (21 weeks) and has an appointment coming up on Tuesday.
My job switched my health insurance to another company which is supposedly better and good healthcare is part of it.
The coverage from the new insurance starts on April 1st.
My old insurance dashboard shows that my coverage ends on December 31, 2024.
We’ve already paid for some things for her pregnancy (around $2.5k).
I also have a 4-year-old son and I think we’re currently all without coverage. I’m not too familiar with how this works since I’m a legal resident from Germany. Financially, we don’t seem eligible for ACA or other assistance.
What are the chances her appointment will be covered, considering we prepaid? In general, how much trouble are we in? Is there a way to get her covered again?
If your UHC was through your last employer, you need to talk to HR about what’s happening with your coverage. Did you update things during open enrollment?
Ray said:
If your UHC was through your last employer, you need to talk to HR about what’s happening with your coverage. Did you update things during open enrollment?
I didn’t have an option to update any info in the payroll system (Gusto) where I signed up for insurance last year. Do I really need to re-enroll every year?
@Lior
Typically, there’s an open enrollment period every year, and HR sends out a lot of info about what you need to do. Many employers will auto-enroll you in the same plan if you don’t make changes, but since your plan might have started on January 1st, the December end date looks strange to me.
@Ray
I have HR in the Philippines and there’s been no communication at all. I see my new coverage starts on April 1st. I’ll have to call UHC. My paystubs show they deducted for medical insurance for me and my dependents. Weird!
@Lior
For future reference, find out if your employer has passive enrollment. If they do, you don’t need to enroll every year unless you want to change your selections. If they don’t, then you must enroll every year during open enrollment.
@Cade
That’s really helpful info! Thank you! Looks like it might be passive enrollment, but UHC says I’m not covered… That’s going to be an interesting Monday for me.
@Lior
Did your boss transfer you to a new company to let you get health insurance during a special enrollment period? You might have to cover the appointment out of pocket, but ask HR if the job change allows you to enroll your family.
@Floyd
Yes, the job switch lets me enroll my family. I already did that with coverage starting on April 1st, but it’s strange that UHC says we aren’t covered anymore. No notice about any special enrollment. Thanks for digging!
EmeraldHydra2 said:
Could you consider moving back to Germany? The health system in the USA is very expensive, almost a scam.
As someone from the UK, I’m often surprised at how good the care is with my insurance in the US compared to the UK. I’d choose the care here over the NHS any day. I think it depends on personal experience.
@Kellen
Still, many people can’t handle a $10,000 visit to the ER or $20,000 for a simple birth. Even with insurance, they can hit you with out-of-network costs or say pre-authorization wasn’t completed.
@EmeraldHydra2
I’m saying that with my insurance, the care is just way better than what I’d get under the NHS. I have great insurance from my husband’s employer, and we’re lucky. But without knowing their insurance, just moving back isn’t an easy fix. If we moved to the UK, we wouldn’t be able to afford the needed chemotherapy. There’s a huge difference in insurance in the US, and saying to just go back isn’t really helpful. The NHS was not good for me, it’s universal, yet the quality suffered.
@Kellen
It honestly depends on where you are in the US. Where I live, cancer patients wait 3 months for evaluations while paying a ton and sometimes the pain meds are hard to get.
Galen said: @Kellen
It honestly depends on where you are in the US. Where I live, cancer patients wait 3 months for evaluations while paying a ton and sometimes the pain meds are hard to get.
In the UK they are trying to work on getting cancer waiting lists down but it’s tough.
“78.1% of people were diagnosed, or had cancer ruled out, within 28 days of an urgent referral in December 2024. The target is 75%.”
“Only 71.3% of people in England got their diagnosis and started treatment within 2 months of an urgent referral in December 2024. The target has not been met since December 2015.”
I wish patients here could see specialists and get treated within 2 months. Just getting in for an initial exam takes longer than that!
@Galen
My mum was diagnosed with cancer recently and it took her longer than 2 months from the urgent GP referral to diagnosis. This is a serious issue.
EmeraldHydra2 said:
Could you consider moving back to Germany? The health system in the USA is very expensive, almost a scam.
The German healthcare system is also pretty costly when you look at total employer and employee payments. But I get what you’re saying, it’s definitely a less stressful system in Germany.