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Canadian moving to U.S. - Help with insurance!

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Posted 3/27/2017 7:34 PM (GMT 0)
Hi there,

I'm new to this forum so any advice is very much appreciated.

I am a Canadian citizen, and previously had my medication costs covered entirely by an insurance plan through my work in Canada.

Next year, I will be graduating medical school and will be doing my medical residency in the U.S. for 3 years, and I wondered if someone could break down how it works to pay for Remicade coverage in the U.S., assuming I have insurance through my employer (a hospital). Am I right in thinking that I can't be rejected for coverage anymore based on this pre-existing condition? How much should I expect to have to pay as a co-pay with each treatment? Anything else important you think I should know about accessing Remicade treatments in the U.S. as someone unfamiliar with the U.S. healthcare system?

Thanks very much in advance!!
-A
Posted 3/27/2017 9:44 PM (GMT 0)
Go to this website: healthcare.gov

Shop for a plan that works best for you as far as medicine, procedures, coverage and cost. You'll be able to enroll in one of those once you're here. You will not be discriminated against for having a pre-existing condition, thankfully.

Which state will you be living in? I can help with the details of California, but unfortunately the marketplace is different in every state.

The (left minority of our) government is now discussing expansion of coverage and potential for broader access. That said, you should be able to find a plan within that website regardless of where you're living. As of now, it depends on the state as to whether you can find a good, lower cost situation. Some states opted out of their Medicaid expansion (Alabama, Georgia, Idaho, Iowa, Louisiana, Maine, Mississippi, North Carolina, Oklahoma, Pennsylvania, South Carolina, South Dakota, Texas, and Wisconsin) which made premiums soar and some insurers opt out. I hope you'll be living in one of the 36 that did not do this.
Posted 3/27/2017 10:16 PM (GMT 0)
Yes, insurance is typically through your employer. It's only considered a pre-existing condition (and not covered) if you have a long lapse without health coverage. You won't so no worries. You've previously had remicade, so if you bring proof then it should be easy to get here.

Usa health insurance has deductables and copays. A deductible is a certain amount of money you must pay before insurance pays a dime, it can be hundreds of dollars, a thousand dollars, or thousands of dollars. Copays are an amount (like $50) that you must pay out of pocket for a service like a doctor's visit or a remicade infusion.

Look into RemiStart by the drug manufacturer, as it helps with the cost of remicade deductible and copays. Nearly everyone here uses it.
Posted 3/27/2017 10:48 PM (GMT 0)
Your employer will most likely provide you with insurance. You may run into the issue of a waiting period before your employer covers you, sometimes 3-6 months. Just an FYI.

There may not be a waiting period because it's a hospital and you're in a highly skilled professional job which is competitive, as an incentive they may provide health insurance after your first pay period.
Posted 3/27/2017 10:49 PM (GMT 0)
You don't need to go through the waiting period if you go through the exchange at healthcare.gov before your employer opens enrollment

Also: not all plans have deductibles on the exchange. I am on an HMO plan with no deductible.
Posted 3/28/2017 1:50 AM (GMT 0)
As an American, allow me to personally apologize for our medieval healthcare costs and insurance system. It's gotten a lot better in recent years, but it's still atrocious. Get ready to pay at least $400 per Remicade infusion. I have just about the best insurance there is, and that's what I pay.
Posted 3/28/2017 11:33 AM (GMT 0)
Thanks all for the feedback! I'm not sure if I'd be eligible for healthcare.gov because of my citizenship (maybe it's okay on the visa that I would have, but I'm not sure), but this has been very helpful. I also don't yet know where I'll be (California is certainly on the list) but I guess that is an important consideration when I am making my decision!!

Thank you!!
Posted 3/28/2017 12:01 PM (GMT 0)

Canaveral said...
As an American, allow me to personally apologize for our medieval healthcare costs and insurance system. It's gotten a lot better in recent years, but it's still atrocious. Get ready to pay at least $400 per Remicade infusion. I have just about the best insurance there is, and that's what I pay.

Have you called Remistart for patient assistance? I think their plan covers anyone on private insurance for $30-$50 an infusion.
Posted 3/28/2017 12:05 PM (GMT 0)
MedStudent,

The manufacturer of Remicade may provide coverage to you while you are in between coverage. I would call the Remistart program to see if they have a program that will cover you for your situation.
Posted 3/28/2017 2:36 PM (GMT 0)
If your employer provides you with insurance (which a hospital most likely will I'd assume) then you won't have a choice for supplier maybe just an option on plans. Usually employers give you a nice little packet that explains all your deductibles and out of pocket costs ahead of time and you'll enroll through your employer. As mentioned, usually there's a waiting period before you're enrolled. For me it was the start of the next month.

Don't worry about shopping for a plan on healthcare.gov if you get insurance through an employer, usually employer insurance is much better.
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