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As someone living outside the US (in the Americas still) with a chronic condition (that would be deemed as "preexisting condition" for insurers) I would be SCAR

As someone living outside the US (in the Americas still) with a chronic condition (that would be deemed as "preexisting condition" for insurers) I would be SCARED of living in California (more broadly the US). In addition to the high cost of living to live within a "sensible" commute distance from whatever office is assigned to me, it will cost me an arm and a leg to pay for my necessary medicine in the US, or jump through the hoops and loops of its healthcare system. No thank you, I prefer working for a Silicon Valley company while still living in my home country, with a very high standard of living (given the income/expenses ratio).

josephcsible 5y ago
Why does having a preexisting condition scare you from living in the US? Doesn't the ACA mean that you can't be denied coverage or charged more for it?
- amyjess 5y ago
  I'm assuming GP's preexisting condition requires frequent doctor visits and medications or other medical devices—or even occasional surgeries—that would be prohibitively expensive if you're uninsured. This means: - If you lose your job, all your coverage goes away at the end of the month. COBRA is completely unaffordable for most workers. You have to ask yourself: "if I end up with a three-month period of unemployment, will I be able to afford the meds I need to stay alive?" - Just because you have coverage doesn't mean you have afforable coverage. You could be stuck with a sky-high deductible, your insurance could pay for such a low percentage of your medical costs, or your company could only pay for a tiny percentage of your premiums, and any of those mean you end up having to choose between medicine and rent. - Just because you have coverage on paper doesn't mean your stuff is actually covered in practice. Getting medications and surgeries approved is often a colossal pain. It's not uncommon for someone to switch insurance carriers because they got a new job and immediately get told their new insurance won't cover the meds they've been on for years unless they try three other medications first and their doctor determines those other medications all don't work. This is especially dangerous because if the other meds don't work, you could die. Also, a lot of supposedly qualified doctors have no idea how to work with a large number of chronic conditions. People with autoimmune disorders often go without a diagnosis for decades because most doctors don't know what to look for. Imagine if the only doctor in your metro area that knows how to handle your chronic condition is out of your carrier's network (and remember you don't choose your carrier, your employer does). Now you're having premiums deducted from your paycheck and you have to pay out the nose to see the only doctor in town who can treat you. The best-case scenario is that the out-of-network rate is still high enough to take the edge off, but that's still going to be expensive. Worse is if you're on an HMO or EPO where out-of-network doctors aren't covered at all. Then you might as well not even have insurance! And it can get worse: many doctors only let patients self-pay if they don't have insurance at all, which means being on the wrong carrier (which, again, your company decides for you) means you're completely blocked from accessing care.
- coldtea 5y ago
  >Doesn't the ACA mean that you can't be denied coverage or charged more for it? No, it doesn't.
  - josephcsible 5y ago
    Can you elaborate? https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co... seems to say otherwise.

josephcsible 5y ago

Why does having a preexisting condition scare you from living in the US? Doesn't the ACA mean that you can't be denied coverage or charged more for it?

amyjess 5y ago
I'm assuming GP's preexisting condition requires frequent doctor visits and medications or other medical devices—or even occasional surgeries—that would be prohibitively expensive if you're uninsured. This means: - If you lose your job, all your coverage goes away at the end of the month. COBRA is completely unaffordable for most workers. You have to ask yourself: "if I end up with a three-month period of unemployment, will I be able to afford the meds I need to stay alive?" - Just because you have coverage doesn't mean you have afforable coverage. You could be stuck with a sky-high deductible, your insurance could pay for such a low percentage of your medical costs, or your company could only pay for a tiny percentage of your premiums, and any of those mean you end up having to choose between medicine and rent. - Just because you have coverage on paper doesn't mean your stuff is actually covered in practice. Getting medications and surgeries approved is often a colossal pain. It's not uncommon for someone to switch insurance carriers because they got a new job and immediately get told their new insurance won't cover the meds they've been on for years unless they try three other medications first and their doctor determines those other medications all don't work. This is especially dangerous because if the other meds don't work, you could die. Also, a lot of supposedly qualified doctors have no idea how to work with a large number of chronic conditions. People with autoimmune disorders often go without a diagnosis for decades because most doctors don't know what to look for. Imagine if the only doctor in your metro area that knows how to handle your chronic condition is out of your carrier's network (and remember you don't choose your carrier, your employer does). Now you're having premiums deducted from your paycheck and you have to pay out the nose to see the only doctor in town who can treat you. The best-case scenario is that the out-of-network rate is still high enough to take the edge off, but that's still going to be expensive. Worse is if you're on an HMO or EPO where out-of-network doctors aren't covered at all. Then you might as well not even have insurance! And it can get worse: many doctors only let patients self-pay if they don't have insurance at all, which means being on the wrong carrier (which, again, your company decides for you) means you're completely blocked from accessing care.
coldtea 5y ago
>Doesn't the ACA mean that you can't be denied coverage or charged more for it? No, it doesn't.
- josephcsible 5y ago
  Can you elaborate? https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co... seems to say otherwise.