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I am going to be living abroad for a year. I left my employer and am on short-term health insurance until I leave. I wasn't planning on maintaining domestic coverage (U.S) while I was abroad, but I am aware of the HIPPA 63 day "creditable coverage" gap for pre-existing conditions. I plan on purchasing travel health insurance through a company like World Nomads, which I believe does not count as "creditable coverage" in the U.S.

I don't believe I have any pre-existing conditions that would cause me to be excluded from a plan when I return, however, even without a pre-existing condition, could I expect my premiums to be very high ( > $1,000/month) when I return because there was a gap?

I found some information on AskMetaFilter that was helpful, but these are for people who do have pre-existing conditions. I can't find any information for those without pre-existing conditions.

Does having foreign health insurance mean you are not gapping in the US?
Can I get affordable insurance with a preexisting condition after living abroad?

I also asked a similar question at travel.se: Travel health insurance that counts as “credible coverage”

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    After some further research, it appears that even without a pre-existing condition a future insurer can exclude me from coverage completely for 6-12-18 months in order to ensure I don't have a pre-existing condition? – jjeaton Jan 11 '12 at 20:58
  • I believe that the ObamaCare solves this problem. Pre-existing condition may result in a higher premium, but you cannot be declined insurance. By the way, even without ObamaCare, I personally didn't have any problems joining a group coverage under employer's plan after living abroad, without any questions asked. – littleadv Jan 11 '12 at 21:41
  • @littleadv, is that in effect now, or is it not until 2014? – jjeaton Jan 11 '12 at 21:46
  • The pre-exclusion provisions are in effect already since 2011 AFAIK – littleadv Jan 11 '12 at 21:47
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    @Chad - its not the state exchanges (that don't exist yet), but a high-risk pool insurance. As I said - you won't get denied coverage, you will pay higher premium with such an insurance. – littleadv Jan 12 '12 at 18:33
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The insurance company is must assume you do have a preexisting condition you are unaware of. The reason for that is that Affordable Care Act precludes the Insurance company from denying coverage of them if you do. Insurance companies are businesses. They are in business to make money(unless you have a nonprofit insurer). They can not do that if you can buy insurance only when you need for them to pay out. So even though you may not have a preexisting condition, they are precluded from requiring an examination that would detect the most expensive preexisting conditions (hidden cancers, neurological, autoimmune disorders). So the companies must do what takes business sense and either deny you coverage or charge a rate that covers the risk they would be forced to take.

In your question on travel there was a response that suggested you get international health insurance instead of travel health insurance that would be considered credible coverage. You are trying to save money which on a personal level is a good idea. However that is against the societal and business need that you maintain health coverage during your healthy times to cover the costs of those who need expensive treatment. So you will be monetarily penalized should you choose to reenter the society of insured people. Once you have paid the higher rate for up to 18 months you should be able to get a better policy for people who have had continuous coverage. Alternately you may be lucky enough to start working for a company that provides health insurance with out requiring continuous coverage.

  • It is not true that health insurance providers are in it to make money. In fact, my provider, one of the best in California, is a non-profit. So the claim that "they're in it to make money" is not an excuse, and is factually incorrect. All the rest of your answer relies on that claim. – littleadv Jan 12 '12 at 19:33
  • @littleadv - OK I edited the answer to preclude nonprofit healthcare... I didnt even rant on what I think of them. – user4127 Jan 12 '12 at 19:51
  • This does make sense to me, as the question I was asking was whether they could deny me coverage or hike the premiums just because of a gap, even without any pre-existing conditions, since the "creditable coverage" requirement seems to apply mainly to pre-existing conditions. I am now looking into a global health insurance policy so I can avoid this whole mess. And just to clarify, I'm not trying to opt-out of the societal need to maintain coverage during healthy times, just opting out of paying insurance that only covers me in the U.S. while I'm living abroad. – jjeaton Jan 12 '12 at 20:43
  • @jjeaton - They can not deny or hike for pre-exisiting that is illegal. They can deny for no creditable coverage. so no they will not deny or charge a huge rate for pre-existing. They will deny or hike for no credtiable coverage. I hope you see the clear difference here... (yes that was sarcasm just like the comment about the state exchanges) – user4127 Jan 12 '12 at 20:57
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I bought Health Insurance for myself after a period without it, and my premiums were not terrible. I was a 27 year old man, living in California, no preexisting conditions, and I paid approximately 90$ a month. This was for a standard Health Insurance plan.

However, when I moved back to NY a little while later, insurance companies wanted almost $500/month for catastrophic coverage.

So, from personal experience, my answer is that price varies widely by state. Different states have different regulations as to what Health Insurance Companies need to cover and at what price. In NY, Health Insurance companies can't charge different rates according to age. Also, in NY, there is a price spiral, where the price is so high, few people buy it, so they have to raise the price because not enough well people are in the pool, so fewer people buy it....

To test it out, go to an online insurance broker, like ehealthinsurace, and put in your proposed information, including that you haven't been covered for a period. This way you will know.

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