Job Benefits

[disneyfan123]

I am looking to see if anyone could help me understand job benefits in the US. We are Canadian and we have government paid health care and then jobs provide benefits for dental, vision, ect and that would be for the whole family.

My husband is applying for jobs in the States under the R1 visa that he qualifies for, but we don't understand what it means when it says Medical, dental, and vision benefits. Is that just for the employee? Does it depend on each State?

What kind of things should we ask if he were offered a job in regards to benefits?

I worry because my daughter has epilepsy and she gets check ups every 6 months with a neurologist and since we would be on one salary I am not sure if we would be able to afford major medical bills.

Any help would be great!

 

[tinkermommyof3]

I am looking to see if anyone could help me understand job benefits in the US. We are Canadian and we have government paid health care and then jobs provide benefits for dental, vision, ect and that would be for the whole family.

My husband is applying for jobs in the States under the R1 visa that he qualifies for, but we don't understand what it means when it says Medical, dental, and vision benefits. Is that just for the employee? Does it depend on each State?

What kind of things should we ask if he were offered a job in regards to benefits?

I worry because my daughter has epilepsy and she gets check ups every 6 months with a neurologist and since we would be on one salary I am not sure if we would be able to afford major medical bills.

Any help would be great!

It actually depends on the company. Some companies will pay for the employee only 100% and then offer benefits to dependents, i.e. spouse, children at a reduced rate that they will deduct from payroll. Your husband should ask HR (Human Resources) for the exact details of the coverage. This will tell you who is covered at what cost to you. It will also tell you what is covered and at what co-pays/deductibles if any. HTH

 

[bettymae1121]

Ditto, it varies from company to company. Except for the poor and elderly, neither the state nor Federal government provides health care.

Most medium and large companies in the US offer some type of health insurance as a benefit of employment. How good the coverage is and how much it will cost you is a huge variable and should be taken into account when comparing job offers.

Some terms you should be familure with. A co-pay is a fee (can be as small as $5 or $10 or as high as $100) you pay for something like a doctor's office visit, prescription, or ER visit. The insurance picks up the rest. A deductable is a set amount you must pay out of pocket before insurance will then kick in. Deductables can be as low as a few hundred dollars on up to $10k depending on the policy. Not all policies have a deductable at all, mine doesn't, but that is unusual. A premium is the cost of the insurance policy, your employer will pick up part of the premium and you have to pay for the rest. For example, at my company they cover 90% of the premium, I cover the other 10% and it's deducted from my paycheck. Other employers may pick up less or more than that.

Vision and Dental insurance is seperate from health coverage and also varies in quality and cost. But vision and to a lesser extent dental costs are something that can generally be afforded out of pocket if you don't get coverage from your employer unless you've got an unusual vision/dental issue. Your main concern should be getting good health coverage.

 

[robsmom]

Most companies will have a packet to give you an overview. They should give this to him to read before he has to accept the job. Benefits vary considerably by company so you really need to read the details.

Medical - if they offer medical it is usually your choice as to if it is for the employee, employee & spouse, employee & children or employee, spouse & children. The rates will vary depending on which you choose. There are different types of plans. Most have a network of some sort. If you use that network of doctors your cost will be lower. The questions that you want to ask are. What is the monthly premium, are there co-pays (portion of the medical cost that you pay), are there deductibles (amount you pay before insurance kicks in), are there stop-loss amounts (maximum that you could have to pay out of pocket, and is there a lifetime or annual maximum that they will pay out. These items will vary greatly from plan to plan. There are also plans that are called high deductible health care account plans. In this type of plan you pay an amount each month into a fund that you then use for medical expenses. Often the employer will contribute an amount to the fund as well. If you don't use the money, it can carry from one year to the next. These plans are often good for young people with low risk. They usually have some sort of catastrophic coverage for major medical issues.

Dental - again varies but usually covers basic preventive dental and some portion of more significant work. Sometimes there is coverage for orthodontia, but there are restrictions and it is usually well below the real cost! Does help though.

Vision - really varies but typical plans will cover an eye exam each year and basic glasses and/or contacts. There is usually some sort of co-pay that you pay. Glasses only covers very simple basic frames and lenses.

Life Insurance - often offered through the employer at a reasonable cost to the employee, sometimes paid by employer.

Retirement - Some companies still have retirement plans but not many. Most will do somesort of match to your 401K contributions. this amount varies. Some will match dollar for dollar up to 6% of your salary. Others will match at 50% of what you contribute up to the 6%. There are other combinations, but these are the most common.

Vacation - always important to ask how much vacation they offer and how flexible they are in using it.

 

[disfan07]

After 9 years navigating the "wonderful" system that's our healthcare in this country (note the sarcasm....) here's my advice...

Read up on whatever you can about company's, deductibles, Out of pocket maximum, EOBs (explanation of benefits)---these are NOT BILLS.
Here's my example using our insurance. I'm 23 and covered under my dads insurance still (thank you ACA!)

Copays: this is what you pay every time you go to the doctor. For some insurance companies, there are also Copays for ER visits, radiology, lab work, etc. for us, we have a $20/$40 Copay. $20 for primary care and $40 for specialist

Deductibles: this is what you have to pay BEFORE your insurance will cover ANYTHING. And the range of dedcutibles is huge. Anywhere from a couple of hundred dollars to thousands of dollars. Also, there are usually individual and family deductibles. For example, we have a $500 individual deductible but a $1500 family deductible.

Out of pocket maximum: this is the MAXIMUM amount you will pay out of pocket before your insurance kicks in for 100% of the coverage. IMPORTANT: this usually DOES NOT include Copays and prescription drugs. That means that if you have a $5000 out of pocket maximum, even after you hit that, you would still have to pay Copays and the cost of prescription drugs

Coinsurance: this kicks in after you meet your deductible. For example, we have an 80/20 coinsurance. That means that after we hit our deductible, the insurance company pays 80% of the cost and we pick up 20% until we reach our out of pocket maximum which is when the insurance company picks up 100% of the coverage

EOBs- these are called explanation of benefits. These basically give you the breakdown of the services received and how much everything cost and what was actually charged to the insurance company. The insurance company is usually given something like 60 days to pay their share before they start coming after you for the rest ( or all otitis you either haven't met the deductible or if they deny it)

In-network: this means that a hospital or doctor is contracted with hat insurance company. This is what your coverage applies to most of the time. Some plans do have out of network coverage

Out of network- this means that the hospital, doctor or outpatient service is NOT contracted with that insurance company. This means that the insurance company will either not cover any of the cost or they will cover under reduced benefits ( explained in your package of benefits)

Also.....very very very important. Make sure you have coverage for ambulance transport and air ambulance transport. Not all insurance includes it and sometimes you have to purchase it separately. We are lucky because we have it included but it's not automatically processed and we got a $1500 bill from our fire department for a 3 block trip to the hospital whe. I went into anaphylaxis at my allergists office!!

Also familiarize yourself with pre approvals and the specifics of your insurance company. Each insurance company seems to have a different definition of "medically necessary" and I can guarantee that there are things that would be covered in Canada that probably wouldn't get covered here.

Also, check about what is being offered. Are you guys looking at a PPO or HMO? HMOs are more restrictive but should cost you less in the end ( unless you have to go out of network) and a PPO is more flexible but can be more expensive.

If you have any specific questions feel free to PM me. I have spent the last 9 years of mylife becoming an expert on navigating and understanding our broken system because you have to be your own advocate. Navigating our healthcare is not for the faint of heart ( no pun intended). And I want you to be better educated on the system than most US citizens are.

And i completely understand the major medical bills thing. We have "premium" health insurance and last year we racked up $22,000 in medical bills we've racked up more than $100,000 over the past 9 years.

 

[akcire]

I am looking to see if anyone could help me understand job benefits in the US. We are Canadian and we have government paid health care and then jobs provide benefits for dental, vision, ect and that would be for the whole family.

My husband is applying for jobs in the States under the R1 visa that he qualifies for, but we don't understand what it means when it says Medical, dental, and vision benefits. Is that just for the employee? Does it depend on each State?

What kind of things should we ask if he were offered a job in regards to benefits?

I worry because my daughter has epilepsy and she gets check ups every 6 months with a neurologist and since we would be on one salary I am not sure if we would be able to afford major medical bills.

Any help would be great!

Ugh. I HIGHLY suggest you have any benefits offer reviewed by a private benefits consultant before you accept the jobs.

Typically professionals are able to get family medical coverage from their employeers, however they pay for that benefit. My husband is a low-level executive with a major US corporation. Our monthly contribution toward our family medical insurance is $1400 per month. Now we have REALLY good insurance, however we still have out of pocket costs until we spend $4000 of our own money. Since "we" are a medical nightmare-it is a deal for us.

Let me know if I can help with any questions. I am also a foreign citizen living in the US.

You are welcome to PM me.

 

[apnep]

I just want to add that we have things like HSA (Health Savings Account) and FSA (Flexible Spending Account), which are accounts you can put pre-tax dollars into to help offset the costs of your medical. Last year we put $5000 into our Flexible Spending Account which we used to help pay for orthodontia for the kids, and copays and deductibles.

Good luck.

 

[cruisers5]

I lived and worked in Canada for 33 years, then moved to the U.S. The health system in Canada is definetly better. It was a shock the first time I went to a Dr. here and was asked for $20 when I checked in. I would notice when I called to make an appointment in Ontario first thing they would ask was when I wanted to come in - here they ask what my insurance is. My husband had his knee replaced (in US) - by time we got through with co-pays for Dr. visits, hospital costs, braces, walkers, OT/PT, etc. it cost us several thousand dollars. My son lives in British Columbia - he had three surgeries on his knee (broke it snowboarding), had surgery by the Canadian Olympic Team Doctor, had a custom made $2500 knee brace and 20 sessions of OT/PT - out of pocket costs - $0. Make sure you find out what the costs for health care are!

 

[tink_n_pooh]

Benefits vary greatly from company to company, many companies even have multiple policies to chose from within the company.

For instance, my husband's company has 2 different policies to chose from - a basic policy with high deductible but low cost to the employee and a very good policy with no deductible but a higher cost to the employee. Employees contribute 50% of the cost of premium for the employee (company contributes the other 50%) and if they want to add their spouse/child/family the employee is responsible for 100% of the additional cost (beyond the 50% of the employees cost that the company contributes). They do not offer any dental coverage and vision is limited to medical conditions, glasses or contacts and routine eye exams are not covered at all. Prescriptions are on a tiered plan, we do not need referrals to specialists, and we must use in network providers. Again, this is specific to my husband's company.

My father's company provides a full benefit package (no $ contribution by the employee) to all of their full time employees and families - this is becoming more and more unusual all the time due to high insurance costs.

Some companies also offer flexible spending accounts and that is a whole different ball of wax

 

[Halbleib1]

I just want to add that we have things like HSA (Health Savings Account) and FSA (Flexible Spending Account), which are accounts you can put pre-tax dollars into to help offset the costs of your medical. Last year we put $5000 into our Flexible Spending Account which we used to help pay for orthodontia for the kids, and copays and deductibles.

Good luck.

Being from Canada they might still have to pay Canadian taxes on that money. Which might not make it all that great of an option. And not all companies offer that option.

Personally I would stay in Canada where you know you have coverage than risk moving here and having to pay a bundle. Also a job is not guaranteed. What would you do if he lost his job? Moving back could be expensive. Good luck with whatever you decide.

 

[KennesawNemo]

I just want to add that we have things like HSA (Health Savings Account) and FSA (Flexible Spending Account), which are accounts you can put pre-tax dollars into to help offset the costs of your medical. Last year we put $5000 into our Flexible Spending Account which we used to help pay for orthodontia for the kids, and copays and deductibles.

Good luck.

for 2013, one can only contribute $2500 due to health care reform

 

[Colleen27]

Is there a pressing reason you want to relocate? Because our system can be very hard to navigate, especially when there are ongoing medical issues to take into account. Cost and coverage will depend on the specifics of the plan his employer selects, and you need to be prepared for both premiums and out-of-pocket costs to increase every year. And if he loses his job you could find yourself with a lot of major bill - continuation of coverage is available but generally very expensive (ours would be ~$2000/mo) and if you let coverage lapse you might find yourself caught up in the "pre-existing condition" exclusions when you start a new plan.

There's really no way any of us can advise you other than recommending hiring a benefits consultant to have any offers professionally evaluated, because everything varies from place to place and job to job. Proceed carefully because medical expenses in the US can easily add up to thousands or even tens of thousands a year without any major catastrophe, and you'll want to be very, very sure that he's earning enough to compensate not only for the immediate costs but also for the expected and predictable increases in those costs over time.

 

[apnep]

for 2013, one can only contribute $2500 due to health care reform

Yes, to this. And that sucks.

 

[beckybowler]

FSA for 2013 is $2500
HSA increases to $6450

 

[QueenElinor]

I just want to add that we have things like HSA (Health Savings Account) and FSA (Flexible Spending Account), which are accounts you can put pre-tax dollars into to help offset the costs of your medical. Last year we put $5000 into our Flexible Spending Account which we used to help pay for orthodontia for the kids, and copays and deductibles.

Good luck.

Yes, to this. And that sucks.

I second (third?) this- I use up our FSA every single year and always will. Also, the threshold for deductions for high medical bills is going up from 7.5% to 10% of AGI. People with significant medical problems and private insurance are going to see their costs go up even higher starting next year.

 

[Tink-aholic]

I've lived and worked in both the Canadian and the US healthcare systems and, as a Canadian, I will tell you that you will be much better off in the US. My opinion, but I saw too much at Canadian hospitals that would never fly in the ultra-litigious world of American medicine.

That said, depending on OP's daughter's age, she could be excluded for a period of time for pre existing condition. Those through age 18 are covered, adults are not until 2014.

 

[KennesawNemo]

I've lived and worked in both the Canadian and the US healthcare systems and, as a Canadian, I will tell you that you will be much better off in the US. My opinion, but I saw too much at Canadian hospitals that would never fly in the ultra-litigious world of American medicine.

That said, depending on OP's daughter's age, she could be excluded for a period of time for pre existing condition. Those through age 18 are covered, adults are not until 2014.

A lot of the group insurances do not have pre-existing conditions at ll. But I agree the op should definitely find out from his husband's company's policy.

 

[disfan07]

I've lived and worked in both the Canadian and the US healthcare systems and, as a Canadian, I will tell you that you will be much better off in the US. My opinion, but I saw too much at Canadian hospitals that would never fly in the ultra-litigious world of American medicine.

That said, depending on OP's daughter's age, she could be excluded for a period of time for pre existing condition. Those through age 18 are covered, adults are not until 2014.

Not if you are someone like me. Living in the US in the current state of our system is a death sentence for me. We're so lucky we have not yet had to declare bankruptcy and without my dads group coverage, I'd be dead.

 

[disneyfan123]

Wow, thank you everyone. That is a LOT to consider and we would speak to a benefit consultant if he gets a job offer and we decide that route. This is something we are considering because it is a job he loves that is not very common in Canada, but positions in the States come up every day, so we have a lot to pray about!

Many Thanks!

 

[MrsPete]

I lived and worked in Canada for 33 years, then moved to the U.S. The health system in Canada is definetly better. It was a shock the first time I went to a Dr. here and was asked for $20 when I checked in. I would notice when I called to make an appointment in Ontario first thing they would ask was when I wanted to come in - here they ask what my insurance is. My husband had his knee replaced (in US) - by time we got through with co-pays for Dr. visits, hospital costs, braces, walkers, OT/PT, etc. it cost us several thousand dollars. My son lives in British Columbia - he had three surgeries on his knee (broke it snowboarding), had surgery by the Canadian Olympic Team Doctor, had a custom made $2500 knee brace and 20 sessions of OT/PT - out of pocket costs - $0. Make sure you find out what the costs for health care are!

Respectfully, your son didn't pay for his medical treatment at the point of service . . . but he did pay for it. He paid a bit of it from his very first paycheck when he was 17-18 years old. He paid a bit of it from his paycheck this month. He'll still be paying for it when he's 60 years old and is ready to retire. He's paying it through taxes. It's not as "obvious" as paying the doctor directly, but he is paying.