Moving to the US while pregnant

itsamurphything

I am SO hesitant to start a new thread but I'm not sure where else to discuss this! 

My fiance works in both Canada and the US at his company's two offices, and we currently live in Canada. This fall (when baby is due) he will need to be in the US - San Francisco specifically - for some major events with his company. We were planning to move to the Bay Area eventually anyway but now we have decided to go before baby comes to avoid traveling so much around the due date. 

So so we will move from Ontario to California this summer, likely in early August. Financially we are luckily okay, and moving costs will be covered by the company. Visas are sorted as well and should be no problem though we will get legally married before moving.

I will need to find a new midwife in San Francisco and have gotten some great recommendations so far but would welcome others. Anything I should be aware of changing providers this late in the game? I'm currently 22 weeks. 

Healthcare - we have the option to go with a kaiser HMO plan or use a PPO (I think Blue Cross? Maybe?) Does anyone have advice on which would be better? I am thinking of doing a home birth or birth center so I am leaning toward PPO but coming from Canada it's all a little confusing. 

My fiancé will likely drive our car down and we will store our things and move them slowly over time to avoid the stress. 

Has as anyone else had a big move while pregnant? Any general advice or tips? 

tsa208

I've generally always gone PPO - my understanding is that PPO gives you way more flexibility. PPOs usually cover out-of-network providers (maybe not 100% but something) while HMO does not. HMO also often makes you see your General Practitioner (family doc) before being able to see a specialist. PPOs are often cheaper though - check out the deductible. If the HMO doesn't have one, then and the PPO does, it may be worth it to go to the HMO. For all of the talk about in-network/out-of-network, every doc I've wanted to see has been in-network for Blue Cross/Blue Shield.

Also, you probably know, but maternity/paternity leave and laws sucks here in the US compared to Canada (I am currently about 0.10 mile from the US/Canada border, thinking about swimming across the Detroit River to give birth, lol). Not sure if that affects you or not, but heads up.

itsamurphything

@tsa208 thanks for all that info! Yes, I definitely have to get a look at the deductibles and all of that, but it's great to get a general sense. 

As for maternity leave, I will be waiting for an employment authorization as well so I won't be eligible to work right away (which is kind of nice) and I believe through some wonderful loophole I may be able to recieve my maternity benefits while out of Canada. Don't hate me
I'm not going to take the standard 1 year that is most common in Canada but it's nice not to have the added pressure of going back to work a few weeks after delivering. 

keiraanne

I have no advice but want to chip in to say that I am extremely jealous that you're moving to San Francisco. It's such a beautiful city. Good luck with finding a new midwife and settling in to your new digs!

itsamurphything

Aww thanks @keiraanne

roo_baby

I would go with Kaiser if you are willing to sacrifice the home birth. It will be the easiest to get in with a good OB and pediatrician and there will be very little extra paperwork to do since anything your doctor orders is covered by insurance (though there are still co-pays). If you go with a PPO, both UCSF and CPMC are great options. However, it may be hard to get in with the better affiliated OBs as a new patient. Not sure how much that matters to you if you are planning to home birth, though. 

That said, usually with US employers, there is one preferred insurance plan that is much better coverage and often more affordable (choose this one), and a second "we had to give you options" plan that is not as good and often more expensive (don't choose this one). Sometimes there is also a third plan high deductible plan for people who never get sick (definitely don't choose this since you are pregnant). If you look at the numbers it should be pretty clear which is which. 

Super jealous you get Canadian maternity leave in the US. 

crazypuglady

@itsamurphything- I'm not from CA, so not sure how good/bad insurance works there... but I imagine they are pretty much the same state to state. HMOs tend to be very strict on who you can see for services and usually require a lot of red tape to go to a specialist- however my impression is they cover more costs than other plans. My friend had Kaiser specifically for a while and she hated it. You can only use their network doctors and sometimes they were very hard to find/not near her. 

PPOs tend to cover a percentage of costs for out of network providers.. which means if you need to see someone and they end up being out of network, they usually cover up to the designated percent. Usually a primary care and/or specialists charge you a small copay for covered services and that's all you pay out of pocket (In addition to premiums.) You may or may not need referrals to see specialists. Every plan is different though.

I guess the bottom line is, read the insurance brochures and research what it covers before you decide. Particularly for maternity care since that will cost a lot and covered services tend to vary between ins companies. Then weigh the pros and cons based on premium cost. Maybe it's worth paying more for the ins if you feel you'll have better coverage that works for your family.

soprano19

I live in San Jose (50 miles south of San Francisco, also a major urban area), and I have Kaiser through my employer and have loved it so far. My school district completely covers the premium, I rarely (if ever) have a copay, and I find it really convenient to have everything in one location (or whichever location I choose). One of the benefits of being in a big city is that you won't have any trouble finding a specialist if you need one. Also, everything is online, which makes it super convenient.

If it helps, I used to have a PPO (Blue Shield) and it was more expensive, both in terms of the premium and copays for prescriptions and appointments. It was also much more overwhelming to find a doctor in the first place, since it almost felt like there were too many options.

Hopefully that's helpful, especially since we're talking about basically the same geographic area. Good luck!

itsamurphything

@soprano19 that is actually really helpful. Thanks! I definitely have lots to think about and compare

dinosaur

*Sorta lurker*
 
Hey @itsamurphything I recently moved back to Canada after living in Southern California for 5 years. I'm originally from BC but I also spent a couple of years living in ON. We moved when I was 23 weeks along. 

After using several different health care companies I highly recommend the Kaiser HMO. The best part about Kaiser is that (almost) everything is in one place. You need blood work? No problem, just walk down the hall! 

I was on a J2 status and filed for a work authorization. I applied in October and received it in January (would have been December but x-mas) and I found a good job in April. 

You will also need to make sure you properly import all of your stuff. The first time we used a Uhal Pod. Don't use them! It took over a month for our stuff to arrive and they messed up the paper work. On the way back we used ABF shipping. They freaking rock!! We received our stuff within the week.  

Please feel free to PM for more details and to ask any questions. Hope this is helpful!!!

itsamurphything

@dinosaur yay for lurking!

thanks for the advice I will have an L2 visa through my husband's employment and I will be in process for the EAD but no rush as I will take some time with baby before returning to work. 

Kaiser seems like a great all-in-one option and may be the best bet as I won't have much time to figure out the system. I was hoping to have UCSF as my backup hospital though, so I will have to compare plans to make sure I wouldn't be paying an exorbitant amount for that decision. 

Thanks also for got the tips about shipping our things. We (my husband) will drive down our car full of things and we will likely move things over a longer period of time as we will still have access to our current apartment for a few months. 

dinosaur

@itsamurphything - No problem! Good luck. 

bluejeanbabi05

@dinosaur you have a pm