Medical Insurance in the States / Having a kid there

How does an American who has lived in Taiwan for over 16 years and his wife (a Taiwanese citizen) apply for and get medical insurance in the States? I have been looking into the cost of having our baby in the US and it’s too expensive without insurance! So I’m wondering whether it’s possible for someone like me who isn’t a resident over there to get it…

Has anyone had their kid born in the States and could you give me a few pointers? Would really appreciate it!


Michael Hammar

Hi Michael. I’ve had two kids in the US and as far as I know, you should be able to apply for insurance with a an insurance provider and just pay the premiums.

Are you moving back there for employment? If so, then your employer should/may offer you health insurance, and the ins company may or may not require that you complete a Health Questionnaire. It will probably ask when your wife’s last menstrual cycle was.

Where I’m from, if they determine that she was pregnant before she got coverage, then her expenses may not be covered, but the baby’s will be. With some companies, if there is a large number of employees insured in the same plan, they waive the Health Questionnaire, and you might get away with “pre-existing conditions.”

If you’re not going to be insured with an employer, then you could apply yourself. Find a yellow pages online in the city you’re moving to, and start calling now to get an idea of what self-pay will cost you. You might end up deciding that it is too expensive and have the baby here–we’re not exactly out in the boonies. :slight_smile:

We were self-employed before we moved here three years ago and our family coverage (2 kids, 2 parents) cost us over $350 a month. At one point we let the dental ins go because we found it cheaper to pay in cash for each visit and any work done.

If you’d like more information on having a baby here, you can visit

Ditto what BH said (have the contractions eased up any?). Health insurance costs a fortune in the States unless it’s through your employer or some sort of group (I’ve heard that some freelance associations have insurance plans). We have a typical HMO plan through our company now (we’re in the States), and it costs about $80/month with minimal dental and no vision coverage. An unemployed friend of mine was paying over $350/month for insuance for himself and his wife.

FWIW, we had both of our children in Taipei (both via C-section) and were satisfied with the quality of health care. You’re on your own more in terms of taking care of the mother after delivery (feeding, etc) and have to pay extra for a private or semiprivate room, but the medical care was fine. One downside, at least at the hospital we used, was that the baby couldn’t stay in the room unless you got a private room. Also, I wasn’t allowed into the delivery room for the C-section.

None, actually. I was just trying to come up with a more anonymous alias. :slight_smile: But thanks for asking!

Thanks for the replies! Really appreciate it.

Clarification: we don’t have a baby on the way yet but I’m looking into this because we plan to have one in the next 1 1/2 years…

I would have our baby born in Taiwan if it weren’t for the fact that I left the US at the age of nine (parents were missionaries) thus any kid of mine wouldn’t be able to get immediate US citizenship. (US Gov’t regulations require that one must have lived in the States for at least 5 years, 2 of them over the age of 14 in order for one’s kid to get citizenship).

The only way would be is for us to go to the States and have the kid there… Didn’t realize that they even had such a regulation… doesn’t seem fair as I was born in the US to two American parents but yet it seems I’m treated as if I were some immigrant wanting to get his kid US citizenship… This sucks.

So I guess for me the only option would be to find out how to get medical insurance coverage as a self-employed person and just start paying premiums…

How about different states? Are there differences in costs? Any suggestions?


I had to look into this a while back, too. I found that the health insurance companies will give quotes, but when it comes to actually writing policies, they refuse when the head office learns that you do not live in the US. You will have to use a US address to apply for the insurance if you do it through a conventional US health insurer, and you will have to be physically present when you make the application. You will also have to work with an agent who will pretend that you actually live in the state where the poicy is issued.

If you can’t get what you need from the traditional insurers, there are also several companies that specialize in health coverage for expats. You can find some of them through google searches or at sites like sometimes posts ads for expat insurers as well.

It is a good thing that you found out about the rule before you decided to have a baby.


Are you sure about your citizenship requirement. I have never heard of this before? My understanding is that if one parent is a US Citizen by birth, the child will be as well. Check with AIT.

Sharky, I believe Michael is right on this one. I remember when I applied for my kids’ passport and registration of birth abroad, I had to furnish proof that I had lived in the States for 5 (consecutive?) years. My highshool and college transcripts (not diplomas) did the trick. If I recall correctly, this rule applies only if one parent is not a US citizen–but check with AIT to be sure.

Well, I will be Monkey’s uncle on this one!

According to the Child Citizenship Act of 2000, if one parent is a non-US citizen the US citizen must spend at least 5 years in the States (2 of which must be over the age of 14) in order for the child to qualify for citizenship…

But, according to the Gov website, if the parent can not meet this requirement, the grandparents may be able to meet it… interestingly enough, the child does not accuire citizenship at birth, they are just entitled to apply for it.

Here is a quote and the website addy

"What Are the Other Provisions of the Child Citizenship Act?

Another section of the Child Citizenship Act provides that children (biological or adopted) of American citizens who are born and reside abroad, and who do not become American citizens at birth can apply to the Immigration and Naturalization Service (INS) for a certificate of citizenship if the following conditions are met.

Sharky, thanks for digging up this info. I think this is it! If this is true, then it will solve all my problems. I tried calling AIT to get confirmation but it’s sure hard getting thru when their voiceboxes are all full… oh well, I’ll just keep trying.

Thanks to everyone for their suggestions. Thank you very much!!! :smiley:



So, Michael, if your parents are back in the States, your future child may still qualify.

Hope this helps.[/quote]

Hmmm… wonder if this is a requirement that my parents must presently live in the States. They’re missionaries and left with me when I was young and have been living overseas ever since. Of course they do meet the requirement of 5 years/ 2 after 14 but then again, what if the requirement isn’t what I think it is…?

Where would I get the official confirmation as to what exactly is required? AIT? Would they even know…? I don’t think an email to the INS would get a response but I can always try…




Try email. I actually had better luck that way than by calling!

I just remembered something that is a bit related. I met a young woman recently whose father was an American GI. While stationed in the Philippines he had three kids with a local woman and then when he left, he would go back regularly to visit them. When the kids got to be teens, he went through the process of getting them all US citizenship and then died just several months later. The citizenship of her kids though is a little sticky. She said something about not meeting the residency requirements (five years???) at the time the baby was born. Second baby was born in the US and she does have US citizenship.


Try email. I actually had better luck that way than by calling!

Uh… I can’t find the INS’s email. I tried looking for the Hong Kong Field Office’s email, the main INS office but there are only phone numbers and snail mail addresses… Anyone know where I can find it?

I’m still trying to confirm one small detail which is:

According to the webpage on, it says that the kid’s grandparents can filfull the physical requirement if the parent cannot.

But on this page, … chowto.htm, it says that the law allows you to rely on the physical presence of the citizen grandparent to apply for citizenship… Sounds like the grandparents must be physically present in the States…

I hope not cuz my parents are still in Taiwan (missionaries here since 1985)… So this is what I’ve been trying to confirm so that I can make plans for the future.


Umm… Maybe I should have read the application forms on the INS website before writing the above post…

According to Form N-600/N-643, Supplement A, Application for Acquisition of Citizenship Through a Grandparent, page 3, it is the same physical requirement as the citizen parent which in my case is exactly what I needed to know!



Well, there you go!!! Good luck anyway, how about going to Guam to have your kid? Closer than the States…

If I were you I would take a taxi over to AIT and ask them, they definitely know.

Well, they didn’t know anything. Went there yesterday and the guy at the Citizen Services Center didn’t even know there was a Child Citizenship Act! I took all the papers that I got off the INS website including the application forms but they had never seen it neither did they know if they could even process it. They suggested I apply directly to the INS HK branch…

I’m still looking for the Hong Kong INS branch email address… still can’t find it…