When Au Pairs Get Gravely Ill — Kindof Open Thread /Topic

by cv harquail on May 23, 2016

Over the past two weeks there’s been a whirlwind of conversation and consternation in the Au Pairing community, over a situation with an Au Pair at Au Pair Care who’s been diagnosed with cancer.

sick-teddy-bear I can’t even begin to recap the steps and the facts, but they include that she was accepted into an experimental treatment program in her host family’s area, her host family wanted to keep her for her remaining contract months while she got treated, her agency decided it would cancel her visa and “send her back home”, but her Host Parents started a Change.org petition to keep her and campaigned to have the Agency reverse its decision. And more.

I’m not sure how it’s settled out, or even if it’s settled.

I reached out to a few folks I know at other agencies, hoping to get some more perspective on what the Agency was concerned about, what the rules were, etc. but it seems this is too difficult and confusing an issue for anyone else to take a stand on what was right or wrong.

Meanwhile, the Au Pairs on Facebook were whipping each other into a frenzy, and the anti-immigration trolls took over the comments in the Washington Post’s article about the situation.

I don’t want to rehash the details here, necessarily, but I do want to invite the AuPairMom community to have a conversation about the situation if you’d like to.

So, here’s a kindof open thread–

Please keep it focused on the general situation of

When an Au Pair gets gravely ill — 

What can and should we do in these situations?

What should we care about?

What should we advocate for?

What can we learn from these situations? 

 

 

 

See also: Washington Post:  ‘If I go back to Colombia, I’m going to die’: An au pair battling cancer fights to stay in the U.S.

 

{ 33 comments }

Seattle Mom May 23, 2016 at 1:04 pm

I’ve been watching this case. If the agency can be taken at their word, it seems that they have a policy in place to protect the au pairs and their future health by sending them home if they have a serious illness- because working in a foreign country is stressful, and could make it hard to recover from serious illness. However they are strangely insistent on adhering to this policy even when it doesn’t make sense in an individual situation- the au pair is getting much better treatment here than she would in her home country (according to what she and her host family says), and in fact if she goes home she is much more likely to die.

Her doctors say she is able to work, and her host family is willing to be flexible so that she will be able to resume her treatment. At face value, it looks like the agency is applying a single standard policy to something that is so variable depending on the nature of the illness, the availability of treatment in the host family community & the au pair’s home, the au pair herself, the host family’s willingness and ability to work with the treatment, etc. In this particular case it seems clear that everyone benefits by having the au pair stay- maybe if she were from Japan or Germany that wouldn’t be the case. Maybe if she were showing more symptoms it wouldn’t be the case.

And of course her illness could get worse, and she could become unable to work. In that case she could be sent home… or change her visa status… but why do all that when it’s not necessary?

I’m impressed by the host family and how they have stood by their au pair. And I was heartened to read in the article that Rep Chris Farr has been helpful- he has a strong connection to the case through his personal life experience.

Seattle Mom May 23, 2016 at 1:16 pm

I realize I didn’t answer the questions, so here’s what I think:

As host parents, we need to help our au pairs get the right diagnosis and the treatment they need. When they are clearly sick and the urgent care isn’t helping, we need to get them to the right place. If possible, we need to help them get access to research and teaching institutions when the treatment is not covered by the insurance or will be too costly. And we need to be honest about what our families can handle, if an au pair becomes gravely ill. I have not been there, but I don’t know that I could sacrifice my family’s well-being… I think it would depend on my relationship with the au pair, and my own needs. I’d like to think that I could do what this family did, but honestly I don’t know.

I recently had a much less serious health scare with my au pair. There was a chance that she would need some costly treatment- not to save her life but to save her vision. We are lucky that the medication given to her by the urgent care doctor worked. There were a few days where we weren’t sure she was getting better. In her case, the worst case scenario was that she would go home for treatment, because she comes from a country with good health care that is more affordable than here. But I’m glad it didn’t come to that, because as an extension AP she probably wouldn’t come back.

As for advocacy, I think it’s important that the agencies have the flexibility to decide what really is the best course of action in each individual situation. I don’t know what the motivation was for the recent case… that’s partly why it’s so damning- it doesn’t seem that they were risking anything to let her stay. I guess they don’t want to have an au pair die on their watch, so they would rather send her home to die while not officially in their employ. Maybe they are worried about litigation, or the amount of paperwork they would have to do. It still seems like their best option is to let her stay. But all of us who have hosted au pairs know that the agencies do not always seem to make great decisions- usually the repercussions are not life or death.

AlwaysHopeful HM May 24, 2016 at 8:57 am

“As host parents, we need to help our au pairs get the right diagnosis and the treatment they need. When they are clearly sick and the urgent care isn’t helping, we need to get them to the right place. If possible, we need to help them get access to research and teaching institutions when the treatment is not covered by the insurance or will be too costly.”

Wow- Seattle Mom, I wish I could promise these things, but quite honestly, I wouldn’t know where to begin. Navigating insurance and treatment options alone is overwhelming. Getting to reasearh and teaching hospitals? How do folks even know what the options are, or what’s available? I know that if a family member were fighting a life-threatening illness, I would move hell and high water to find the best treatment available, but that might also mean i take a leave of absence from my job in order to focus, organize and provide suport and advocacy. I would want to do everything I could reasonably do to help an au pair whose survival could be impacted by it, but for myself, reasonable would be subject to my own (perhaps pathetic ) limitations.

For example, I could see our family doing what this family is doing. We have outside support, my job is fairly flexible, and NIH is not too far away. On the other hand, if she had to take regular trips up to Sloan -Kettering, or to the Mayo Clinic, we couldn’t swing it. Or, if it were up to me to FIND the experimental treatment, it may never be found. Bottom line– I know that I would do everything my family could do to help an au pair who was gravely I’ll (no matter how good an au pair he/she had been), but I don’t know that what we COULD do would be nearly enough.

WarmStateMomma May 24, 2016 at 12:57 pm

+1 AlwaysHopeful

Seattle Mom May 24, 2016 at 1:03 pm

I don’t mean we have to move heaven and earth to get to the bottom of a problem, but we need to pay attention when our au pair seems to be sick and not getting better… sometimes we need to insist that they see a specialist, and that might involve calling the insurance company to find out what/how much is covered. In the case of the au pair with cancer, she had an urgent care doctor telling her she had allergies. They had to help the au pair figure out where to go next- I guess she could have relied on her LCC, but I do think that’s a reasonable host family role. In some cases the answer might be that there’s no local option, and the au pair will have to go home for treatment or rest.. but I think we need to be on top of that. All of my au pairs have had some sort of medical situation at some point. One of them went to the ER and never told me about it… she was actually ok, but she was worried. She was extremely independent. Another au pair had some phantom illness at the end of her stay that seemed very low-grade, and honestly I think it was stress about leaving and homesickness- she went to urgent care and they could find nothing wrong with her. She was just having some abdominal pain and fatigue… it didn’t seem that concerning to me, based on her symptoms and what she said the doctor said, I told her she could do the bare minimum with the kids to get some rest (they were in school a lot at that point). Sure enough, she got better after she got home. My current au pair had a corneal ulcer. It didn’t respond to drug treatment right away and I thought she was going to have to go back home for treatment- it’s way too expensive in the US. But I helped her figure out her insurance and what her options were if it didn’t get better- it was the kind of thing that if it didn’t get better within a week she had to move fast or she could end up blind, so it was not something I could just let her figure out on her own.

We do what we can.

massmom May 23, 2016 at 1:30 pm

I can understand the intent of the policy — an au pair’s health should come first, and in most cases, both the lack of decent au pair insurance coverage in the U.S. and the need to recuperate free of work/childcare demands would probably mean a better outcome for the au pair if she returned home. But in this particular case, I don’t think there is any way to argue the au pair would be better served by returning to Colombia.

I wonder if the agency is concerned with setting a precedent, but again, the facts in this case are pretty unique. She was diagnosed after arriving in the country, she happened to qualify for an experimental trial with free healthcare coverage and thus far is able to continue with her childcare duties with the blessing of her doctors.

This seems like it could be a tremendous marketing opportunity for Au Pair Care to demonstrate the bonds formed between au pairs and host families; the way they’ve handled it so far just seems to reinforce negative stereotypes about the program.

MarHostMom May 23, 2016 at 2:01 pm

This story has really made me think about hosting au pairs from underdeveloped countries in the future.

It’s wonderful that the au pair’s host family has the resources (time, back up care, and professional experience) to assist the au pair, but I imagine it’s difficult, if not impossible, for families who really rely on the au pair for regular care do not have those resources.

Of course no one wants to see an au pair suffer, and I’m sure there are many families who will go out of their way to help an au pair, as this family did. And I don’t mean to sound harsh. But if I had a crystal ball and knew that my au pair would get sick, I would rather have her have the support that she needed from her own country’s health system and family.

Aupair Paris May 23, 2016 at 5:08 pm

What should host families do? Their best. The family in this particular case has gone above and beyond and if that’s within a family’s capabilities, that’s really wonderful. As other people have said, it’s worth taking on a case by case basis – but it’s a question of basic human decency, surely, that if you have the ability and resources to help someone close to you extend their life or quality of life after the onset of a serious illness, you should do so.

A similar situation might be an au pair taking on extra responsibilities if a host parent got sick. They wouldn’t have the same responsibility for advocacy, and insurance etc – but the degree of tasks you’d have to take on if HM was suddenly completely out of commission would require an insane degree of flexibility from an au pair – but again it’s basic human decency that in that situation, you do everything you can.

No denying, some families don’t have the resources, the emotional energy, the will etc etc for this. Some APs don’t. But if you can help, you should, surely..?

Taking a Computer Lunch May 23, 2016 at 9:22 pm

The au pair lives in the Washington DC metro area and her HF is well-connected politically. The Washington Post recently covered her story: http://pqasb.pqarchiver.com/washingtonpost/doc/1790226317.html?FMT=FT&FMTS=ABS:FT&date=May+22%2C+2016&author=Moyer%2C+Justin+Wm&desc=%27If+I+go+back+.+I%27m+going+to+die%27&free=1 (this is the free version – you can probably search Google and find the version with pictures).

What I gleaned from the article – the AP is likely to recover, but her rare and aggressive form of cancer (treated for free at the National Institutes of Health – not a “free clinic” but one of the best medical research facilities in the U.S.) means that she is receiving far superior care in the U.S. than she could expect at home. The agency is now willing to help the AP transition to a special rare diseases visa and keep her employed until she does so – sort of.

I must admit, that as the HM of a medically fragile and mentally retarded child, I have been grateful that 99.9% of the time my APs wake up on time and are healthy enough to care for The Camel without complaint. Over the years we’ve had pulled teeth, twisted ankles, strep throat, the flu, and a few other complaints that made AP’s plea to roll over in bed and go back to sleep. Our policy has always been that if the kids caused it, we pay 100% of the costs and help the AP file the paperwork.

I don’t know what we would do if an AP couldn’t do her job for a few days every month (the Chinese AP who – most likely for cultural reasons – didn’t want to work when her period started, was told to buck up and live like an American), or was so sick that she needed weeks of treatment. While parents of typically developing children might be able to tolerate a broken arm, DH and I are totally dependent upon an AP’s ability to pick up a 55 lb child several times a day (as we do, too!)

Bottom line – it would completely depend on whether we had an A++++ AP or a so-so AP; what the AP wanted from her medical treatment; how much the inconvenience of her care would have a negative impact on our work (I can force my supervisor to tolerate only so much – I call it Caregivers Syndrome – you get a rep if you’re constantly taking time off as a caregiver even if you’re far from having a negative vacation balance). I want to be understanding, I really do. The reality is that I’m far more able to give extra vacation weeks in advance, then gracefully cover at the last minute.

WestMom May 24, 2016 at 8:39 am

This is an important topic and I am glad people are talking about all sides of the discussion. The comments against the agency have been impressive, but I am not casting any stone to APC because I am sure there are a lot more complicated things in the background than we are able to see.

What can we learn from these situations?

Curious. Does this raise any questions about the health screening? Of course, things could be missed or appear after the screening is done. But is the health screening sufficient as it is currently? From previous conversations, it sounds like the immunization requirements might be a bit lax. Are APs required to take blood tests (which may show abnormalities, or drug use)?. Dental check up is required to register a student at our public school, but not required to enter the AP program (which personally I think it should).

And I realize that even with more screening, results would possibly vary from one country to another (bribes anyone?).

It also brings up the possible challenge of hosting au pairs from underdeveloped countries, as MarHostMom mentioned. If we can’t trust the application, the screening, the driving license, and their natural families/country are unlikely or incapable to help in times of need, then we should be aware that there is potentially a greater cost to bringing in APs from certain countries.

WarmStateMomma May 24, 2016 at 1:02 pm

The greater cost to bringing in APs from developing countries is perhaps offset by the profits they bring the agencies. No German AP is going to pay thousands of dollars to an agency to become an AP in the US. No three-person staff in Western Europe is going to produce 2,000 APs. The agencies actively seek APs from developing countries at a lower cost and higher profit than APs from countries with good medical care. The “fluke” was that the AP developed cancer, not that she comes from a country with lesser medical care. The HF may have greater costs associated with APs from developing countries but I’m betting the agencies do not.

Schnitzelpizza June 3, 2016 at 6:11 am

“Does this raise any questions about the health screening? Of course, things could be missed or appear after the screening is done.”

But see… there basically is no health screening for APs. (At least not in Germany, this might of course differ from country to country)

“Health screening” for my agency means the AP takes the medical questionnaire to their GP and gets it signed. APs who have just turned 18/19 might just have moved up from their pediatrician to a GP. APs who are generally healthy (other than a cold here and there) might not have seen either in years. A thorough GP might weigh or meassure them, maybe suggest updating vaccinations before going abroad but if they do not complain about health issues… there is no “screening”. No blood is drawn, no xrays, nothing. Partly, I assume, because health insurance would most likely not cover it as it’s pretty much a “well-child visit”, which is not something that’s available to adults (there are now J1/J2 well-“child” visits for 12-14 and 16/17 year olds but the J2 isn’t even covered by all health insurances but there is nothing for a healthy 18/19/20 year old).

The medical form list what? Childhood and chronic illnesses and allergies?
So if a “healthy” 20 year old, without a chronic condition, without any acute diseases, who doesn’t complain of any – even minor – issues comes to their GP, which might be her mom’s GP because she is now to old to visit he pediatrician (who can no longer see her because she is now 18+) but has never needed to see a doctor since she turned 18, the GP might simply rely on what AP tells her to fill in. Or even if she had a GP that has seen her before (you can see a regular GP even at 12/13 if more convenient) and who knows when she had mumps or rubella or got her tonsills removed… there is no thorough health check.

Should the be one? Maybe.
I usually suggest it when screening. I also suggest to see their gyn and their dentist (well check ups are totally common, and paid for by insurance, when it’s about your teeth or your uterus). I suggest getting vaccinated (MMR, DPT, polio, maybe hepatitis) and suggest asking the HF if they think a flu shot is usefull / necessary.

But even a thorough check up might not catch things.
I was diagnosed with Hashimoto’s 15 months after returning back home from the US. Today I know it’s a family thing (grandpa had it, grandma had it, aunt has it, I suspect mom has it) and I suspect it was set off by going on the pill (which, had I been in the slightest interested in having intercourse while in the US, might have happened right before or even during my year). However, I assume it could just as well have started “just because” when in the US. And I was miserable! I had Hashitoxicosis which came with pretty much all symptoms on the list – weight loss (10 kg / 22 lbs in two weeks (!) while eating a whole large pizza, drinking four cups of coke and eating a pound of ice cream every night), intolerance to heat, hair loss, weakness, hyperactivity, irritability, sweating, palpitations, dyspnea, nausea, vomiting… you name it, I had it. I had a heart rate of 120 (resting), my hands were shaking, I was so weak I threw up when walking down the stairs. My aunt’s friend (who is a doctor’s assistant) thought I was on drugs when she saw me.
I had blood drawn and my thyroid checked four weeks (!) before it started (when going on the pill). Everything was completely normal and at that time I wasn’t even aware that the thyroid issues everybody in my family had, had a diagnosis with a name.

Things happen.
The question is how they are dealt with. I generally agree with “safeguard the health, safety and welfare of the au pair” and in general, sending an AP who has just had a cancer diagnosis back home where she has the support of her family, might make sense – IF the medical care she needs is available to her in her home country.
Many APs might want to go back home. Especially if they are young and would return back home to a loving family and good medical care.
Many APs might have to go back home because staying on as an AP is not an option (too sick, surgery and recovery needed).
But maybe, just maybe, what safeguards the “health, safety and welfare of the au pair” is staying in the US instead of returning them to their home country where they will not be able to receive the necessary medical care.

In this case, the AP wants to stay, the HF wants her to stay (and can work around her medical care), her doctors say there is currently no reason why she couldn’t continue working. Might she take a turn to the worse? I guess. I am not a doctor. But I have seen a friend work pretty much full-time while being treated for breast cancer. And any AP could suddenly fall too ill to do her duties. Why not extend her visa and see what comes? They could still send her home (or make her switch to another visa – I assume a B2 in this case?) in a month or three or six if she can no longer do her job. I understand they don’t to set want a precedent. But “safeguard[ing] the health, safety and welfare of the au pair” might mean that it has to been taken on a case by case basis and maybe in this case “safeguard[ing] the health, safety and welfare of the au pair” might mean that extending her J1 and allowing her to stay and work and receive medical care.

I think the support her HF offers is amazing, over the top, more than required by a HF and more than is expected. But if that’s what they want to offer… why not let them? They are her support network, they are her source of income, they house her. If she is made to switch to a B2 I assume they might still do just that but currently they are bound to do it by a contract, as soon as she is no longer their AP she will lose her income and her place to stay. I don’t know that I feel that in this particular case that makes much sense.

HRHM May 24, 2016 at 9:39 am

I think each family is in it’s own unique position to deal (or not deal) with this scenario. As a physician (and I know many of us are) I would be comfortable helping an AP find great care, administering meds at home, dealing with symptoms, etc. As a HM with older kids, if my AP needed a couple days a month of down time for illness (chemo recovery, etc) we would manage just fine. Living in a major metro area, we have access to large tertiary care hospitals and a medical University. And if our fabulous AP got sick, we would move heaven and earth to keep her under our roof where we could take care of her and make sure she got the best care possible, rather than send her back to an impoverished system in a former Iron Curtain country.

However: If I was a business manager with no partner and two or three small kids living in a rural area with a so-so AP from the UK or Germany, we’d likely part ways.

I think the big mistake the agency made in this case was trying to implement the “one size fits all” approach to a very sticky situation. I can’t really fault them though – if this lovely young lady gets to stay and is successfully treated, imagine the response in undeveloped countries. 19 year old finds out she has leukemia and quickly and quietly applies to AP agency, knowing that once she is safely ensconced in the US, she can go see a doctor, get a public diagnosis and stay for medical care. It’s a slippery slope with the potential to open the AP program up to some unforeseen consequences.

German Au-Pair May 25, 2016 at 6:37 am

I simply don’t get they agency’s stand on this. If the doctors had decided it’s best for her to go home -fine. If the Hf had said they can’t do it -fine. But the agency has to literally do NOTHING except sit back and do watch. They are not expected to cover for the AP, the family doesn’t want anything from them…the AP can work and the amount of work needed varies from family to family anways so when the family says they can do with less work then why on god’s earth does the agency even care? I know from personal experience that it is absolutely possible to be kept even though you cannot work over a longer period of time due to medical issues. And this AP apparently can work in contrast to me who was out for several weeks. Had my family said “no” that would have been fine and understandable but they also happened to be in a situation where they could sit out my recovery and the agency knew and didn’t mind.
So aside from the fact that this girl is getting much better treatment in the US than at home, which makes it absolutely useful for her to keep being in the US, I simply don’t get why it’s the agency’s business in the first place.

OpinionatedHM May 25, 2016 at 1:34 pm

While I do not agree with the agency at all in this situation, they do have a responsibility to the AP. If the family for some reason decides it’s not working after extending with this AP, the agency has to deal with the problem. If the AP takes a turn for the worse and is hospitalized, the agency has to manage the situation. If there is a precedent set, what happens the next time there is an AP in this situation whose family isn’t as connected or able to help.
Do I think the agency is doing the right thing? Absolutely not in this situation. But to be fair, we have to acknowledge the responsibility that the agency accepts by facilitating this situation.
In light of this, could we revisit the fallacy of AuPairs being part of the family? We would never turn away a family member who is ill and certainly not if that meant sending them to a country with inadequate care.

AlwaysHopeful HM May 26, 2016 at 6:17 pm

I would disagree that part of the family is a farce, even in this context. Just because I wouldn’t take the same extraordinary steps that I would for, say, my child, doesn’t mean that I wouldn’t offer an au pair the same level of support I’d feel would be appropriate to offer a cousin or niece — still family.

WarmStateMomma May 27, 2016 at 12:12 am

+1

There are different levels of “family.” FWIW, I’d give my current AP a kidney but my extended family … maybe not.

OpinionatedHM June 23, 2016 at 8:21 pm

just checked back in – summer break.

I mean the agencies referring to Au Pairs as a member of the family but then sending them home in circumstances like this case. Everyone wants to help which is what we would do for a family member, but the agency wants to send her home. The reality for the agency is that this is a business. I think it creates a mistrust when the AP’s have their first experience with the business aspects of being an AP usurping the “member of the family” expectations.

FirstTimerHM May 28, 2016 at 6:51 pm

I appreciate your entire comment @OpinionatedHM. I want to comment on this specific portion:
In light of this, could we revisit the fallacy of AuPairs being part of the family? We would never turn away a family member who is ill and certainly not if that meant sending them to a country with inadequate care.

Since hearing about this situation, I have often reflected on what I would do, what I should do, and how we would be able to do anything, if we were in their situation. The point that drives home for me is the cultural exchange part when choosing to have an au pair take care of your child care needs. We choose this. I think your right to call it a fallacy for some. If you are not prepared to treat this person as a member of the family then having an au pair might not be the right choice for your family.

German Au-Pair May 29, 2016 at 1:54 pm

But all of the above is true for any AP. If the family decides to kick her out after extending and she cannot find another family (for any reasons, may that be her cancer!) she gets kicked out and has to go home and no one is at fault. If her condition worsens she cannot work anymore and the family will have to see what they do with that but that can happen with ANY AP on any given day. I’m not saying the agency should go above and beyond to make a sick AP stay. But they don’t NEED to do that. All parties involved have agreed that they want to extent and the medical professionals she is seeing say she’s fine to work. I don’t see how the agency can possibly think they are better fit to decide what’s best for this AP-HF-situation than literally all parties involved.

WarmStateMomma May 25, 2016 at 11:42 pm

I think the lesson here is don’t provide the agency with information they don’t need.

Suburban Samurai May 25, 2016 at 10:00 am

This has made me question the au pair program. From my au pairs’ experience with the insurance, it’s become clear the agencies actively discourage its use. Essentially, they provide something that meets the State Department requirements, but if an au pair is sick enough to need it, they’re out of the program in a heartbeat to keep the agency’s premiums down.

After reading the article, I was particularly struck by the silence on the part of the State Department. This girl had insurance. She was covered. The illness was not pre-existing, and the doctors cleared her to work. Why doesn’t the State Department step up and say, “When we say they have to have insurance, we also meant that they have to be allowed to use it”?

I’m in the same region and have an au pair from the same country, but have nowhere near the cultural capital that this host family had. If it had been my au pair, she would have been sent back to Colombia, and I’m not sure I can in good faith ask someone to come here and be part of my family knowing that there’s no safety net if they get sick.

I think as host families, we have to be clear to the agencies and the State Department that this is something that is important to us. My agency fee will go to the first agency that stands up and says “that’s not how we do business.” I will note that while lots of agencies have blogs and newsletters, there has been total radio silence on this issue, while when a few years ago there was talk of changing the J-1 visa rules, the were all over us.

WarmStateMomma May 26, 2016 at 10:28 am

In this case, there also would have been no lifesaving care for the AP if she had stayed in her home country. So the struggle to let her stay to receive care here wouldn’t put me off hosting APs. But I’m completely agreed with you on the insurance issue. The AP is insured up to $100k per illness or injury for a reason.

HRHM May 26, 2016 at 1:19 pm

If you’ve ever looked at the insurance, you would realize that they don’t actually get “health insurance” in the traditional American sense. They get “travel insurance” like what you buy when you are going on a Caribbean cruise. It will cover an acute care visit and some antibiotics and it will cover emergency return to your home country for medical reasons. It will not cover prolonged medical care in a foreign country nor will it cover any care for a chronic or pre-existing condition.

If this AP wasn’t getting care through an NIH study, there is no way that her cancer treatment would be a covered benefit through ANY of the agencies’ current insurance programs. This isn’t about the agency keeping their premiums down (the AP pays the premium, not the agency) The insurance just wouldn’t cover the care, period.

2 kids and a cat May 26, 2016 at 5:17 pm

To be fair, the same level of insurance is provided for US undergrads studying abroad. The assumption is – same as the cruise- that you have a more comprehensive policy in your home country. HF pay for the insurance, but CCAP encourages the APs to pay for a supplemental policy.

WarmStateMomma May 26, 2016 at 11:59 pm

The State Dept regs require that the AP insurance to cover $100k per illness or injury. I’ve always assumed it’s just super basic travel insurance but $100k could cover real expenses depending on the providers used.

My AP got pressured into the $500 upcharge for “extra” insurance before she left China but I advised against it for her extension year. If the agency pushes it so hard, they must be pocketing a large part of the money which means very little goes to purchasing insurance benefits….

HRHM May 27, 2016 at 1:23 pm

The Erika policy covers 100000 but that is all stuff combined. There are limits on what they’ll pay for surgery, meds, and other individual items that are way lower.

WarmStateMomma May 27, 2016 at 1:40 pm

I know the policy blows but if you google the actual regulations, they require $100k per accident or injury. If the policy fails to comply, the agency could be in trouble for failing to comply with pretty clear regulations. It’s not like they have that many to follow that something could legitimately fall through the cracks like say, a hospital.

Suburban Samurai May 27, 2016 at 12:13 pm

Which would be great if au pairs had insurance in their home country. My current au pair doesn’t come from a country with national health care, and discontinued her coverage when she left the country. Probably lots of au pairs from less developed countries (…and the US) do that, so knowing that they’ll be sent home doesn’t make me feel any more comfortable.

HRHM May 26, 2016 at 1:24 pm
Anonymous in CA May 27, 2016 at 1:39 am

Anecdotally, a friend was with one agency and discovered that the agency provided insurance coverage that would be deemed appropriate for the AP’s country of origin…so, my friend’s AP from Western Europe had fantastic coverage, but her AP from the Global South had abysmal coverage. It was more than offensive to realize this distinction. So my friend shopped around for agencies and found an agency that across the board seems to provide the best insurance for all its APs, not just those from countries with excellent healthcare.

WarmStateMomma May 27, 2016 at 12:07 pm

Disgusting. Especially since the AP with lousy coverage was likely paying the most to the agency.

greg May 30, 2016 at 4:34 pm

An interesting one and one where the agency got things wrong or look like the villain here – Au pairs become part of the family and you would and have to treat them like one of your kids to a degree….Would deffo do all we could to help our au pair in a time of need.

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