Health insurance

[Kaptan 0]

Hi,

For those of you who have already moved to the U.S, which health insurance plan did you get? We are planning to move in July, but it seems we will have missed the ACA's (Affordable Care Act) open enrollment period. Assuming we will also not have a "life changing event" to qualify for special enrollment, how are we going to buy insurance to cover the period of time between our arrival and the next insurance period (2016)?

I have gone online to try to get a quote from a few U.S.-based companies, but all I get is that they are "sorry that the 2015 open enrollment period is over." I get that, and I realize I will not be able to claim the tax advantage of ACA but I don't care about any tax advantages at this stage. I just want coverage!

And how about the tax penalty for not having enrolled in a plan? At what stage will the system get "alerted" that I exist in the U.S. as a permanent resident and that I have not purchased health insurance? Will they impose a tax penalty for something that I want to get but they are refusing to sell me?

We tried to get an international expat plan from Allianz but they say they do not sell to permanent residents or citizens of the U.S. for whatever reason. We will try to buy it using our current Hong Kong residency but are concerned they might cancel the coverage once they realize we have become U.S. permanent residents. We will clarify this with Allianz before purchasing anything. For now I am trying to get clarity on how to purchase a family plan from a U.S.-based insurer.

TIA for any useful information you may be able to provide on this.

[SusieQQQ 11,584]

Immigration is a qualifying life changing event...

I'm not clear if you want Obamacare or not. We went private and used a broker (recommended by someone) as even coming from somewhere with private health insurance the U.S. system was very confusing, what hospital you can use depends on what plan you have etc etc so having someone to help us first figure out what we needed for our specific family health issues and then what plan worked to fit that plus budget was a huge benefit.

Edited March 16, 2015 by SusieQQQ

[Boiler 43,401]

Agree, as far as the exchange is concerned well it is by State and then pricing by Zip Code. Where you are living will depend on what is available and at what cost.

[Kaptan 0]

Thank you both for your input.

I don't necessarily want to be enrolled in Obamacare - in fact, if I am able to buy insurance in the middle of the year without having to demonstrate a life changing event, my understanding is that that would fall outside of the scope of Obamacare anyway (please correct me if I am wrong).

What I was surprised about was to be told on the few insurers' websites I visited that I have unfortunately missed the enrollment period and being offered no solutions other than to see if I might be eligible for special enrollment. What if I did not have a life changing event? Do they not want to sell their product throughout the whole year? Or are they no longer allowed to sell their products outside of regular or special enrollment periods as per law, i.e. has buying insurance now become a tax-like, once a year obligation for Americans?

SusieQQQ, I didn't see "moving to the U.S." as a life changing event on any website, but I did see that moving to a new state is, so that might be our way in. As you have suggested, as soon as we settle somewhere, one of the first things we should do would be to go to a local agent/broker to find out about our options.

Thanks.

[Lauren and Kevin 55]

We used Blue Cross Blue Shield of New Jersey. Eventually went with Silver EPO. BUT and it's a big but, we sat down and very carefully worked out the options with different levels of co-pay and deductibles vs levels of policy cost per month - it's very much a balancing act with a certain amount of crystal ball gazing into how sick you expect to be, and with a cap on it for catastrophic events.

Essentially, how much do you have in savings to pay the full deductible if you have to - how much of a payment can you afford each month...and the MOST essential part - can you protect those savings you have which are for paying the AOS fees, so unexpected medical bills don't kill your dream

[belinda63 2,981]

Becoming an LPR is a life-changing event although you may have to use the phone to enroll rather than doing it online.

Obamacare is a program, not insurance. You can choose to receive the subsidizes monthly as a reduction in your premium by enrolling through the ACA website or you can claim the credit when you file your taxes, provided you qualify for such. You can go online to any private insurance company and receive a quote but you will need to know the area you will be living in.

[Kaptan 0]

Thanks Lauren and Kevin and belinda63.

Lauren and Kevin, were you inside the regular enrollment period by any chance, or did you qualify for special enrollment under a "life changing event," when you purchased the BCBS NJ plan? Or was it just a regular purchase without being part of any kind of "enrollment" as defined under Obamacare?

[SusieQQQ 11,584]

Kaptan, trust us on this one... Immigration/becoming an LPR IS a life changing event. Think about it logically. If moving to a new state is, how can moving to a new country not be? Our broker assured us of this. We did pretty much what Lauren and Kevin did and I suggest you do the same, find a broker and explore all the options. You have a grace period (not sure exacty, 30 or 60 days i think) to sort it out after you move, but given healthcare costs you want to do it ASAP after you get here.

[Boiler 43,401]

I do not think it is illegal to sell cover that is not Obama compliant.

As far as selling cover outside the sign up period, I know that it is possible, going to be challenging, would no doubt be medically underwritten etc.

[SusieQQQ 11,584]

From the healthcare.gov website:

https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/

Life events that may qualify you for a Special Enrollment Period:

Getting married

Having a baby

Adopting a child or placing a child for adoption or foster care

Losing other health coverage

Permanently moving outside your plans coverage area

Gaining citizenship or lawful presence in the U.S.

Gaining or continuing status as a member of an Indian tribe or an Alaska Native shareholder. Members of federally recognized Indian tribes and Alaska native shareholders can sign up for or change plans once per month throughout the year.

Leaving incarceration

For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

Edited March 16, 2015 by SusieQQQ

[Lauren and Kevin 55]

Hi Kaptan, it was just a normal purchase, we did research, rang them up and enrolled on the phone. They said we could start a new plan or leave this one on a months' notice - it does not tie you in for the year.

Truly though, as a UK person, I took me a good two days to understand what on earth this co=pay and deductible stuff was for....!

[Kaptan 0]

Hi,

Thank you all for your valuable input. SusieQQQ, you have finally convinced me that moving to the U.S. is a "life changing event"!

I happen to work in the insurance field so am quite familiar with the concepts of copays, deductibles etc. but the U.S. products tend to have annual deductibles rather than the per-visit deductibles common in other parts of the world - but anyway, let me not bore you guys further with the topic of insurance!

[SusieQQQ 11,584]

Hi,

Thank you all for your valuable input. SusieQQQ, you have finally convinced me that moving to the U.S. is a "life changing event"!

I happen to work in the insurance field so am quite familiar with the concepts of copays, deductibles etc. but the U.S. products tend to have annual deductibles rather than the per-visit deductibles common in other parts of the world - but anyway, let me not bore you guys further with the topic of insurance!

The thing I had to wrap my head around was provider limitations. In SA you could choose whatever provider you want and claim back from insurance. Here which doctors, hospitals etc you can use depends on your insurance plan. So we worked back that way with advice too eg: you have kids - this is the best hospital for kids in the area - and these are the plans that allow you to use it.

Hi,

Thank you all for your valuable input. SusieQQQ, you have finally convinced me that moving to the U.S. is a "life changing event"!

I happen to work in the insurance field so am quite familiar with the concepts of copays, deductibles etc. but the U.S. products tend to have annual deductibles rather than the per-visit deductibles common in other parts of the world - but anyway, let me not bore you guys further with the topic of insurance!

The thing I had to wrap my head around was provider limitations. In SA you could choose whatever provider you want and claim back from insurance. Here which doctors, hospitals etc you can use depends on your insurance plan. So we worked back that way with advice too eg: you have kids - this is the best hospital for kids in the area - and these are the plans that allow you to use it.

[Kaptan 0]

I have a follow-up question: Would the fact that we will not immediately have social security numbers prevent us from buying health insurance when we arrive? I would like to take care of insurance as soon as possible, but I wonder if SSN is part of the application and whether we would therefore have to sit around without insurance cover, waiting for our social security cards to arrive. Assuming SSN is part of the application form, is there any other number we can provide that would also be accepted, such as our LPR visa numbers?

Thanks for any input you may be able to provide.

[NigeriaorBust 4,087]

The bigger danger is waiting on SS numbers could put you outside of the limited window of a major life event and then you could't get insurance. You need to be inside the window ( 30 days ? ) to be eligble to use the window to apply outside of open enrollent