What kind of health insurance can a wealthy retired immigrant get in the U.S.?

By "wealthy" I mean someone who has retired with maybe a million dollars in their
bank accounts, not a billionaire like Trump or Bill Gates.

Should they even bother with insurance? Hospital bills can be expensive - especially
as you get older, you don't really want to start shelling out tens of thousands of dollars
left and right, even if you can afford it.

I don't really know how this works. Anyone?

I believe you can buy Medicare insurance just like any retired US citizen who worked in the US can. The difference is that you'd be paying about $500/month for the coverage.

Otherwise, start hitting up all the US insurance companies and see what they give you for price quotes.

Heh, in what world is someone old with $1 million saved a "wealthy" immigrant? Sounds like a lot of people, and you'd still be struggling to make ends meet.

I'm not sure if you're trying to be funny or serious.

Me neither. People with 1 million saved are wealthy immigrants in a lot of worlds.

I know I'll never have that much in my personal bank account.

Why wouldn't any wealthy person have health insurance? The average heart operation can easily run in the 2 to $300,000 range

That's actually what I was referring to. $1 million saved is not a level where you don't need health insurance. You just buy it. BFD. I don't even understand the original question.

Agreed, $1 million at retirement is hardly wealthy. Buy private insurance.

How old is the immigrant? How is his or her health?

I'm guessing you included the $1million figure to let us know that the person has the means to purchase health insurance, so we're not having to limit ourselves to bargain-basement kinds of deals. Without knowing the specifics, it's hard to say, but insurance companies tend not to like to have older people in the risk pool because statistically they're a lot more likely to incur heavy medical costs. It should be buyable somewhere, but expect a heavy premium. (If no one wants to sell them insurance, I believe they can buy into Medicare.) First step should be to look into price quotes from insurance companies.

Insurance is definitely a necessity, and I'd say having one that comes with doctor's visits & regular checkups covered is no longer optional if your friend is older. High-deductible is great when you're young and never go to the doctor, but when you're old, things start breaking and needing regular maintenance. And $1 million goes up in smoke pretty fast should your friend have a heart attack or get diagnosed with cancer or any of the other things that start happening.

Just because someone wants to buy medical insurance doesn't mean that any company will choose to underwrite a policy for you. We are going through that scenario with my 22 year old stepdaughter now. She has been on C.O.B.R.A. from my work health insurance since she got too old to be on the family plan and got dropped. C.O.B.R.A. is only mandated by law to extend coverage on an existing plan for 36 months at extra cost. For those that don't know what COBRA is...it is a law that lets someone that loses health insurance through loss of employment or (in my stepdaughter's case) is too old to remain on the family coverage I get through work to remain insured. We were paying $241.33 a month extra to keep her covered on the COBRA policy. The 36 month period will end on January 31st for her and we are now trying to get her an individual health insurance policy. We have already been refused coverage by Blue Cross Blue Shield of Texas and are waiting for word from an application at UniCare. I don't know what I'll do if she gets refused coverage by them too.

All of us that sponsored immigrants are financially responsible for public charges through the I-864 Affidavit of Support. One bad accident or serious illness could be a major problem if the government ever goes after you for emergency medical bills. Unfortunately we are responsible until they become US citizens. For my stepdaughter that is 2 years away before she can even file a N-400. Until then I'm on the hook.

peejay, I don't know if she has any pre-existing health conditions which might make finding coverage difficult, but I have a couple suggestions: 1) if she's young and in excellent health, pretty much all you are buying insurance against is the likelihood of an accident. A plan with a high deductible (~$5K) that has little day-to-day coverage but will cover all expenses in the case of a car crash might suffice until she manages to get employment. It's usually a little easier to get (because so much is out of pocket), and is more cost effective if she's not requiring constant doctor's visits or prescriptions. 2) Call up Blue Cross Blue Shield if you haven't already. A friend of mine (27, excellent health, no pre-existing conditions) recently had to purchase her own insurance and was denied the first time, but when she called them up, they reconsidered.

I know in some states that if you can document you've been unable to purchase health insurance (usually because of pre-existing conditions), you can get coverage through the state. (And this might be something a permanent resident is eligible for, since it's not means-tested.) I don't know if Texas has that kind of safety net, but it might be worth looking into as a stopgap until she lands a job (just finished college?) that has benefits.

Unfortunately my stepdaughter suffers from mild seizures and is successfully treated with medication. This is more than likely the reason they do not want to cover her on an individual policy. Blue Cross Blue Shield did not want to underwrite any policy for her, not even a high deductible policy. I called to get them to reconsider, but they didn't want our business.

I have always gotten health insurance through my employers' health plans all of my adult life and never had to go find an individual policy. This is new to me. I have found out that Texas does not have any laws that mandate that companies must provide coverage to extend existing coverage. Some states do, but Texas does not. It is all "at will". Once you get kicked off a group policy (through loss of work, COBRA, etc.) you are at their mercy. Nothing is mandated by law in Texas.

The insurance agent I applied for UniCare through told me if they decline to cover her we can apply for health insurance (at jacked up rates) through a risk pool. We are not at that point yet so I do not know what to expect from that scenario or whether they will even cover her in that. It will take about a week for the UniCare application to be vetted and a decision whether to cover her rendered. I learn as I go.

There is also the Harris county Gold Card program through the public clinics in the Harris County Hospital District. They do take legal immigrants, but it is only offered to the indigent. I'm not sure if her income is low enough. That would be our last resort if I can't get a private plan.

As far as her situation. I could keep her on my family health plan at work until age 24 if she were a full time college student. My wife and I paid 100% for her to go to community college full time, but the girl won't go to classes and flunked out 3 years ago. She gravitates toward employment that offers zero benefits...just a pay check. What can I do? You can lead a horse to water...but you can't make them drink.

It is sufficient to say that when you marry someone you get all the baggage that goes with it. The foreigner aspect requiring the I-864 just adds to it. We will make do somehow. A lot of this situation is out of my hands and there is very little I can do about it except to say that I tried to do the right thing.

I see what you mean. $1m was just an order of magnitude estimate, the actual number may
be higher.

Perhaps I should have used "well-off" instead of "wealthy". However, to answer your question
(in what world ...), $1m is wealthy in the world of immigrants. The word "immigrants"
doesn't exactly evoke images of multi-million dollar bank accounts.

Anyway, $1m or not, how much money do you think a person needs not to bother with health
insurance?

Which brings us back to the original question: would health insurance save you money if you're
70 years old and just arrived here?

It the answer is "yes", then it doesn't matter if you're have $1m or $100m in your account -
you'd still want to get it.

I'd have to be pretty rich before I ever went without health insurance in this country by choice.

At today's prices, I'm talking like.....11 figures or better.

Why would a wealthy person want to put themselves in the same position as a lot of the working class poor?

Good question.

Let's forget about the $1m limit for a second and pretend you have unlimited funds at your disposal.

You want the best healthcare that money can buy.

Do you really want an insurance company to tell you what you can and cannot do?

Maybe you do, I just don't know. Does Bill Gates have an HMO or PPO?

Unlimited funds...then why would you buy insurance. You probably wouldn't.

But a 'well off' retired person (1M or better) could find themselves wiped out pretty quickly without some type of coverage.

Perhaps because most insurance health plans have restrictions and exclusions that they would find unacceptable?

That's not the relevant calculation, mawilson. With unlimited funds, I'd probably quit my career, but that doesn't give me good advice about what I should do now.

Chances are, unless your friend is extraordinarily wealthy, insurance will always be in his best interest. Not just because costs for likely end-of-life benefits (ongoing cancer treatments, surgery, etc.) can run into the millions of dollars, but because even if you have millions to spend potentially on your health, why would you if you could get coverage and do other things with those millions?

Peejay....

From what you have said, at this point I kind of don't think your step-daughters coverage is your 'family' problem any longer. You know what I mean?

The girl needs to find her own coverage. Either through work or by other means. I presume she understands she can't take assistance from the government without some level of risk to you via the I864 you filed for her.

In our city, there is a private clinic that offers medical services to the poor who have no health coverage. If there is something like that around you, I'd suggest she go there.



I mean why would they go without coverage when they can well afford it?

Like I said, you'd have to be VERY wealthy in this country to go without coverage. Unacceptable restrictions trumps wiping out a small, hard earned fortune.

But a health insurance company doesn't tell you what you can and can't do; they just tell you what they will and won't pay for. If you're a gazillionaire, and your health insurance company doesn't want to pay for an experimental surgery, then you can pay for that out of pocket.

One can still buy one's way around the restrictions. Your friend would be able to pay out-of-pocket for things he wanted, and use the insurance for the rest.

Agreed.

So does anyone know how expensive or hard it is to insure a 70-year-old immigrant
(in good health and no pre-existing conditions)?

I understand that.

At the same time, insurance companies are businesses. How can they make money insuring
an old person, unless they charge them outrageous premiums and deductibles?

Thanks, C.

The original question was



What's there not to understand?

One is just going to have to shop around for the best deal!! No different than 1 has to shop around for the best automobile insurance!!
Insurance can be pricey no matter what age one is!! Hospitals/Insurance companies are here for 1 reason--too make money!! The more of a risk you are, the more $$$ they will charge you. a non smoker rate will be more than a non smoker, just like a healthy 70 yr old rates will be more than a healthy 20 yr old! 1 just has to have the facts together, and go shop for the best coverage that suits you. If one thinks they are fit as a fiddle, maybe you want to have insurance that has a higher deductible. Then one has to consider PPO, HMo's. There is soo much to know about the USA health care system, it can lead you to alcoholism,lol My wife works for the Federal govt, and i recall her bringing home a book on what type of insurance we wanted to go with and it was thick!! Soo many options!! Best of luck

Risk pools, basically. I'm 28 and until last week had never used any medical care beyond an annual checkup and the occasional prescription. Yet my health insurance runs about $5000 per year (counting what I and my employer pay). Get people my age and under into a plan, and it's pretty much free money for the insurance company, out of which they can pay for people who are using it. (This becomes a problem as a population ages, generally.)

Still, it's not going to be easy for a 70 year old, for the reasons you cite. It'll be expensive. As to whether any will take him on, that's a good question I'm not really qualified to judge. And a lot of policy varies by state, so it would make a difference where he intended to live what his options are.

We also found it difficult to secure C. health insurance before he was a permanent resident. We ended up buying six months of travel insurance, but we're going to have to revisit this question again soon. Bleh.

I know what you mean. If it weren't for the I-864 it would and really should be my stepdaughter's problem to live with. It's not really a family problem, but it is a Peejay problem though because of the I-864.

No...she does not know that an uninsured trip to the emergency room is a big risk to my life savings. My wife does not want me to tell her. If she did know I seriously doubt that it would even register on her radar screen. It's nothing personal against me...we have a good relationship. It's just that she is the kind of kid that 5 minutes from now is the future and 5 minutes ago was the past and that small 10 minute window of her life is the extent of her consciousness, comprehension, and attention span. She's not a bad kid, but that's just the way it is.

The point of this whole thread has been that most people would not risk their life savings against going totally uninsured. I certainly would not take the chance of leaving my stepdaughter uninsured when the dime falls on me. I'll do everything I can to keep her insured until she is eligible for US citizenship and hope she will fulfill the requirements necessary to become a US citizen. Thus freeing me from the obligations of the I-864. However, there is no guarantee she will do the necessary work to become a US citizen...even if we paid the fees. Case in point being the money we threw down the drain trying to send her to college classes she habitually cut.

I didn't post this looking for sympathy or to vent. I have always taken what life throws my way and deal with it as best as I can. I just want to bring to everyone's attention that there are ramifications to signing an I-864. You are financially responsible if you sign an I-864. You never really know how things will eventually turn out and you are financially responsible for situations that are out of your hands and you have absolutely no control over. That's the bottom line. Leaving a sponsored immigrant uninsured is a risk not to be ignored.

I believe that emergency medical care is not excluded by the I-864. Now, if she's still your dependent, &c., the financial risk from an emergency is there, but I don't think the I-864 burdens the USC sponsor with emergency care (since it's not a means-tested benefit.)

I've always been under the impression and assumption that the I-864 burdens the sponsor with any public charge. Certainly the uninsured in Houston / Harris county end up at the city or county taxpayer funded hospitals. They are mandated by Federal law to provide emergency medical care. It is no small stretch of the imagination to assume that they can find out if someone is a sponsored immigrant. Emergency medical care is not free if there is a deep pocket with money to pay the bill. The question is whether they would sue for payment using the I-864.

I read about a naturalized US citizen in one of the northeastern states that was sued by her state for public funded medical care provided to her sponsored immigrant mother through the I-864. Sued by the state...not the Federal government. I do not know if that is just the policy of that one state or even if the other 49 states do it too. I don't know if fraud was involved or remember the circumstances cited in the story.

It gave me the impression that I wouldn't want to go there and that scenario is something to be avoided. I wish I knew more about the extent of liabilities that sponsors are actually liable for. I've always assumed it was for any taxpayer funded public charge.

I'm pretty sure it says right on the I-864 that you're not responsible for emergency medical care. Could be wrong, and I'm way too lazy to check.

http://www.uscis.gov/files/form/I-864.pdf

Dont see that on there!!

As stated, "any taxpayer funded public charge" is not quite true, or rather, "public charge" means something fairly specific The wording is that the sponsor's income counts as the immigrant's income for the purposes of granting means-tested benefits. Meaning, e.g., if C. were to apply for food stamps, they'd count my income from the I-864, and thus deny his claim, because he would be over the poverty level. And this has been interpreted by the courts, too, as giving the state standing to sue to recover for certain means-tested benefits, and one case found that the immigrant had standing to sue the sponsor for support.

I don't have a cite for you handy, but I am reasonably certain that emergency medical care is excluded from this sort of calculus. That likely means very little practically, since if you're still claiming her as a dependent you'd be on the hook for the medical bill anyway with even having to look at the I-864, and the benefits of having health insurance to cover medical emergencies far exceed any immunity the I-864 may or may not provide.



"Emergency Medicaid", which I think is what covers emergency services to the indigent. Excluded, page 6 of the I-864.