Health Insurance Requirements

[matlm 1]

Prior to leaving for the states, what health insurance requirements are demanded of the foreign spouse? I have private insurance not obtained from work and therefore cannot add my wife onto my plan.

Edited July 12, 2013 by matlm

[BOS_LHR 829]

There shouldn't be any health insurance requirements prior to her entering the country. As of January 1 2014, individuals in the US have to have health insurance (with few exemptions) or pay an annual fee mandated by the Affordable Care Act.

Under the ACA, every state has to have an online health insurance exchange where consumers can purchase plans. Maryland has elected to create its own Exchange (info here: http://marylandhbe.com/). Exchanges across the country have to be ready for open enrollment on October 1st of this year for plans beginning on January 1. If you can't add your wife to your plan, you should look into finding her coverage on the Exchange come October.

Take a look here for another source of info regarding companies offering plans in Maryland and their proposed rates: http://www.zanebenefits.com/blog/bid/295790/Maryland-Health-Insurance-Exchange-Update-Proposed-Carriers-Rates

[matlm 1]

Thanks, that's really helpful. I'm familiar with what will happen at the beginning of next year, but to what extent does the law apply to an individual with a CR-1 visa? I'm guessing this law applies to them? Looks like we are in the same boat.

[belinda63 3,053]

Beginning 1 Jan 2014 (as things stand now) everyone in the US will be required to have health insuranceor pay a fine on their taxes. Individuals and families under a certain income will qualify for assistance to help cover the cost of the insurance. The details are being worked out (?) but recently they delayed the requirement for employers to provide the insurance until 1 Jan 2015. How this will work is a good question.

[BOS_LHR 829]

Thanks, that's really helpful. I'm familiar with what will happen at the beginning of next year, but to what extent does the law apply to an individual with a CR-1 visa? I'm guessing this law applies to them? Looks like we are in the same boat.

Yes, LPRs are included in the individual mandate. If your wife doesn't have insurance one way or another come January 1st you'll be subject to the fee. The possibly good news is that while you need to make 125% FPL to sponsor an immigrant, subsidies for purchasing health care on the exchange are available for those with incomes up to 400% FPL. Not sure whether that'll affect you but it's worth mentioning.

Beginning 1 Jan 2014 (as things stand now) everyone in the US will be required to have health insuranceor pay a fine on their taxes. Individuals and families under a certain income will qualify for assistance to help cover the cost of the insurance. The details are being worked out (?) but recently they delayed the requirement for employers to provide the insurance until 1 Jan 2015. How this will work is a good question.

The delay announced recently re: employer coverage wasn't for all employers, it was for large employers, those with 50+ employees.

[matlm 1]

Wouldn't accepting subsidized insurance be considered a public charge?

Okay, gotcha on whether it applies to CR-1s. Wasn't sure if a Conditional Permanent Resident was considered an LPR.

[BOS_LHR 829]

Yeah, it's a blanket rule for everyone lawfully in the country, whether or not their permanent resident status is conditional. Illegal immigrants aren't subject to the individual mandate for obvious reasons.

Here are a couple of good, fairly concise resources for how the ACA affects non-citizens:

http://aspe.hhs.gov/hsp/11/ImmigrantAccess/Coverage/ib.shtml

http://www.ciab.com/workarea/downloadasset.aspx?id=2189

"Aliens who are 'lawfully present in the United States' are subject to the heath insurance mandate and are eligible, if otherwise qualified, to participate in the high-risk pools and the exchanges, and they are eligible for premium credits and cost-sharing subsidies" (emphasis mine).

The requirement that immigrants not receive welfare benefits is, I think, a separate thing from the subsidies being offered for the exchange. If your wife were to apply for EBT, SNAP, Medicaid, etc. that would be a violation in terms of the agreement you'll sign for the AOS. Receiving a subsidy or credit through the exchange for a private health plan, however, is a tax issue -- specifically, the Advanced Premium Tax Credit. In theory it shouldn't make her a public charge any more than claiming a refund for having a mortgage or a child.

I hope that makes sense... let me know if there's anything I can clarify better. I work for a company directly involved in building the state-based health insurance exchanges (marketplaces), so I've been living and breathing this stuff for a while

Edited July 12, 2013 by BOS_LHR

[NikLR 13,234]

If it is a means tested benefit then the LPR is not eligible to receive them and the sponsor or joint sponsor must pay back the government.

However, if you have private insurance, is it not possible to also set up a private insurance plan for your wife?

[belinda63 3,053]

The insurance subsidies would not be a means-tested benefit just as receiving the EIC or child tax credit on your taxes don't count against you. This is going to be a big mess as it stands right now as the employers are not required to provide the insurance for another year, which means they won't pay the fines for not providing it, which means some of the money to fund the program won't be available, which means.....wow. For those of you in Kentucky there is a website KYNECT...won't be up and running until October, but it might have more information then. For me to buy private insurance with a $5,000 deductable will be about $250 a month.