Green card, joint sponsor, medicaid eligibility

[talkingheads85 0]

Just found this forum and so wish I had done so earlier as it looks like it would have been useful during the slow process of stressful visa applications and waiting. I am a permanent resident and applying for jobs these days and my wife is currently on a low income so my wife’s sister was my joint sponsor for the marriage visa affidavit of support etc etc. My wife could get Medicaid if single according to her income level and I could too, according to our joint income level right now. But am I eligible? After all I am new in America and not a citizen. And in addition to this maybe I am not eligible because my wife’s sister (the sponsor) should in theory pay for my health insurance instead of me claiming benefits? Of course, I’m not going to ask her to do that but we are just wondering how the rules are on this. Can anyone shed any daylight on this grey area? If you can we would be very thankful. It seems the clock is ticking on getting health cover worked out these days so it's a bit of a worry. thanks though.

[aussie_jason 195]

You won't qualify for federal non-emergency medicaid until you have been a resident for 5 years, even then your sponsor is technically on the hook for paying it.

[Caryh 5,206]

Your sponsor may be on the hook for this though. Although it's fairly rare to chase down sponsors for payment on such things.

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

Health coverage for immigrants during the five-year ban is limited to children and pregnant women under CHIPRA in most states, but 14 states and the District of Columbia provide state-only-funded health coverage to immigrants other than children and pregnant women (figure 4). State-only funded health coverage is limited based on age, immigration status, disability, and other criteria. For example, Washington provides medical assistance to qualified immigrants who are seniors and persons with disabilities and receive state-only cash assistance (NILC 2010b, 2010c).

[Brother Hesekiel 2,236]

Up to a few months ago, answering your question would have been very easy. Now with the ACA in full swing, it gets complicated.

The basics: "means tested benefits" are reserved for US citizens. In layman's terms: a foreigner cannot get any financial help from the United States government to take care of his bills. Therefore, Uncle Sam requested an Affidavit of Support from a viable sponsor. In your case that was your wife, and your sister-in-law became the co-sponsor. If you receive means tested benefits unlawfully, it could not only backfire into your sponsors' face, but it would make you potentially subject to deportation.

That was the easy part. Now let's complicate it, the American way!

The ACA requries every US citizen who resides in the United States and every lawful permanent resident (LPR) -- who by default resides in the United States -- to have health insurance coverage. This coverage can come from a variety of sources. Those who do not have health insurance, in most cases because it is ridiculously expensive for people who are older or have a pre-existing condition, can now sign up through the federal health insurance exchange or, in certain states, the state-run exchanges. In the Golden State where I reside, it's CoveredCalifornia.

Determination on how much of the bill is covered by Uncle Sam depends on the houshold income. Your household is your wife, a US citizen and you, a Green Card holder. You both need to have health insurance coverage and if your wife's income is so low that she qualifies for Medicare (MediCaid in California), it's certainly low enough for you to be covered under the same provider.

What all the smart lawyers haven't figured out yet is how to solve the conflict of interest here. my thoughts to you is that you and your wife sign up as a household and submit all information truthfully. I can tell you from experience that the documents you and your wife need to provide will make your head spin. That's good as it prevents document fraud, but also bad as it's a pain in the behind. If the system then directs you and your wife toward Medicare, there's a slight chance that Uncle Sam at some point in the future might ask your wife for "money back." I can't even guestimate how likely that will be, but you have no other choice, really, short of buying your policy on the free market.

Edited March 19, 2014 by Brother Hesekiel

[talkingheads85 0]

You won't qualify for federal non-emergency medicaid until you have been a resident for 5 years, even then your sponsor is technically on the hook for paying it.

hi, i think i understand, thanks. Non-emergency medicaid is to make appointments to see a doctor, so even if you don't have this you can still be covered if you need to call an ambulance, in an emergency?

I have met an asylum seeker who had medicaid in less than 5 years. Even before getting the green card. Does that seem to be true?

[talkingheads85 0]

Your sponsor may be on the hook for this though. Although it's fairly rare to chase down sponsors for payment on such things.

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

Health coverage for immigrants during the five-year ban is limited to children and pregnant women under CHIPRA in most states, but 14 states and the District of Columbia provide state-only-funded health coverage to immigrants other than children and pregnant women (figure 4). State-only funded health coverage is limited based on age, immigration status, disability, and other criteria. For example, Washington provides medical assistance to qualified immigrants who are seniors and persons with disabilities and receive state-only cash assistance (NILC 2010b, 2010c).

thankyou Caryh, i'll read this, although it doesn't look like fun reading

What is the 5 year ban? 5 years as resident green card but with a ban on medicaid?

[talkingheads85 0]

Up to a few months ago, answering your question would have been very easy. Now with the ACA in full swing, it gets complicated.

Brother Hesekiel, thanks.

Ok, so according to your “easy part’ I won’t be claiming any medicaid or medicare or whatever it is.

So how much can I expect to pay, if my wife is on Medicaid and I am paying? I will go to the online marketplace or whatever it is called and see. I am hesitant to start that and log in and give details until I know exactly what I am doing. And i heard so many different stories, form paying $100 every month to $600. this is going to be really tough.

I don’t exactly understand when you say “if your wife's income is so low that she qualifies for Medicare (MediCaid in California), it's certainly low enough for you to be covered under the same provider”. Do you mean that if my wife is entitled, according to the income, then so am I. Except that there is the problem of resident (not citizen) status? By provider you mean Medcaid, do you? Because I think Medicaid then works through individual companies, which might be what you mean by provider. So my wife and I could be with the same company, but I pay for my insurance, while my wife’s is paid for by Medicaid. I think this is what you mean.

As for the head-spinning documents, what kinds of things are required?

So you think it is okay for my wife to claim medicaid and for me to pay privately?

ahhh can't wait to be out of this situation, better income and feeling relaxed knowing that we are covered for healthcare.

We much appreciate your information and advice.

[Brother Hesekiel 2,236]

I really meant it when I said "complicated," mostly because we are now in unchartered territory. A situtation where no man has been before.

Massachussets has Romneycare, the model after which Obamacare has been coined and in fact a capitalist's and corporatist's dream: all private, for profit, mandate to buy insurance, and so on. Not that it matters much, but Romeny disassociating himself from the one and only good thing he ever created was plain stupid. He should have claimed credit for Obamacare, should have told the American people that it was HIS idea and that it works like a charm and the bad black man in the White House has stolen his idea. Guess that wasn't an option as he would not have been able to pull this through the primaries with all the religious right's and Tea Party crazies' influence. Oh well, back to the topic at hand.

Massachussets residents sign up for the ACA via www.MAhealthconnector.org. Since they work within the framework outlined by the ACA, you and your wife sign up as one household, and both of your income counts when determining whether you get subsidies when signing up for a health care plan or your combined income is so low that you'll be covered by Medicare which at this point is 100% subsidized by the US government. If your wife is covered under Medicare, so are you. You have no choice. All you can do is provide the information requested truthfully, and see what you'll end up with. Frankly, I'm not a good dancer in this dance myself. I've walked the walk, but I'm not expert in the ACA. Far from it. Again, you do not have a choice. Take it one step at a time, and see where it takes you.

Edited March 20, 2014 by Brother Hesekiel

[Caryh 5,206]

thankyou Caryh, i'll read this, although it doesn't look like fun reading

What is the 5 year ban? 5 years as resident green card but with a ban on medicaid?

Immigrants are basically not allowed most income based federal government assistance until they've had a green card for 5 years. That is what the sponsor is agreeing to provide with the affidavit of support. They're actually promising to provide it for ten years. As part of the last major change in immigration laws, in order to get the bill passed, supporters of immigration needed to promise anti-immigration elements this change to keep taxpayers from having to pay government benefits to people who would never be here if they had not immigrated. Which I view is a very fair law. Asylum seekers have a loophole in the law so they can still get some benefits, I believe (although I'm not 100% certain on that).

States can make their own laws about giving income based assistance to immigrants.

[talkingheads85 0]

Thank you. But I'm so confused.

If our sponsor is eligible in any way, then I don't want to risk applying for Medicaid as a household. Maybe better for my wife to apply as an individual, and for me to bite the bullet (an expression once related to medical procedures, ironically) and pay for health cover via the marketplace.

It's all as clear as mud. Except one thing -- many Americans' aversion to "socialism" means that probably now many Americans are paying more for health care than British and Canadians pay in taxes for healthcare. But the market is alive and well and business is making nice profits from other people's suffering!

[Caryh 5,206]

Thank you. But I'm so confused.

If our sponsor is eligible in any way, then I don't want to risk applying for Medicaid as a household. Maybe better for my wife to apply as an individual, and for me to bite the bullet (an expression once related to medical procedures, ironically) and pay for health cover via the marketplace.

It's all as clear as mud. Except one thing -- many Americans' aversion to "socialism" means that probably now many Americans are paying more for health care than British and Canadians pay in taxes for healthcare. But the market is alive and well and business is making nice profits from other people's suffering!

Yes Americans pay much more for healthcare than any other first world nation. And the sad part is, we get much less for that health care to.

As to the complicated part, we certainly are in uncharted territory, as stated before. And I would advise you to seek healthcare in the private marketplace. Even though I have health insurance through work, of which they pay half, I've also been looking into the private marketplace. With the changes in the law, plans are changing and spreading the risk over larger pools of people, than the much smaller pool of people working at my company. Its a very close call that I may be able actually save money by not getting my company's insurance and buying my own. Due to a few cases of cancer in my company, our corporate health insurance has gone through the roof. I'll have to see what happens with our first update to our insurance this year before deciding though.

[talkingheads85 0]

My first reply was in relation to Brother Hesekiel’s post. Seems we were posting on here at the same time, Caryh.

Yes, I see it makes sense and is in some respects it is fair, Caryh. And also I see that the UK is amazingly generous in that all immigrants (sponsored or not) get free healthcare. But British people don’t, on the whole, see this as unfair (though many would draw a line at other “benefits”).

[talkingheads85 0]

Such a stressful situation. I don’t mean for immigrants like me (although it’s confusing and is stressful). But I was meaning for Americans. Even with these bronze, silver and gold thing categories, and having to pay the first $1,000 or whatever, the marketplace seems like a lottery. And it’s so sad that so many Americans have had to wait until 2014 (!!) before they can get covered, and yet the system is a mess from the start.

Ok, will follow your advice and have to go private. Any idea how much can i expect to pay? I'm almost overpowered by the stress and anticipation. As if job searching is not stressful enough, health insurance searching on top is too much.

[Caryh 5,206]

Such a stressful situation. I don’t mean for immigrants like me (although it’s confusing and is stressful). But I was meaning for Americans. Even with these bronze, silver and gold thing categories, and having to pay the first $1,000 or whatever, the marketplace seems like a lottery. And it’s so sad that so many Americans have had to wait until 2014 (!!) before they can get covered, and yet the system is a mess from the start.

Ok, will follow your advice and have to go private. Any idea how much can i expect to pay? I'm almost overpowered by the stress and anticipation. As if job searching is not stressful enough, health insurance searching on top is too much.

Your age and where you're living is going to have a huge affect. I went on my state's obamacare site, and lied about having insurance through work. I then found a bunch of companies that brought up and checked them out directly. What I found was a plan slightly better than my work sponsored plan for $600 per month for the two of us.

[talkingheads85 0]

$600 per month! Can't afford even half that right now