Health Insurance Question

[Stagnant Sloth 5]

Hello,

 

I entered the US on a K1 visa last month - we are already married, I have my SSN and my documents for AOS, AP and AED have already been sent off. The first notice for all three have been received as well as my appointment letter for fingerprinting.

 

I was filling out the form for health insurance and it asks for my immigration status. The options listed are:

 

-Permanent resident card.
-Temporary I-551 stamp (on passport, or I-94, I-94A).
-Machine readable immigrant visa (with temporary I-551 language).
-Employment authorization card (EAD, I-766).
-Arrival/Departure Record (I-94, I-94A).
-Foreign passport.
-Reentry Permit (I-327).
-Refugee Travel Document (I-571).
-Certificate of Eligibility for Nonimmigrant (F1) Student Status (I-20).
-Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019).
-Notice of Action (I-797).
-Other documents or status types.

 

Which of these would I select in my situation?

 

Thanks!

 

[Stagnant Sloth 5]

Is anyone able to provide any guidance on this? Thanks.

[yuna628 9,680]

Are you attempting to sign up via Obamacare, or are you trying to sign up via a private plan?

[Stagnant Sloth 5]

I'm currently researching purchasing a plan through both the Obama care exchange or a private plan, I'm just trying to see all the options available. For the question in the original post, it's a question asked when creating an account on Obama care. I wouldn't qualify for any form of financial relief on the exchange (if that's an issue), due to my wife's income. But, I was interested in browsing the plans at full price to consider everything. Thanks for your reply. 

[bcking 3,157]

If you choose the "Other" option does it ask you to explain?

 

I would either choose that and provide some copy of some sort of evidence, or just put "Permanent Resident". I'm not familiar with the K-1 that much, but I'd say technically you are an "other" category, but also probably wouldn't make much of a difference if you put in the first one since you will have a Permanent Resident Card in what, a couple of months?

[bcking 3,157]

Just now, Dee elle said:

Do you have your NOA1 for the I 485?  You cannot state you are a permanent resident as you are not yet!, Until you get your NOA1 I think you are still a visitor on a valid K1   Once you get the NOA 1 then you are in lawful status while the AOS is being processed.. but you do not become an LPR until it is approved... 

I do not know what USCS calls this in between time.  The GC may not be in  hand for up to 12 months after you apply.. EAD and AP will take 3 to 4 months

You are eligible for coverage now under your spouses workpkace health insurance as marraige is a qualifying event. 

If your spouse does not have workplace health insurance, seems like a strange loophole to have several months where you are still just a "visitor" and technically can't get insurance for yourself.

 

Then should people coming over on a K1 get travel insurance to cover the time it takes to get their LPR status? I've seen a post from someone asking about that for a CR-1, but that is clearly "immigrating" when you arrive so travel insurance wouldn't apply. Perhaps for a K1 you should though? I wonder if a travel insurance company would question you if you got sick during the time you are a "visitor" on the K-1.

[yuna628 9,680]

21 hours ago, Stagnant Sloth said:

I'm currently researching purchasing a plan through both the Obama care exchange or a private plan, I'm just trying to see all the options available. For the question in the original post, it's a question asked when creating an account on Obama care. I wouldn't qualify for any form of financial relief on the exchange (if that's an issue), due to my wife's income. But, I was interested in browsing the plans at full price to consider everything. Thanks for your reply. 

From a personal standpoint, and mind you not everyone agrees - I rather prefer to deal with the insurance company directly rather than go through the exchange, especially if you are confident no discount will be received. One of the reasons why I just turned my own personal plan into a joint plan, was to avoid all the government red-tape and spending ages arguing with a bunch of people on the phone that don't even understand their own rules. The fact is, if you've got an NOA1 for your AOS, you can sign up. And plenty of people have managed to do so... but plenty of people haven't been able to.. not because they aren't allowed, but just because they can't get past the e-forms that aren't specific to unique situations, or the phone people that are clueless. It's the same problem people get into if they didn't obtain their SSN yet (which also doesn't prevent you from obtaining health insurance but they run into plenty of idiots that will tell them otherwise). The next earliest time, and the most easiest time to sign up to O'care with little fuss about documents, is when you have your EAD or of course the Green Card. The problem is by that time, in a lot of scenarios, the deadline to sign up for O'care has likely ticked down.

 

So here's how I tend to look at O'care, it's kind of like a giant search database for insurance plans. Some people get discounts, but a lot of people won't. The plans listed on the site, are literally the same plans you can obtain by going to the insurance company directly. And some of those plans have little cost difference, some may even be cheaper. There was no cost benefit to me using our state exchange for instance, and the plans offered there that were cheaper had very poor coverage options (and the insurances offered were at the time, abysmal) - BCBS has a rather large chokehold monopoly on our state - so I just elected to go with them directly as I'd always been with them. It cut out so much red tape, I filled out the forms online, and faxed over a document and that was it. They did not ask my husband's status or documents, and since I had already obtained his SSN ahead of time I had that (even though you do not have to provide it by law no matter what they say). It's expensive as hell, but most insurance is these days.

 

If your wife has insurance via work though, that is always going to be the best option to go with btw. The cost will be cheaper. Your problem with that though will always be dealing with HR, who in many cases, are ignorant. Not saying every HR is of course, but I've seen bad info come from them time and time again.

 

6 minutes ago, bcking said:

If your spouse does not have workplace health insurance, seems like a strange loophole to have several months where you are still just a "visitor" and technically can't get insurance for yourself.

 

Then should people coming over on a K1 get travel insurance to cover the time it takes to get their LPR status? I've seen a post from someone asking about that for a CR-1, but that is clearly "immigrating" when you arrive so travel insurance wouldn't apply. Perhaps for a K1 you should though? I wonder if a travel insurance company would question you if you got sick during the time you are a "visitor" on the K-1.

Yes, it is kind of like a loophole. But it's a little more complicated than that. O'care didn't really consider all different types of specific visa-holders in mind when they created it. Yes they put in a giant list of documents that immigrants could provide. For most people, like those that get a green card or EAD right off the bat this doesn't give them problems. But K1s are a unique category, that in between the time of the I94 running out and applying for AOS and waiting for their EAD, they are kind of in a limbo status. Now the laws for O'care say that this isn't really an issue, and there's ways to get around it - but you won't find the info provided, the e-forms, or even the employees too helpful. It's almost like they want to make it convoluted. Still - and I really mean this, there is nothing to prevent a K1 couple that has married from getting onto their spouse's insurance, or having their spouse roll them onto a joint plan, or buying a plan for themselves privately. Even before AOS has been even filed. But in dealing with O'care, some kind of AOS process has to have started. The problem with that is, O'care only gives you a 'window' under 'special enrollment' for SEQLE. In a perfect world, if the USCIS wasn't so tardy in handing out the EAD this wouldn't be an issue - but because the individual pretty much waits 90+ days to obtain it... you can see how it gets problematic. The NOA1 should be a qualifying document, and many have used it to sign up, if they find someone on the phone that knows what they are doing.

 

As for travel insurance, no point. Travel insurance as a rule ends the moment you land. Special one-way insurance like my husband used, ended within a day or two of landed. Travel medical insurance isn't helpful to a K1 for two reasons - 1) you are immigrating and not visiting. 2) these types of insurances are subpar and are not federally compliant -- that means the government considers you 'uninsured' and the penalty still applies. Now-a-days, especially after O'care came into existence, there are lots of companies out there offering temporary insurances to new immigrants - unfortunately the government also considers those subpar... and they offer dubious coverage at best... the penalty still applies. As a healthy person, my husband went without insurance, until after we married, we quickly applied for AOS, and then I added him to my private plan. There were a few weeks without insurance yes, but he felt the risk was worth it, and he was still penalty exempt for a short time. And honestly, even if had gotten sick? Our clinics here are really good. Even with insurance I still pay a lot to go there (where the insurance company hardly pays out to the doctors there.. it's pathetic)... without insurance a one-off visit to a doctor might cost us $250... whereas a bill of $700+ per month drains us dry with our premium. In perspective, it's why a lot of people just choose to go without and pay the penalty. Huge cost savings, if you feel the risk is worth it.

[yuna628 9,680]

8 minutes ago, Dee elle said:

One more group of immigrants who have problems are the over 65 y/ o as my husband is.. going direct to the insurer doesnt work as their plans stop at age 65.. technically  the age people are required to transfer to medicare.. as lpr we cannot access  Medicare for 5 years, even though we have 40 qualifying SS quarters. The only way to get insurance was  via marketplace. Otherwise, yes, go straight to the insurer.. they will always take your money. 

I disagree with your comment about K1 being  immigrant .. it is dual intent and allows immigrant AOS, so technically you are stil a visitor until the AOS NOA1 and hence home country travel insurance will still cover as long as you are prepared to be repatriated if needed. 

And yes elderly immigrants are yet another issue O'care did not address, and in some cases there are also scenarios with pregnant immigrants that run into problems too. These are all things that could have been corrected, unfortunately it doesn't seem like they were interested in doing that.

For the elderly there are some scenarios, that offer assistance in O'care specific programs in some states. https://ww2.kqed.org/stateofhealth/2013/10/09/for-legal-immigrants-obamacare-has-options-for-aging-parents/

As for travel insurance I have seen quite a few people try to argue that point with their company, unfortunately they are often told since their ''intent'' is to immigrate, the insurance is null and void. That may not be with every travel insurance company, mind you... but I've seen it happen, and I don't like to assume that companies like this will just be kind enough to cover via nuances like that.

Edited April 18, 2017 by yuna628

[bcking 3,157]

21 minutes ago, yuna628 said:

 

As for travel insurance, no point. Travel insurance as a rule ends the moment you land. Special one-way insurance like my husband used, ended within a day or two of landed. Travel medical insurance isn't helpful to a K1 for two reasons - 1) you are immigrating and not visiting. 2) these types of insurances are subpar and are not federally compliant -- that means the government considers you 'uninsured' and the penalty still applies. Now-a-days, especially after O'care came into existence, there are lots of companies out there offering temporary insurances to new immigrants - unfortunately the government also considers those subpar... and they offer dubious coverage at best... the penalty still applies. As a healthy person, my husband went without insurance, until after we married, we quickly applied for AOS, and then I added him to my private plan. There were a few weeks without insurance yes, but he felt the risk was worth it, and he was still penalty exempt for a short time. And honestly, even if had gotten sick? Our clinics here are really good. Even with insurance I still pay a lot to go there (where the insurance company hardly pays out to the doctors there.. it's pathetic)... without insurance a one-off visit to a doctor might cost us $250... whereas a bill of $700+ per month drains us dry with our premium. In perspective, it's why a lot of people just choose to go without and pay the penalty. Huge cost savings, if you feel the risk is worth it.

Technically you aren't immigrating though. You have a visitor visa that allows you to legally marry and then adjust your status once you are here.

 

So I would say you are a "visitor" until you adjust your status. 

 

There should be no "penalty" for the K-1 visa holder until AFTER they have successfully adjusted their status. Obamacare doesn't require people in the country that aren't permanent residents from having insurance. As you have mentioned, a K-1 visa isn't a "permanent resident" yet until they apply for AOS. If they aren't a permanent resident, they are a visitor. They are a visitor on a visa that allows them to legally apply for AOS, as opposed to a visitor travelling on a typical visa where they can't.

 

I'd say in the end they are a "visitor" until their AOS goes through, in which case they wouldn't be subject to a penalty. 

 

As for travel insurance being subpar - It isn't subpar for what you would need it for (emergency coverage). It doesn't provide primary care coverage, but of course it doesn't since it isn't intended for that. I've had travel insurance pay at quite well when my wife was admitted in hospital (when we were travelling). If you had it for 90 days until your AOS went through, it would protect you in case of emergency. Of course you wouldn't be able to see a GP type doctor, but that is less important in that period of time (unless you have serious chronic health problems).

[bcking 3,157]

6 minutes ago, yuna628 said:

As for travel insurance I have seen quite a few people try to argue that point with their company, unfortunately they are often told since their ''intent'' is to immigrate, the insurance is null and void. That may not be with every travel insurance company, mind you... but I've seen it happen, and I don't like to assume that companies like this will just be kind enough to cover via nuances like that.

Didn't see the before I quoted your other post.

 

I had a feeling some companies would argue it. I think you can make a pretty strong case and argue back at that. If needed and you took them to court I would guess they would lose. You are a visitor until you have adjusted status. 

[yuna628 9,680]

5 minutes ago, bcking said:

Technically you aren't immigrating though. You have a visitor visa that allows you to legally marry and then adjust your status once you are here.

 

So I would say you are a "visitor" until you adjust your status. 

 

There should be no "penalty" for the K-1 visa holder until AFTER they have successfully adjusted their status. Obamacare doesn't require people in the country that aren't permanent residents from having insurance. As you have mentioned, a K-1 visa isn't a "permanent resident" yet until they apply for AOS. If they aren't a permanent resident, they are a visitor. They are a visitor on a visa that allows them to legally apply for AOS, as opposed to a visitor travelling on a typical visa where they can't.

 

I'd say in the end they are a "visitor" until their AOS goes through, in which case they wouldn't be subject to a penalty. 

 

As for travel insurance being subpar - It isn't subpar for what you would need it for (emergency coverage). It doesn't provide primary care coverage, but of course it doesn't since it isn't intended for that. I've had travel insurance pay at quite well when my wife was admitted in hospital (when we were travelling). If you had it for 90 days until your AOS went through, it would protect you in case of emergency. Of course you wouldn't be able to see a GP type doctor, but that is less important in that period of time (unless you have serious chronic health problems).

When I say subpar, I only say it in terms of how the federal government considers it (not sufficient for basic standard of care and all the specific provisions that the federal mandate says insurance must provide.)....  And yes, there should be, but at this point, the government has had plenty of time to consider these scenarios, and have not acted on correcting them. K1s as in most things, are kind of like an afterthought to them lol. The penalty will not apply to them before the I94 expires, and it is unlikely that it should apply afterwards if they at least make an attempt to get covered. But there are many who have tried and were turned away, given false info, or delayed their AOS... and then run into trouble.

4 minutes ago, Dee elle said:

Tongue in cheek but.... NOT elderly at 61 and 65... you will be that one day! Happy to own older 😎

 

Yes, insurers are expert at creating loopholds where no loophole exists to our ordinary eyes... and the issues with healthcare aren't going to be easily fixed....

 

Its really important for all pltential immigrants to do  ery thorough research into the impact of  immibrsting on 2 areas... health care and taxes, otherwise there can  be some  very nasty surprises that have significant  ongoing impacts. 

And yes it's very important that any immigrants research the subject, but also that their US spouses do their very best to explain the situation to them. It was a lot for my husband to take in, and it's still frustrating for him, coming from the NHS. He does not get enough hours to get coverage through work yet, but we're hopeful that will change soon.

4 minutes ago, bcking said:

Didn't see the before I quoted your other post.

 

I had a feeling some companies would argue it. I think you can make a pretty strong case and argue back at that. If needed and you took them to court I would guess they would lose. You are a visitor until you have adjusted status. 

My husband could not find anyone that would cover him when he discussed the situation with them (I suppose there are many that wouldn't bother to go down that rabbit hole and just roll with it) so it's why he opted for one-way insurance. He's a safe driver and healthy so he wasn't concerned not having health insurance, especially because we worked to get him covered as soon as possible. Even with this health insurance, when we were eventually struck by a distracted driver, we couldn't have afforded to go to the hospital in the first place because of the copay and high deductibles.

[bcking 3,157]

1 minute ago, yuna628 said:

 Even with this health insurance, when we were eventually struck by a distracted driver, we couldn't have afforded to go to the hospital in the first place because of the copay and high deductibles.

Not a discussion to be had here but...

 

Really insurance serves no purpose if someone can't afford to go to the hospital, despite having insurance. 

 

My wife is luckily only going to have about 2 weeks without insurance, essentially just the time it takes for me to submit the forms to add her to my plan. I believe it would be retroactive if something were to happen though. Very thankful for that.

[TBoneTX 45,524]

On ‎4‎/‎12‎/‎2017 at 6:06 PM, Stagnant Sloth said:

my documents for AOS, AP and AED have already been sent off

The technical status is "applicant for adjustment" or "adjustment applicant."