Help! When do I need to register with health insurer to avoid ACA fine as a K1 immigrant?

[Moosebites 3]

Hi everyone,

 

So I've been issued my K1 visa and I'm moving to the states next month, yay! But I'm getting hopelessly confused with health insurance. My fiance is self-employed so he doesn't have a work-based insurance plan that I can join once we're married. So I was planning on getting a 6-month plan for new immigrants for myself to cover the gap until I get employment authorisation and hopefully I can then get insured through my employer once I get a job (any recommendations or tips for a provider for new immigrant insurance appreciated!)

 

However, I was reading about how immigrants have to get cover with an insurance provider as a requirement of the affordable care act, or they get fined - but I'm not sure I understand if/when this applies to me. Does this only apply once I get my green card, or does it apply as soon as I arrive in the US? Does it matter what state I'll be living in (Washington, for the record). Can anyone explain this to me in plain English, I'm getting rather stressed! 

 

Thanks in advance!

[yuna628 9,829]

28 minutes ago, Moosebites said:

Hi everyone,

 

So I've been issued my K1 visa and I'm moving to the states next month, yay! But I'm getting hopelessly confused with health insurance. My fiance is self-employed so he doesn't have a work-based insurance plan that I can join once we're married. So I was planning on getting a 6-month plan for new immigrants for myself to cover the gap until I get employment authorisation and hopefully I can then get insured through my employer once I get a job (any recommendations or tips for a provider for new immigrant insurance appreciated!)

 

However, I was reading about how immigrants have to get cover with an insurance provider as a requirement of the affordable care act, or they get fined - but I'm not sure I understand if/when this applies to me. Does this only apply once I get my green card, or does it apply as soon as I arrive in the US? Does it matter what state I'll be living in (Washington, for the record). Can anyone explain this to me in plain English, I'm getting rather stressed! 

 

Thanks in advance!

If they don't have it via work does your fiancé have a personal health insurance plan that you could be added to or do they pay the fine?

 

Your options are in general:

 

Sign up to the federal or state exchange (WA does have it's own exchange).

Have the new spouse add you to their plan or get a joint plan together privately (usually the most simple and easiest option). Having something jointly together will be good in the future too.

Have a shot term plan until you start working. However there is no guarantee when you will start working, AND short term plans are not ACA compliant, meaning the penalty may still apply. In general though the penalty will be going away next year I believe, but the details are a bit murky. The penalty is far cheaper than health insurance premiums for sure though. Keep in mind also that short term plans and those marketed directly to new immigrants DO NOT provide pre-existing coverage. So they are not the best sort of coverage for those that need actual healthcare on a regular basis. They are mostly for a peace of mind type of thing, and the coverage is dubious at best. In the long term they are cheaper than real compliant health insurance, but ask yourself if you will actually need it and if you should just bite the bullet so to speak, and obtain real coverage that will help you when you need it.

 

There is... well debate and uncertainty when the penalty should apply to a new immigrant. Does it begin immediately after marriage? In general after marriage your window to sign up outside of open enrolment (special enrolment as you have a qualifying event) is a short gap, somewhere between 30-60 days. Wait too long, and you can't sign up for anything. The clock starts ticking from that point. Some though might say the penalty phase would begin once you meet the resident status test for green card holders by the IRS which would end up being a more significant gap period (the EAD is taking longer these days.. and green card won't be coming for a year at least).

 

There will be sticker shock. No doubt about it, no matter what you choose.

 

Edited April 27, 2018 by yuna628

[JadeyHexed 29]

I can't answer all your questions but I can tell you what our experience was like.

 

My husband (UK citizen) is a Type 1 diabetic. It was extremely stressful trying to figure out how to get him health insurance asap after arriving stateside. We looked at the short-term plans but they were quite expensive as the quotes we looked at through the ACA. After our wedding, I was able to sign him up for the ACA under special enrollment (through marriage), and we were required to provide proof of his legality through our NOA of the AOS. The health plan we got him on was fantastic as it covered a lot of his diabetic supplies and prescriptions, although our monthly premium made things rough for us in the beginning when we were superbroke. The interesting part is, after my husband got a job, even the least expensive health insurance plan offered through his employer was still more expensive than the ACA plan he was on. Fast forward four years and he is still insured through the ACA because the plan is more affordable for us. 

 

If my husband was not diabetic, we certainly would not have pushed so quickly to get him insured, as the penalty per year is nothing compared to the monthly premiums (even for our relatively modest plan). I have a friend who pays the penalty because she doesn't quality for the ACA and can't afford her employer-based health plans. Also, just so you know, if you do forego health insurance in favor of paying the penalty, the penalty will be marked for every month you go without health insurance which gets reported when you and your spouse file your yearly taxes. 

 

In my humble opinion, the short-term plans are quite expensive for what they are, but only you can figure out through quotes which option is best for you. Luckily you are able to receive quotes here free of cost to help you determine your best course of action, be it a short-term plan, the ACA, or paying the penalty. And keep in mind that your future employer-based insurance plans may be more expensive than the ACA plans. Just get quotes before making any decisions.

 

Congratulations on your upcoming nuptials and starting your new life! <3

Edited April 27, 2018 by JadeyHexed

[Moosebites 3]

4 hours ago, yuna628 said:

If they don't have it via work does your fiancé have a personal health insurance plan that you could be added to or do they pay the fine?

 

Your options are in general:

 

Sign up to the federal or state exchange (WA does have it's own exchange).

Have the new spouse add you to their plan or get a joint plan together privately (usually the most simple and easiest option). Having something jointly together will be good in the future too.

Have a shot term plan until you start working. However there is no guarantee when you will start working, AND short term plans are not ACA compliant, meaning the penalty may still apply. In general though the penalty will be going away next year I believe, but the details are a bit murky. The penalty is far cheaper than health insurance premiums for sure though. Keep in mind also that short term plans and those marketed directly to new immigrants DO NOT provide pre-existing coverage. So they are not the best sort of coverage for those that need actual healthcare on a regular basis. They are mostly for a peace of mind type of thing, and the coverage is dubious at best. In the long term they are cheaper than real compliant health insurance, but ask yourself if you will actually need it and if you should just bite the bullet so to speak, and obtain real coverage that will help you when you need it.

 

There is... well debate and uncertainty when the penalty should apply to a new immigrant. Does it begin immediately after marriage? In general after marriage your window to sign up outside of open enrolment (special enrolment as you have a qualifying event) is a short gap, somewhere between 30-60 days. Wait too long, and you can't sign up for anything. The clock starts ticking from that point. Some though might say the penalty phase would begin once you meet the resident status test for green card holders by the IRS which would end up being a more significant gap period (the EAD is taking longer these days.. and green card won't be coming for a year at least).

 

There will be sticker shock. No doubt about it, no matter what you choose.

 

Thanks. Thankfully, I don't have any pre existing conditions so in the short term, I just want to at least make sure I'm covered for any catastrophic health issues. My fiance is on Obamacare right now, and also only just moved to WA so I need to talk to him about exactly what cover he has right now. But it sounds like if we try to get me cover that is ACA-compliant, there's still going to be at least a few weeks after I move to the US that I'm not covered - so maybe it's worth getting new immigrant insurance just for these few weeks?

 

I guess I should also look up the penalty cost too. I have no idea what the logic of the penalty is... it makes no sense to me? What happens if someone can't afford any healthcare cover at all, do they still have to pay a penalty? 

 

4 hours ago, JadeyHexed said:

I can't answer all your questions but I can tell you what our experience was like.

 

My husband (UK citizen) is a Type 1 diabetic. It was extremely stressful trying to figure out how to get him health insurance asap after arriving stateside. We looked at the short-term plans but they were quite expensive as the quotes we looked at through the ACA. After our wedding, I was able to sign him up for the ACA under special enrollment (through marriage), and we were required to provide proof of his legality through our NOA of the AOS. The health plan we got him on was fantastic as it covered a lot of his diabetic supplies and prescriptions, although our monthly premium made things rough for us in the beginning when we were superbroke. The interesting part is, after my husband got a job, even the least expensive health insurance plan offered through his employer was still more expensive than the ACA plan he was on. Fast forward four years and he is still insured through the ACA because the plan is more affordable for us. 

 

If my husband was not diabetic, we certainly would not have pushed so quickly to get him insured, as the penalty per year is nothing compared to the monthly premiums (even for our relatively modest plan). I have a friend who pays the penalty because she doesn't quality for the ACA and can't afford her employer-based health plans. Also, just so you know, if you do forego health insurance in favor of paying the penalty, the penalty will be marked for every month you go without health insurance which gets reported when you and your spouse file your yearly taxes. 

 

In my humble opinion, the short-term plans are quite expensive for what they are, but only you can figure out through quotes which option is best for you. Luckily you are able to receive quotes here free of cost to help you determine your best course of action, be it a short-term plan, the ACA, or paying the penalty. And keep in mind that your future employer-based insurance plans may be more expensive than the ACA plans. Just get quotes before making any decisions.

 

Congratulations on your upcoming nuptials and starting your new life! <3

Ok great, that's good to know thanks. I thought as an immigrant I wasn't eligible for anything under the ACA; I'm still not sure I understand how it works, but hopefully I (we) can find some good cover. 

[yuna628 9,829]

2 hours ago, Moosebites said:

Thanks. Thankfully, I don't have any pre existing conditions so in the short term, I just want to at least make sure I'm covered for any catastrophic health issues. My fiance is on Obamacare right now, and also only just moved to WA so I need to talk to him about exactly what cover he has right now. But it sounds like if we try to get me cover that is ACA-compliant, there's still going to be at least a few weeks after I move to the US that I'm not covered - so maybe it's worth getting new immigrant insurance just for these few weeks?

 

I guess I should also look up the penalty cost too. I have no idea what the logic of the penalty is... it makes no sense to me? What happens if someone can't afford any healthcare cover at all, do they still have to pay a penalty? 

 

Ok great, that's good to know thanks. I thought as an immigrant I wasn't eligible for anything under the ACA; I'm still not sure I understand how it works, but hopefully I (we) can find some good cover. 

If the fiancé has an Obamacare plan they can certainly add you to it after marriage. However since it is an Obamacare plan and you're dealing with the government, they're likely going to want to see proof of status. As the poster above noted - a marriage certificate and NOA1 for your AOS should do it. To make it even easier, before you marry follow the instructions in the guides section about how to obtain an SSN. An SSN is not required to have insurance by law, but you'll find it significantly less emotional stress in dealing with insurance people having one.

 

It sounds to me like you've got the start of a plan. I'd grab the SSN as soon as possible, marry, file for AOS (you can grab a short term plan for a few weeks if you want), and when you have the marriage certificate and NOA1 in hand, have the spouse add you to their insurance.

 

The penalty is generally around the cost of one or two months worth of an average premium. To give you a ballpark figure will depend on circumstances, but let's just say when I added my husband to my insurance I was paying somewhere around $600 per month for an insurance premium, that soon was about to shoot up to $800 per month. As you can see, people that don't have insurance get off significantly cheaper. The ACA works like a giant swimming pool. Everyone pays in - including those that don't have insurance. The person that wants insurance pays a premium (a reduced premium only applies in certain circumstances) and those that don't have insurance pay the penalty. Those that are wealthy and can afford it.... well that penalty is nothing. There's no real 'teeth' to the penalty or anything to give a person an incentive to obtain insurance... and most people have seen their premiums continue to increase. Those that couldn't afford insurance anyway, and have to pay a penalty? Well it's not ideal, but it is cheaper than actually paying a years worth of premiums by far. To top it off though, most of the insurance plans offered on the ACA website are likely the same ones you can shop around for privately. They may or may not be cheaper so it's good to check. You can also still obtain healthcare even if you don't have insurance. There are minute clinics in every town these days. But don't worry, a lot of people don't understand the logic or agree with the penalty... it does nothing to make the system better. ;-)

 

Plans work on tiers: platinum, gold, silver, and bronze. In states where choice is very limited, don't be surprised at the lack of options. The more you pay, the better the benefits.

 

When my husband arrived here, he assessed the risks and decided to go without. As soon as we applied for AOS, I added him to my private insurance plan. The good thing about private plan was that since you aren't dealing with the government, they didn't need to see his NOA1 either, so no extra waiting around. He was covered soon after. We're now on his work plan.

[Moosebites 3]

18 hours ago, yuna628 said:

If the fiancé has an Obamacare plan they can certainly add you to it after marriage. However since it is an Obamacare plan and you're dealing with the government, they're likely going to want to see proof of status. As the poster above noted - a marriage certificate and NOA1 for your AOS should do it. To make it even easier, before you marry follow the instructions in the guides section about how to obtain an SSN. An SSN is not required to have insurance by law, but you'll find it significantly less emotional stress in dealing with insurance people having one.

 

It sounds to me like you've got the start of a plan. I'd grab the SSN as soon as possible, marry, file for AOS (you can grab a short term plan for a few weeks if you want), and when you have the marriage certificate and NOA1 in hand, have the spouse add you to their insurance.

 

The penalty is generally around the cost of one or two months worth of an average premium. To give you a ballpark figure will depend on circumstances, but let's just say when I added my husband to my insurance I was paying somewhere around $600 per month for an insurance premium, that soon was about to shoot up to $800 per month. As you can see, people that don't have insurance get off significantly cheaper. The ACA works like a giant swimming pool. Everyone pays in - including those that don't have insurance. The person that wants insurance pays a premium (a reduced premium only applies in certain circumstances) and those that don't have insurance pay the penalty. Those that are wealthy and can afford it.... well that penalty is nothing. There's no real 'teeth' to the penalty or anything to give a person an incentive to obtain insurance... and most people have seen their premiums continue to increase. Those that couldn't afford insurance anyway, and have to pay a penalty? Well it's not ideal, but it is cheaper than actually paying a years worth of premiums by far. To top it off though, most of the insurance plans offered on the ACA website are likely the same ones you can shop around for privately. They may or may not be cheaper so it's good to check. You can also still obtain healthcare even if you don't have insurance. There are minute clinics in every town these days. But don't worry, a lot of people don't understand the logic or agree with the penalty... it does nothing to make the system better. ;-)

 

Plans work on tiers: platinum, gold, silver, and bronze. In states where choice is very limited, don't be surprised at the lack of options. The more you pay, the better the benefits.

 

When my husband arrived here, he assessed the risks and decided to go without. As soon as we applied for AOS, I added him to my private insurance plan. The good thing about private plan was that since you aren't dealing with the government, they didn't need to see his NOA1 either, so no extra waiting around. He was covered soon after. We're now on his work plan.

Thanks for the advice, I think that's a good plan. Now I just have to decide if it's worth getting cover for the few weeks before I have my NOA1...