Health care for resident parents

[Stann 3]

Aaron is correct that emergency Medicaid is not considered to be a means-tested public benefit by the federal government. Regular Medicaid, on the other hand, IS considered a means-tested public benefit. The federal government's position is that both sponsor deeming and sponsor liability apply to regular Medicaid, but not to emergency Medicaid. Sponsor deeming means that the government is supposed to consider the sponsor's income and assets to be available to the immigrant, and should be included in determining the immigrant's eligibility for the benefit. Sponsor liability means that the sponsor can be asked to reimburse the government if the immigrant collects the benefits while the affidavit of support is in force.

However, Medicaid is jointly funded by both the federal and state governments. Because of this, the federal government doesn't dictate to the states every aspect of how the programs should be managed. Some states don't apply sponsor deeming or sponsor liability to any form of Medicaid. Some have public policies that apply sponsor deeming and sponsor liability only to regular Medicaid and not to emergency Medicaid. Some apply sponsor deeming and sponsor liability only when Medicaid is used for long term institutionalized care. Some don't have a stated public policy about this at all.

The whole thing may be moot. There is at least one immigrant advocacy group that claims that no state has ever sought reimbursement from a sponsor for an immigrant who used Medicaid.

Yes, this is one of three cases where the discretionary public charge determination comes into play. A consular officer can deny a visa if they believe that an alien might become a public charge in the US. USCIS can deny adjustment of status if they believe the intending immigrant might become a public charge. The third case, and the one that LPR's who used public benefits should be concerned with, is that a CBP officer can deny admission if they believe an LPR has been or will become a public charge. While an LPR would generally not be deported if they became a public charge, they could be taking a risk if they leave the US and try to reenter.

Great info, thank you, Is there an easy way to find out my states (Illinois) policy on Medicaid and sponsors liability or is it easy enough to find with an internet search? Also would you take the risk and have your relative use Medicaid given what you say about the immigrant advocacy groups findings?

Thanks

[Gary and Alla 3,694]

Great info, thank you, Is there an easy way to find out my states (Illinois) policy on Medicaid and sponsors liability or is it easy enough to find with an internet search? Also would you take the risk and have your relative use Medicaid given what you say about the immigrant advocacy groups findings?

Thanks

Google "Health benefits IL"

You may find something else offered also, depends on the state. Vermont offers "Catamount Health without Premium Assistance" which is available to ANY Vermont resident, even recent immigrants as long as they are LPRs and Vermont residents. It is very reasonably priced insurance, through one of two private insurers and generally a better deal than you will find anywhere else, plus there are no exclusions for pre-existing conditions. It is not a means tested benefit as regards the I-864.

It would not be possible to cover someone in one of these plans before they got a visa and green card BUT it could be shown that they will be eligible for coverage and would probably satisfy any question at the interview. An interim policy is usually available from foreign medical coverages

[JimVaPhuong 4,863]

Great info, thank you, Is there an easy way to find out my states (Illinois) policy on Medicaid and sponsors liability or is it easy enough to find with an internet search? Also would you take the risk and have your relative use Medicaid given what you say about the immigrant advocacy groups findings?

Thanks

First, they probably wouldn't be eligible for Medicaid even if they were US citizens who had lived here their entire lives. Regular Medicaid is primarily for disabled adults or parents with minor children. Non-disabled adults without minor children are generally ineligible for regular Medicaid, regardless of their income level.

Second, because they are immigrants the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 applies to them. This means they aren't eligible for means-tested public benefits until they've been an LPR for five years. This has nothing to do with sponsor deeming or sponsor liability. They're simply not eligible for the first five years.

I take whatever an immigrant advocacy group claims with a grain of salt. Their ultimate objective is often to open the flood gates to any immigrant who wants to live in the US, and to give legal status to all of the non-legal immigrants who are already here, and they are fond of finding loopholes in existing laws if it helps them to get closer to their objectives. One such group is the Center for Public Policy Priorities, and they are one of the groups who claim that the federal government has never sought reimbursement from a sponsor for a sponsored immigrant who collected Medicaid benefits. I don't doubt that claim is true, but I also don't read it as a wholesale endorsement for doing something which the law clearly says you're not supposed to do.

You are a sponsor signing an affidavit of support. Read the contract portion of that affidavit, and understand what it requires from you. You should sign it with a good faith intention to fulfill the obligations you're agreeing to fulfill, and not with the intention to circumvent those obligations just because you believe the government won't enforce it. I don't personally believe it's ever acceptable to view the law of terms of "What can I get away with without getting caught?".

Your parents will never be eligible for free Medicare, not even after they've been here for five years. The eligibility requirements for free Medicare are comparable to those for Social Security retirement benefits. They'd need 40 quarters of work credit through the Social Security Administration, which for most people means they'd need to have worked and paid taxes for 10 years. What they WILL be eligible for is premium Medicare, provided they pay the full premiums. It's a lot less expensive than most private health insurance.

[Stann 3]

Google "Health benefits IL"

You may find something else offered also, depends on the state. Vermont offers "Catamount Health without Premium Assistance" which is available to ANY Vermont resident, even recent immigrants as long as they are LPRs and Vermont residents. It is very reasonably priced insurance, through one of two private insurers and generally a better deal than you will find anywhere else, plus there are no exclusions for pre-existing conditions. It is not a means tested benefit as regards the I-864.

It would not be possible to cover someone in one of these plans before they got a visa and green card BUT it could be shown that they will be eligible for coverage and would probably satisfy any question at the interview. An interim policy is usually available from foreign medical coverages

Thanks that is great, I am going to research Illinois health benefits and also look into the Bridge Plan and private insurance. Got some internet research to do! Thanks again for all your help

[Stann 3]

First, they probably wouldn't be eligible for Medicaid even if they were US citizens who had lived here their entire lives. Regular Medicaid is primarily for disabled adults or parents with minor children. Non-disabled adults without minor children are generally ineligible for regular Medicaid, regardless of their income level.

Second, because they are immigrants the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 applies to them. This means they aren't eligible for means-tested public benefits until they've been an LPR for five years. This has nothing to do with sponsor deeming or sponsor liability. They're simply not eligible for the first five years.

I take whatever an immigrant advocacy group claims with a grain of salt. Their ultimate objective is often to open the flood gates to any immigrant who wants to live in the US, and to give legal status to all of the non-legal immigrants who are already here, and they are fond of finding loopholes in existing laws if it helps them to get closer to their objectives. One such group is the Center for Public Policy Priorities, and they are one of the groups who claim that the federal government has never sought reimbursement from a sponsor for a sponsored immigrant who collected Medicaid benefits. I don't doubt that claim is true, but I also don't read it as a wholesale endorsement for doing something which the law clearly says you're not supposed to do.

You are a sponsor signing an affidavit of support. Read the contract portion of that affidavit, and understand what it requires from you. You should sign it with a good faith intention to fulfill the obligations you're agreeing to fulfill, and not with the intention to circumvent those obligations just because you believe the government won't enforce it. I don't personally believe it's ever acceptable to view the law of terms of "What can I get away with without getting caught?".

Your parents will never be eligible for free Medicare, not even after they've been here for five years. The eligibility requirements for free Medicare are comparable to those for Social Security retirement benefits. They'd need 40 quarters of work credit through the Social Security Administration, which for most people means they'd need to have worked and paid taxes for 10 years. What they WILL be eligible for is premium Medicare, provided they pay the full premiums. It's a lot less expensive than most private health insurance.

Thanks for the wealth of information and your frank response. I am inclined to agree with you in regard to the ethics of trying to claim Medicaid. So far in my immigration journey I have always erred on the side of caution when faced with a grey area, if for no other reason than knowing my luck I would be the one case that got caught / made an example of! Thanks again.

[Boiler 45,470]

After much soul searching I cam to the conclusion that only practical method for elderly parents to move is if:

They are from Countries that have no health system and they are poor so they have nothing to lose.

They are stinking rich.

[JohnL 4]

If you live in California there might be some hope. California will be covering all legal permanent residents regardless of the 5 year waiting period. Who knows if it is going to be affordable????? Since mother-in-law lives with us, I expect the rate to be based on the family income as a whole. Please check out the link on Covered calif website

http://www.coveredca.com/PDFs/English/Covered_California_List_of_Lawfully_Present_Individuals.pdf