Obamacare Plans as a Conditional Permanent Resident

[VeeNDee 44]

A question about eligibility for health insurance under Obamacare. My husband and I currently have insurance through his work, but since he is a contractor/vendor we have to pay the full price and the company doesn't pay anything- currently our health insurance is higher than our mortgage AND that's not including the upcoming baby and it only covers 70% maternity!!! We were looking at some of the new plans and it looks like with gold coverage in Washington state, we'd get better coverage, for more people, for less money.

My main concern is the whole affidavit of support - I am currently a conditional permanent resident. Am I eligible to participate in this plan with my husband and upcoming child or is there some kind of exception due to possible subsidies? I really don't want to think we've got a better insurance deal and are saving money and then run into trouble further down the road with either immigration issues or having to pay back what we have been saving.

Does anyone have any experience or knowledge about these options?

Here is the link for the Washington Health Plan Finder:

https://www.wahealthplanfinder.org

[Kimbear 53]

That should not have any impact the status of your green card since it is your husband getting coverage for his family, and your soon to be born baby. It would only affect you if you were applying alone as seen here in this link:

http://thinkprogress.org/immigration/2013/10/01/2708441/affordable-care-act-immigrant-types-coverage/

Edited October 7, 2013 by Kimbear

[Ms Hogan 295]

I was wondering about this as well however my husband is self-employed so I realize it is a little bit different. My husband currently makes more than what would allow for any subsidies but if we fall back below that threshold then what? If we are applying as a family doesn't that mean I'm accepting the assistance?

From the site in the link in the previous post:

Legal permanent residents who have lived here for less than five years. Legal permanent residents with incomes up to 400 percent below the federal poverty level can qualify for subsidized health care coverage. Those who have been in the country less than five years do not qualify for Medicaid.

What does that even mean? I've lived here for less than five years. Is all of Obamacare considered subsidized? Or does that just mean you can get the subsidies if that's your income level?

Edited October 8, 2013 by MsHogan

[NigeriaorBust 4,087]

Until you have been here 5 years only your spouse and child would qualify for help but all household income counts.

[SarahBear 4]

Hello! I hope I can help shed some light on this issue. I've been doing a lot of reading and research myself on Obamacare as we'll probably have to sign up for it when we eventually move to the US.

If you are not a US citizen, but living in the USA for less than 5 years legally, you do not qualify for Medicaid regardless of the income level for you or your family. US citizens can qualify for medicare depending on income, but new immigrants living in the US for less than 5 years do not. However, from what I've read, you are going to qualify to purchase insurance through the healthcare.gov marketplace and would be eligible for a subsidy if: 1. You and/or your spouse do *not* have the option to buy insurance through your workplace and 2. you meet the income requirements depending on your family size and how much total income you and your family bring in that year.

This calculator gives you an idea of how much it will cost to purchase insurance through the marketplace and how much (if any) of a subsidy you'll qualify for depending on family/income: http://kff.org/interactive/subsidy-calculator/

Now here's another interesting tidbit - I've read through different sources that *anyone* legally in the US (even those on student visas) can potentially qualify a subsidy to pay Obamacare premiums. So those of you who are worried about being labeled "conditional" status, I don't believe you have anything to worry about. Thing is, if you have the option to buy insurance though your or your spouses' workplace, I do believe that automatically disqualifies you for a subsidy, although you would still have the option to purchase insurance through the exchange. From what I read, you cannot qualify for a subsidy if you have the option to buy insurance though your workplace if purchasing through the exchange.

This is all based on things I read - some from several months ago so I can't guarantee that all of any of this is accurate as of today because I don't know if there have been changes to the law. It's probably best to check on the specific rules when you go to enroll in coverage, but I do hope this helps.

[SarahBear 4]

I was wondering about this as well however my husband is self-employed so I realize it is a little bit different. My husband currently makes more than what would allow for any subsidies but if we fall back below that threshold then what? If we are applying as a family doesn't that mean I'm accepting the assistance?

From the site in the link in the previous post:

Legal permanent residents who have lived here for less than five years. Legal permanent residents with incomes up to 400 percent below the federal poverty level can qualify for subsidized health care coverage. Those who have been in the country less than five years do not qualify for Medicaid.

What does that even mean? I've lived here for less than five years. Is all of Obamacare considered subsidized? Or does that just mean you can get the subsidies if that's your income level?

From my understanding, you will not qualify for Medicaid but if your husband were to fall below the income threshold based on your family size, then your family would qualify for a subsidy and you would get one too. If his income is high, you will likely not get a subsidy but you will still be eligible to purchase insurance through the exchange. This calculator should help with that calculation: http://kff.org/interactive/subsidy-calculator/ Good luck and hope this helps!

[VeeNDee 44]

Hello! I hope I can help shed some light on this issue. I've been doing a lot of reading and research myself on Obamacare as we'll probably have to sign up for it when we eventually move to the US.

If you are not a US citizen, but living in the USA for less than 5 years legally, you do not qualify for Medicaid regardless of the income level for you or your family. US citizens can qualify for medicare depending on income, but new immigrants living in the US for less than 5 years do not. However, from what I've read, you are going to qualify to purchase insurance through the healthcare.gov marketplace and would be eligible for a subsidy if: 1. You and/or your spouse do *not* have the option to buy insurance through your workplace and 2. you meet the income requirements depending on your family size and how much total income you and your family bring in that year.

This calculator gives you an idea of how much it will cost to purchase insurance through the marketplace and how much (if any) of a subsidy you'll qualify for depending on family/income: http://kff.org/interactive/subsidy-calculator/

Now here's another interesting tidbit - I've read through different sources that *anyone* legally in the US (even those on student visas) can potentially qualify a subsidy to pay Obamacare premiums. So those of you who are worried about being labeled "conditional" status, I don't believe you have anything to worry about. Thing is, if you have the option to buy insurance though your or your spouses' workplace, I do believe that automatically disqualifies you for a subsidy, although you would still have the option to purchase insurance through the exchange. From what I read, you cannot qualify for a subsidy if you have the option to buy insurance though your workplace if purchasing through the exchange.

This is all based on things I read - some from several months ago so I can't guarantee that all of any of this is accurate as of today because I don't know if there have been changes to the law. It's probably best to check on the specific rules when you go to enroll in coverage, but I do hope this helps.

Ugh I fear what you are saying might be true but that's just rough. With the baby we are going to be paying I believe about $1300 a month.... that's just ridiculous. So because we have the OPTION to buy it, we can't get the government version? It's so painful financially to afford that every month, but with pre existing conditions still posing a problem at the moment, it was our only option. And because it's available but the company doesn't pay ANY of it, we still have to use that option as compared to people with insurance through work where the company pays part of it?

[SarahBear 4]

Ugh I fear what you are saying might be true but that's just rough. With the baby we are going to be paying I believe about $1300 a month.... that's just ridiculous. So because we have the OPTION to buy it, we can't get the government version? It's so painful financially to afford that every month, but with pre existing conditions still posing a problem at the moment, it was our only option. And because it's available but the company doesn't pay ANY of it, we still have to use that option as compared to people with insurance through work where the company pays part of it?

Sadly that is my understanding. I know it is rough - my last job in the US had terrible health insurance and we could only pick one plan. The premium was ridiculous and we had to hit a really high deductible before the plan paid out a dime. You have to look at health insurance as part of your total compensation to determine if it's worthwhile to take or keep a job these days. It's pathetic.

Pre-existing conditions will become a non issue as of 1/1/2014 so if that's why you're in that crappy plan, maybe you can get out of it for next year. Does your husband have open enrollment coming up where maybe he can select a new plan at a better rate?

Even if you don't have the option to purchase health insurance using a subsidy, it may be worthwhile to look at what the offerings are through the exchange. You may find a better rate there even without a subsidy.

[VeeNDee 44]

Sadly that is my understanding. I know it is rough - my last job in the US had terrible health insurance and we could only pick one plan. The premium was ridiculous and we had to hit a really high deductible before the plan paid out a dime. You have to look at health insurance as part of your total compensation to determine if it's worthwhile to take or keep a job these days. It's pathetic.

Pre-existing conditions will become a non issue as of 1/1/2014 so if that's why you're in that crappy plan, maybe you can get out of it for next year. Does your husband have open enrollment coming up where maybe he can select a new plan at a better rate?

Even if you don't have the option to purchase health insurance using a subsidy, it may be worthwhile to look at what the offerings are through the exchange. You may find a better rate there even without a subsidy.

Ohh I didn't think of that option. So, even if we have an employer insurance option, we can still use the exchange to get non subsidized healthcare? I suppose there is a way to specify that when you search or something...

[SarahBear 4]

Ohh I didn't think of that option. So, even if we have an employer insurance option, we can still use the exchange to get non subsidized healthcare? I suppose there is a way to specify that when you search or something...

You can still purchase insurance through the exchange even if your employer offers healthcare, but you won't qualify for a subsidy. You may also want to check and see if your husband's plan offerings will change in 2014 to explore all your options. Who knows, maybe next year they'll offer better quality plans?

[Kimbear 53]

Ohh I didn't think of that option. So, even if we have an employer insurance option, we can still use the exchange to get non subsidized healthcare? I suppose there is a way to specify that when you search or something...

Yes you can. We looked into that since hubby works for a company with a Grandfathered plan, meaning i get screwed out of alot of stuff especially with the pregnancy. Unfortunately, his company offers more than the minimum, so it would not be worth it for us. You can just go on the health site and put in info and do a search, you don't need to tell them who you are or commit to anything.

You can still purchase insurance through the exchange even if your employer offers healthcare, but you won't qualify for a subsidy. You may also want to check and see if your husband's plan offerings will change in 2014 to explore all your options. Who knows, maybe next year they'll offer better quality plans?

Since all this technically kicks in January 1, i imagine most things will be sorted out by then and some places will adjust plans depending on demand etc. At least its a start.

[SarahBear 4]

Goodness, we have 3 pregnant women on this thread! I am due on November 29th but we are staying in Canada at least until after the baby is born for sure to help us avoid this headache. I am so thankful for my OHIP coverage. Good luck to you ladies with your new arrivals and congratulations!

[Kimbear 53]

Goodness, we have 3 pregnant women on this thread! I am due on November 29th but we are staying in Canada at least until after the baby is born for sure to help us avoid this headache. I am so thankful for my OHIP coverage. Good luck to you ladies with your new arrivals and congratulations!

I wish i could have done that! lol but i moved here 3 years ago I've already eaten up my deductible and half my out of pocket and i still have a few weeks left! in fact looking at education prices as well, it'd be cheaper to send my kid to Canada for school than do it here in Chicago. Good grief..i don't know how people do it down here. I never realized how much i miss Canada until I got pregnant lol.

[Ms Hogan 295]

I just did my application on healthcare.gov site.

It asked whether or not each person was a citizen and when I said NO for myself and the kids, it automatically went to another step asking for the type of status we had with a dropdown menu where I could select that we are green card holders.

We don't qualify for subsidies so that didn't apply at any point after the beginning.

Now if I can just get the system to verify my identity i might be able to get somewhere with the numbers! I want to know HOW MUCH it is going to cost through the exchange. I have Type 1 Diabetes and haven't been able to get coverage so far.