Success getting healthcare coverage for immigrant parents over 65

[missads 59]

To find out what insurance options are available for your specific situation, use this link

https://www.healthcare.gov/lower-costs/

You have to trick the system by using an income level just above the medicaid limit, to look at the various health plans in the open market. If you plug in zero income, it will keep defaulting to Medicaid.

Keep in mind that the premiums might not be accurate (will likely be reduced due to tax credits for people with no income,) but you can at least survey the various health plans in your state.

Edited January 21, 2016 by missads

[Boiler 45,731]

I know this subject has been done to death many many times.

OCare can mean both Insurance you buy with tax subsidies if appropriate and Medicaid which often has local State names.

Generally you are not entitled to Medicaid until you have been a LPR for 5 years, anything paid out by Medicaid would also be reclaimed from your Estate on death.

Not an issue getting tax subsidy, same way as they is not for any other tax credit, mortgage etc for example.

Medicare assuming you do not have the credits you would only be able to buy into after 5 years. Not sure why you would buy Medicare rather than Insurance through the exchange?

Big problem with going through OCare is finding a Doctor etc that will take it, they are used to dealing with Medicare for Seniors that pays them more than OCare.

Edited January 21, 2016 by Boiler

[missads 59]

What he said ... except I don't know if this topic has been really discussed that much on VJ. I couldn't find more than a couple threads, and they weren't too helpful either.

Also, if you already have a doctor/hospital in mind, you can choose an insurance plan that is accepted by them. That's what I did. It's just like any other insurance, doctor shouldn't have a problem with it.

Again, use the help of a Navigator. They can help deal with this kind of detail.

[MarinaMaya 3]

https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Questions-and-Answers-on-the-Premium-Tax-Credit

Look at the last requirement. You can't get tax credit if someone can claim you as a dependent. (it's not whether someone claimed you but the fact that you qualify as a dependent). Please see the link on IRS website.

Who is eligible for the premium tax credit?

You are eligible for the premium tax credit if you meet all of the following requirements:

• Purchase coverage through the Marketplace.
• Have household income that falls within a certain range (see question 6).
• Are not able to get affordable coverage through an eligible employer plan that provides minimum value (see questions 8 and 9).
• Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
• Do not file a Married Filing Separately tax return (unless you meet the criteria in section 1.36B-2T(b)(2) of the Temporary Income Tax Regulations, which allows certain victims of domestic abuse and spousal abandonment to claim the premium tax credit using the Married Filing Separately filing status (see questions 12 and 13).
• Cannot be claimed as a dependent by another person.

[Boiler 45,731]

https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Questions-and-Answers-on-the-Premium-Tax-Credit

Look at the last requirement. You can't get tax credit if someone can claim you as a dependent. (it's not whether someone claimed you but the fact that you qualify as a dependent). Please see the link on IRS website.

Who is eligible for the premium tax credit?

You are eligible for the premium tax credit if you meet all of the following requirements:

• Purchase coverage through the Marketplace.
• Have household income that falls within a certain range (see question 6).
• Are not able to get affordable coverage through an eligible employer plan that provides minimum value (see questions 8 and 9).
• Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
• Do not file a Married Filing Separately tax return (unless you meet the criteria in section 1.36B-2T(b)(2) of the Temporary Income Tax Regulations, which allows certain victims of domestic abuse and spousal abandonment to claim the premium tax credit using the Married Filing Separately filing status (see questions 12 and 13).
• Cannot be claimed as a dependent by another person.

So what?

[missads 59]

https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/Questions-and-Answers-on-the-Premium-Tax-Credit

Look at the last requirement. You can't get tax credit if someone can claim you as a dependent. (it's not whether someone claimed you but the fact that you qualify as a dependent). Please see the link on IRS website.

• Cannot be claimed as a dependent by another person.

That just means the parent can't get the subsidy and then be claimed as a dependent by the child/sponsor on their tax return, i.e. no double dipping.

[Boiler 45,731]

I could think of a situation where the person being sponsored claims the one who completed the I 864 as a dependent for tax purpose.

[missads 59]

10 things immigrant families need to know about the Obamacare marketplace

https://www.healthcare.gov/blog/10-things-immigrant-families-need-to-know-about-the-marketplace/

Check out #2 - it clearly states that LPRs are eligible for tax subsidies (based on their income, of course.)

LPR parents with no income ARE eligible for tax credits. Period.

[Mia77 2]

LPR parents with no income ARE eligible for tax credits. Period.

I think it depends on can you claim them as dependents or not. If you can - they can't get tax credit.

https://www.irs.gov/...mium-Tax-Credit

You can't get tax credit if someone can claim you as a dependent.

If you CAN be claimed as a dependent by another taxpayer, you must file as a dependent whether you are being

claimed or not.

(See https://www.irs.gov/pub/irs-pdf/p4012.pdf)

[missads 59]

I think it depends on can you claim them as dependents or not. If you can - they can't get tax credit.

https://www.irs.gov/...mium-Tax-Credit

You can't get tax credit if someone can claim you as a dependent.

If you CAN be claimed as a dependent by another taxpayer, you must file as a dependent whether you are being

claimed or not.

(See https://www.irs.gov/pub/irs-pdf/p4012.pdf)

Where exactly does it state that if you CAN be claimed as a dependent you MUST file as a dependent? What the law says is that IF you (the sponsor/child) claim someone (parents) as a dependent, then you can't claim a tax subsidy for their health premiums, because your income is included in the household income. If they file separately, they are considered a separate "tax household" even if they live in your house (same filing address.)

With all due respect, it doesn't matter what you "think". The only thing that matters is the law.

To summarize, in order to claim the tax credit for parents with no income:

- Beneficiaries (parents) should NEVER have been claimed as dependents on their sponsor's (child's) US tax returns (this is REALLY important)

- Beneficiaries should file their own tax returns as married filing jointly (if married) In this case, it would be 0 income, 0 taxes on the forms.

- Fill out the health subsidy reconciliation form the following year. Again 0 income means 0 taxes.

I wish people would stop fear mongering and just stick to the facts.

[Mia77 2]

Where exactly does it state that if you CAN be claimed as a dependent you MUST file as a dependent?

With all due respect, it doesn't matter what you "think". The only thing that matters is the law.

To summarize, in order to claim the tax credit for parents with no income:

- Beneficiaries (parents) should NEVER have been claimed as dependents on their sponsor's (child's) US tax returns (this is REALLY important)

- Beneficiaries should file their own tax returns as married filing jointly (if married) In this case, it would be 0 income, 0 taxes on the forms.

- Fill out the health subsidy reconciliation form the following year. Again 0 income means 0 taxes.

I wish people would stop fear mongering and just stick to the facts.

Dear Missads,

This is just a discussion in the attempt to find the truth. I would appreciate if you could change the form of your answers to be more polite.

This sentence:

"If you CAN be claimed as a dependent by another taxpayer, you must file as a dependent whether you are being

claimed or not"

is in this IRS publication (and many others places) on page 41 at the top:

https://www.irs.gov/pub/irs-pdf/p4012.pdf

[missads 59]

I refer you to page 38 of the above document. See explanation for Line 6 in form 8962 (the form for reconciling Premium Tax Credits PTC)

Did the taxpayer qualify for the PTC?

Answer yes (income less than 100% Federal poverty line) if ...

(1) Taxpayer or an individual in taxpayer’s tax family enrolled in a qualified
health plan through the Marketplace, and the enrolled individual is a lawfully
present individual ineligible for Medicaid due to immigration status.

Ergo, LPRs with 0 income are eligible for Premium Tax Credits.

I apologize if the tone of my replies didn't sit well with you. I was just trying to emphasize that facts matter more than opinions.

I have presented the facts to the best of my knowledge. The readers can review this discussion, do their own research and come to their own conclusions.

My parents applied for healthcare, qualified for PTC, and are enrolled in an AFFORDABLE health plan. We didn't withhold any information regarding immigration status or income when applying.

As is often the case in life, YMMV...

[yuna628 9,687]

Since the parents have filed married filing jointly, this precludes the rules about being claimed as a dependent.. of which it would not matter much anyway. The law states all persons must have health insurance or pay a penalty, but since the parents in this case make well below any threshold for a penalty, the penalty will not apply... yet they certainly need healthcare. However, because they also make below the threshold, but will not qualify for Medicaid because of their immigration status, they are well within their rights to obtain insurance from the exchange whether it is subsidized or not. That's how the ACA is supposed to work.

If the parents did not file, or for some reason filed married but filing separately due to provisions regarding abuse or refugee status, combined with the children buying a private health insurance plan for them (which you'd probably be hard pressed to find a private insurance that would accept someone of that age) which contributed toward the dependent claim threshold support test - this would be a different story.

This article is regarding the ACA, state and federal exchanges, and discusses several scenarios involving immigrant and elderly parents. http://www.seattletimes.com/seattle-news/obamacare-answers-to-your-most-pressing-questions/ You'll have to scroll a bit to see them near to the bottom in the immigrants section.

The question over if the OP's solution is legal and factual is none. It is legal and it's great that the OP found a solution for his elderly immigrant parents. Repeat after me. It is legal. It IS legal. IT IS LEGAL.

https://www.medicareresources.org/faqs/can-recent-immigrants-to-the-united-states-get-health-coverage-if-theyre-over-65/

http://ww2.kqed.org/stateofhealth/2013/10/09/for-legal-immigrants-obamacare-has-options-for-aging-parents/

http://www.consumerreports.org/cro/news/2014/11/health-insurance-for-immigrant-seniors/index.htm

[Kelvavik 1]

At the risk of repeating other posts, I just wanted to share my experience of being able to find affordable health insurance for my parents. Here are some details:

Parents - over 65, here on Green Card (permanent residents)

Living in the US for less than 5 years (about 2 years)

Eligible for tax subsidy through Obamacare (this does NOT constitute a public charge)

Residents of State of Michigan, have social security numbers

Eligible for Silver level insurance plans

Filed their $0 federal/state taxes jointly, separate from mine (I do NOT claim them as dependents on my tax return - this is important)

I had searched the healthcare.gov website last year for insurance for them and came up empty handed. We purchased "travelers insurance" online (***removed***) but got shafted. My parent had a major health incident and they didn't cover anything (all claims were denied as pre-existing condition) Stay away from these types of insurance.

I tried healthcare.gov again this year and couldn't find anything again. Many seem to assume, wrongly, that everyone over 65 is eligible for Medicare by default. This isn't true for immigrants, they need to have lived in the US for at least 5 years before they can participate in Medicare.

Anyway, the short story is healthcare.gov has still not caught on to this. If you want to purchase health insurance, you will need to work with a healthcare navigator. There are several public service organizations that have these navigators who will help you for free. They will help you do the application over the phone, and then it works just fine. I am in Michigan and went through Jewish Family Service. Have your parents green cards and SSN handy, that is all they need.

There appears to be a widely held misconception that immigrant seniors over 65 are not covered by Obamacare. This is absolutely NOT true. You don't have to wait for 5 years for Medicare to kick in. Recent immigrants older than 65 can purchase health insurance via healthcare.gov, just like any other US citizen or legal permanent resident. Some state exchanges might not know it, the person you talk to on the phone might not know it, the healthcare.gov website certainly doesn't appear to understand this special situation, but trust me parents on green cards who have been in the US less than 5 years ARE eligible for subsidized health coverage.

I was able to get health insurance for my parents who have no income, for around $100 a month per parent (after a $1000 tax subsidy, because their income is less than limit of ~$21K) Now that is REALLY affordable, and it is proper mainstream insurance (Blue Cross Michigan) None of that travelers' insurance BS.

Just trying to get the word out, because the open enrollment deadline is January 31st. If your parents arrive after Jan 31st, you can still sign up at that time, because their arrival date qualifies as a special "life event". But if they are already in the US, please sign up by Jan 31st. Otherwise they will have to wait until November for the next enrollment period to begin.

Thanks for sharing your experience. Can you share with us how one gets in touch with a healthcare advocate?

Also, was Blue Cross Michigan the carrier for the insurance you got through healthcare.gov?

What do you know about the turnaround time between application date and effective date of insurance through healthcare.gov? If there's a delay, can one apply for the insurance before the immigrant arrives in the US?

Thanks!

[missads 59]

Thanks for sharing your experience. Can you share with us how one gets in touch with a healthcare advocate?

Also, was Blue Cross Michigan the carrier for the insurance you got through healthcare.gov?

What do you know about the turnaround time between application date and effective date of insurance through healthcare.gov? If there's a delay, can one apply for the insurance before the immigrant arrives in the US?

Thanks!

You can search online for healthcare advocates in your area. Look at churches and other religious non-profits, they usually have someone to help.

Blue Cross was the insurance carrier we selected through healthcare.gov, there were others as well but Blue Cross was the best fit for us.

The application is usually accepted the same day, pending submission of proof like immigration status and SSNs. The effective date of insurance can vary depending on when you apply during open enrollment (November 1st thru January 31st each year.) Since open enrollment has ended for 2016, yours would be handled as a special case (qualifying life event) effective the date the immigrant arrives in the US. I believe you have 30 days to enroll since the date of arrival. I don't think you can apply before their arrival, as they will need to apply for SSN.

I would start by finding a local healthcare navigator and discussing your case with them. Every state has slightly different rules, they will be able to explain your available options.

One thing is for sure though, your immigrant family members are eligible for healthcare coverage. Just do the research ahead of time and get all the documents ready, so that you can apply soon after they arrive.

Also remember NOT to claim them as dependents on your tax return (if they are not likely to work/have income in the US) The resulting tax credits for the premium will be well worth it.