Very frustrating on health insurance

[Morgon 0]

Hi everyone,

I figured I'd vent but maybe I'll get lucky and find someone who has gone through the same thing and perhaps succeeded.

My 21 year old daughter took up residency this week from Australia. Last year during sign up when I inquired through my work health insurance I mentioned that she would be immigrating and they said "Just let us know when she gets here". Now when I have tried to sign her up, they are stating that their rules do not have immigration as a qualifying event, so she is outside the enrollment period and we will have to wait till January before she can get insurance.

I've looked at the plan's group admin guidelines and they have such a narrow band of "qualifying events". For the natural child of a member, the only qualifying event permitted is "loss of other coverage" within 31 days of loss. Nothing else. Yet, the ACA has a much broader band of qualifying events, including gaining lawful presence in the US. I guess that means we could go through the marketplace - but it's at least $200 a month.

Because Australia is pretty much free healthcare, the loss of coverage would only be loss of medicare entitlements because she is no longer an Australian resident for taxpayer purposes. Do you think that one would fly?

[Lemonslice 4,968]

I'm guessing she lost her Australian coverage? I would go with that and print the details of admissibility from the Australian Health Department (or the actual agency managing the health insurance there). Canadian colleague of mine did just that and had no problem. Good luck.

[Amor Verdadero 33]

I would definitely call again and push that her coming to this country constitutes losing her previous coverage, plus she is a dependent child still under the age that qualifies for coverage through her parents... I had to argue the same thing for my husband since I didn't add him to my insurance immediately after marriage since he was still in central America. (He came on CR-1). I told them that he was coming from out of country and would be losing his benefits upon entering the country. They accepted it. There is absolutely no reason they shouldn't add her. I would be adamant about it and even ask to talk to someone else etc.

[NikLR 13,232]

I agree. Unless it specifically says this sort of loss of coverage isnt included, you should push the issue in that direction.

[Love To Teach 161]

I have been told the same thing...that entering this country is not a reason to add him. I am going to have to add him this year and pay 400 a month for coverage that he won't use until he gets here...which could be years. We can only add a person during "open enrollment" which is October. It becomes effective the following January. I will be interested to know if you have any luck. What is your insurance carrier? Mine is CIGNA.

[yuna628 9,716]

All coverage must meet the federal standard. Unfortunately you are dealing with people who have no understanding of the law and what they should be covering. She qualifies under health insurance loss and under immigration. If you cannot get through to them, there are other options such as using Obamacare or buying private coverage temporarily until your personal insurance will ''allow'' you to add her (check both of these options as many of the plans are the same or may be cheaper either way).

[Morgon 0]

I have been told the same thing...that entering this country is not a reason to add him. I am going to have to add him this year and pay 400 a month for coverage that he won't use until he gets here...which could be years. We can only add a person during "open enrollment" which is October. It becomes effective the following January. I will be interested to know if you have any luck. What is your insurance carrier? Mine is CIGNA.

My carrier is Blue Cross Blue Shield. I phoned healthcare.gov this morning and they said that health funds CAN do that and the rules are slightly different for employer based health funds.

Thanks all....I'm going to give it a go the "Lost coverage" route and see what they say.

[SusieQQQ 11,587]

My carrier is Blue Cross Blue Shield. I phoned healthcare.gov this morning and they said that health funds CAN do that and the rules are slightly different for employer based health funds.

Thanks all....I'm going to give it a go the "Lost coverage" route and see what they say.

We got blue shield insurance outside of the normal enrollment period using immigration as a life changing event.... Edited July 1, 2016 by SusieQQQ

[Morgon 0]

We got blue shield insurance outside of the normal enrollment period using immigration as a life changing event....

That's interesting. It might seem a bit ignorant after being here a few years already, but are the Blue Shields in each state differently owned/administrated? We are in Arkansas. Also not sure if it is because it is a particular employer group policy that they can set/negotiate their own rules.

[yuna628 9,716]

We also have BCBS without any issues obtaining outside enrollment period using both immigration and marriage. As I said if you cannot obtain it via work, you'll have to look at Obamacare or private (more than likely both will offer BCBS plans).

[SusieQQQ 11,587]

That's interesting. It might seem a bit ignorant after being here a few years already, but are the Blue Shields in each state differently owned/administrated? We are in Arkansas. Also not sure if it is because it is a particular employer group policy that they can set/negotiate their own rules.

Not sure of the details, I do know ours was blue shield "of California" so perhaps. Also we went through a broker, my experience with medical insurance call center people is they don't always know the details of situations they don't see everyday and I have heard of instances where callers do get given wrong info for a particular circumstance - although that doesn't seem to be what's happened in your case.

[mlh 93]

I had to argue with my HR team and finally got them to call our insurance broker to confirm that immigration is indeed a qualifying event. It's not one that most HR teams have to deal with so they just assume it's not covered, when it really. With our timeline, it ended up being easier to just buy a temporary policy to cover him for the 6 weeks before he was covered as of Jan 1 since I finally knew the date and was able to include him in open enrollment.

Here's the site that we used.

https://www.ehealthinsurance.com/