New Healthcare Requirements for US Immigrants

[geowrian 22,337]

Healthcare is in a sad state. Insurance is just one part of that whole issue, but it is a big part of it.

The bigger issue is we don't even have an idea of what we want to do to address it. Single payer system? Private insurance? Required to have coverage or not (I know...SCOTUS ruled on this part already)?

The system is broken and we as a nation are still trying to figure out what we even want to do about it, let alone move towards actually doing it.

/politics

 

I don't think anybody is joking about how hard it is to get decent coverage for a reasonable price. Sometimes people are forced to make hard decisions between coverage and more immediate needs.

That said, it still does remain a fact that going without coverage - and without substantial assets in lieu of coverage - is dangerous.

As a society, we have decided that it is not in our best interests to let people just die because they don't have coverage. But the consequence is that somebody has to foot the bill - usually the provider or the individual, but sometimes even the government.

Also as a consequence of the above, people still die and/or make their conditions much more worse and costly. I know people denied chemo because they can't cover the costs - knowing that it will lead to much more costly bills as a result. I know people who refused to see a doctor and now are facing considerable pain and high doctor bills because they tried to self-treat or not-treat.

 

The fact is I don't have a clear solution. Nobody does. I have ideas, but that goes into politics again.

The best I can say for now is that insurance coverage is a very high priority. I'd easily be bankrupt if I did not have it. It's not food and shelter, but it's not that far off either in today's world.

(Well, at least until medical costs can actually be controlled...the massively inflated costs is a disgrace to everybody involved in making that happen).

[USS_Voyager 1,972]

1 hour ago, sol_sol said:

Is not there any way parents can buy private insurance before entering?

Of course you can buy before they entering. It's just most people after they find out it's gonna cost $800-$1400/month then they decide not to buy... 

[artcodex 28]

1 minute ago, USS_Voyager said:

Of course you can buy before they entering. It's just most people after they find out it's gonna cost $800-$1400/month then they decide not to buy... 

Interesting If you have any references/links on where or how would be very useful. I haven't been able to find too many apart from travel insurance companies.

[USS_Voyager 1,972]

1 hour ago, Lil bear said:

The public charge test is different to assessing the future health risk of a beneficiary.

I already see all sorts of problem with that. The COs are not medical professionals. Who are they to determine what future health risks may be, let alone how much it will cost? 

[USS_Voyager 1,972]

5 minutes ago, artcodex said:

Interesting If you have any references/links on where or how would be very useful

Call up insurance companies... 

[artcodex 28]

1 minute ago, USS_Voyager said:

Call up insurance companies... 

cool will do. Guess I've only looked online so far and all I get is marketplace policies and medicare

[artcodex 28]

10 minutes ago, USS_Voyager said:

I already see all sorts of problem with that. The COs are not medical professionals. Who are they to determine what future health risks may be, let alone how much it will cost? 

Could be wrong but I think the medical exam results do list some details, of course those are just data points and the medical doctor cannot make conclusion the CO must and yes very hard to asses risk and cost with very little data to go on

[Lil bear 4,207]

10 minutes ago, artcodex said:

Interesting If you have any references/links on where or how would be very useful. I haven't been able to find too many apart from travel insurance companies.

The marketplace website enables anyone to get a look at the plans and costs available for them .. age and location specific.  So it  is possible to identify the plan and premium ahead of time. You cannot buy ACA policies though until  you qualify .. which for a new immigrant is at  POE .. we had Blue Cross Blue Shield policy in place and paid for 10 days after POE on IR5 .. hopefully documentation identifying the policy and evidence of means  to pay for 12 months would be adequate at the interview 

[Lil bear 4,207]

4 minutes ago, artcodex said:

Could be wrong but I think the medical exam results do list some details, of course those are just data points and the medical doctor cannot make conclusion the CO must and yes very hard to asses risk and cost with very little data to go on

The current medical exam is restricted to certain specific issues ... communicable diseases, drug use, mental health issues which present present danger to self or others and vaccinations. It would require a huge change to the medical examination and report.., and would require a dr to make a subjective recommendation ....  very few practitioners would be prepared to do that. BTW .. I have just retired from 42 years in the medical professions and yes I do have Dr. in front of my name.🤪

[Boiler 45,514]

I do not see the issue, certainly for a Parent I would have thought the No 1 factor would be Healthcare and how you are going to address it.

 

The current policy could actually be ramped up so that is more closely looked into. I certainly remember cases which have not been approved because of this, not many.

 

So basically they have formalised the situation. So for a Parent it could be well the current price of cover from the exchange is x amount, which is something that we can cover from our savings, pensions whatever.

[artcodex 28]

3 minutes ago, Lil bear said:

The current medical exam is restricted to certain specific issues ... communicable diseases, drug use, mental health issues which present present danger to self or others and vaccinations. It would require a huge change to the medical examination and report.., and would require a dr to make a subjective recommendation ....  very few practitioners would be prepared to do that. BTW .. I have just retired from 42 years in the medical professions and yes I do have Dr. in front of my name.🤪

Lol. cool. don't know why I was led to believe they included more data then just the communicable diseases / mental issues, vaccines etc, but good to know thats all the exam covers.

[Boketto 211]

I feel like instead of making everyone prove their overseas taxes and assets and credit score, they should have just implemented THIS policy while enforcing the affidavit of support. It would be much easier to collect from these sources when unforeseeable cost situations occur, and saves so much headache for immigrant couples. 

Edited October 7, 2019 by Boketto

[artcodex 28]

2 minutes ago, Boiler said:

I do not see the issue, certainly for a Parent I would have thought the No 1 factor would be Healthcare and how you are going to address it.

 

The current policy could actually be ramped up so that is more closely looked into. I certainly remember cases which have not been approved because of this, not many.

 

So basically they have formalised the situation. So for a Parent it could be well the current price of cover from the exchange is x amount, which is something that we can cover from our savings, pensions whatever.

I tend to agree that one needs to have health insurance covered especially for parents. My only thing right now is more guidance on what acceptable proof is for this, and how to go about that. I'm all for making things more objective (and hoping with good guidance for this policy that it does exactly that reducing discretion and making things more clear). Right now as you say it is still something a CO at their discretion can decide to deny a case for, it just seems a lot more subjective at the moment.

[Lil bear 4,207]

1 minute ago, Boiler said:

I do not see the issue, certainly for a Parent I would have thought the No 1 factor would be Healthcare and how you are going to address it.

 

The current policy could actually be ramped up so that is more closely looked into. I certainly remember cases which have not been approved because of this, not many.

 

So basically they have formalised the situation. So for a Parent it could be well the current price of cover from the exchange is x amount, which is something that we can cover from our savings, pensions whatever.

You’d think that health insurance would be foremost in the minds of IR5 beneficiaries .. it certainly was in ours .. we had already been LPR previously so I already knew the mess that is the  health system .. and I researched the costs of self  insurance .. but we don’t have to look far on these forums to see the many who don’t know .. and then when given the  harsh  reality .. don’t want  to know. ... to realise it’s a huge black hole that many ignore. Reality .. $25k for a  couple for a year before insurance pays anything ( cost of monthly premium and deductible ).  Beneficiaries would need to be told that they had to have this amount available additional to the sponsor requirements. One way some countries handle this is to require the purchase of a bond which is then used  to pay premiums etc .

[Boiler 45,514]

2 minutes ago, artcodex said:

I tend to agree that one needs to have health insurance covered especially for parents. My only thing right now is more guidance on what acceptable proof is for this, and how to go about that. I'm all for making things more objective (and hoping with good guidance for this policy that it does exactly that reducing discretion and making things more clear). Right now as you say it is still something a CO at their discretion can decide to deny a case for, it just seems a lot more subjective at the moment.

Give it a chance just a couple of days and we have the text but will need to see the practice.

 

It is currently discretionary and will continue to be so, the more I think about it making strict rules to cater for every circumstance is not likely to be practical.