Health Insurance gap after move to US

[fjxs 133]

I am trying to figure out what to do about Health Insurance after I move to the US, and wondering if anyone here knows of anything that would work, or what other people have done. (I am going to be moving on an IR1/CR1 visa.) 

 

I can get health insurance after my move, but it will take a few weeks for that to become active. If I apply & get all the paperwork done in between the 1st-15th of the month, it should be active the first of the next month. If I do it between the 16th-31st of the month, it should be active the 1st of the 2nd month following. (E.g., if I move there in late December, I can get insurance for Feb 1.) I would like to have some kind of insurance during this gap, just to cover emergencies (and, if possible, I would like it to include COVID coverage). The options I have looked into are: 

 

1. My current BC MSP Insurance: This will be good until the end of the end of the month that I leave BC, but it is basically useless - it only covers $75 a day for hospital care outside of Canada!!!

 

2. Travel Insurance for Canadians: I have always just used travel insurance when I go to the US, but everything I am familiar with requires you to be a Canadian Resident to be eligible. Since I am actually moving & getting a Green Card, I don't believe I will count as a Canadian Resident anymore. 

 

3. Travel Insurance for visitors to the US: As far as I know, this will not cover US residents in the US, so it will not work. I will be a US resident from the moment I cross. 

 

4. Expat Insurance: I don't know much about this, but I have found some policies meant to cover Canadian Citizens who are residing outside of Canada, or cover people who are moving to new locations. Most of the "expat" insurance I've found is meant to cover longer periods, i.e., over one year. And one of the policies I looked at for Canadians specifically states that it won't cover anywhere that the Govt of Canada recommends avoiding non-essential travel to (which is everywhere right now). 

 

5. Short term insurance policies designed for US residents & citizens living in the US: In Washington State the only provider that offers that is LifeMap, and one of their eligibility criteria is that you can't have any other health insurance coverage. I don't think I meet that, since I WILL have my BC insurance, at least until the end of the first month. (One possibility would be that I can arrive in the US at the very end of a month, and that way my BC insurance will expire in a day or two, allowing me to get the short term insurance & leaving a gap of only a few days. This would not be my preference, since I don't want to have to time my move like that.) 

 

6. I could try to enroll in regular health insurance before I move: The open enrollment period is until Dec 15th, so I could enroll for a Jan 1 start date, and then move on Jan 1. I am not 100% sure if this is allowed, and can't really get a straight answer from either the exchange (WA health plan finder) or the insurance company. I think it *will* let me enroll without an SSN, but the application form asks "Are you lawfully present in the US?". I can't say "yes" to that – I am not currently in the US at all, so it isn't true and I can't provide the evidence they want (entry date, etc). But I don't want to say "no" to that question either, since that implies that I am currently illegally in the US, which also is not true (and I really wouldn't want a record of that to be anywhere!!!) 

 

Is there anything I am missing? Does anyone know of anything that would actually work? Has anyone been able to sign up with an exchange plan before moving, or figure out something that actually covers the gap? 

 

[Mike E 11,739]

Doesn’t your spouse have health insurance through work?

[fjxs 133]

My spouse is self-employed, so has to buy health insurance on the exchange (or directly from the insurance companies that are on exchange). In both cases, they seem to follow the exchange dates & rules, so I can be added during a special enrollment period or during the open enrollment period. 

[fjxs 133]

30 minutes ago, eketros said:

My spouse is self-employed, so has to buy health insurance on the exchange (or directly from the insurance companies that are on exchange). In both cases, they seem to follow the exchange dates & rules, so I can be added during a special enrollment period or during the open enrollment period. 

To be clear - I can be added, but that will have the wait period I was talking about: if I apply to be added on the 1st-15th, I get it the 1st of the next month, and if I apply 16th-31st, I get it the 1st of the 2nd month following. I can try to add myself during the open enrollment period (which is right now), but when I tried that on the exchange website I had the issue I talked about in point 6 – it asks if I am "lawfully present in the US". 

[fjxs 133]

Ok, well I will update with what I've learned so far, incase this is helpful to anyone else in a similar situation: 

 

I confirmed with LifeMap that I can't get their short term insurance unless the start date is after my Canadian health insurance has ended. If you are in a different state, the rules might be different though – there are different short term insurance providers & rules in each state, so that's something you could look into. I know a company called United offers short term health insurance in many states, but don't know the details of their rules. 

 

I have talked to more than one person at WA Health Plan Finder (the marketplace/exchange in Washington State), and can't really get a consistent answer about whether I should apply for insurance before I move – they say you CAN apply up to 60 days before your life change that gives you a special enrollment period, and I also should be able to apply during the open enrollment period as long as I will be a WA resident at the start of my insurance. BUT they also say there is no way to get through the process without answering the question "Are you lawfully present in the United States?", and I really don't want to answer "no" to that on an official form. Their website says that they keep records of applications for 10 years, and I don't want any records anywhere making it look like I was illegally present in the US at any point! They say that I can wait until I am present in the US and then apply at that point, and they can *request* that my coverage start immediately, but that is only a request and is not guaranteed to work. 

 

What's looking the most promising right now is Expat insurance. I found one through MSH International called LivExpat that is emergency-only coverage up to 500k USD, which can be bought for a minimum of 1 month. You are eligible if you are a Canadian citizen living outside of your home country. You don't need to be a Canadian resident or have Canadian health care. (That is a requirement of most Canadian travellers insurance.) And "Home country" is defined by the country that you have a passport for, so the fact that you have a Green Card won't disqualify you. (That disqualifies you for most travel insurance for visitors to the US.) So I am going to try to apply for that, and will let update with if it works out. 

 

I don't know how common this issue is, but I'm sure I can't be the only one, so hopefully someone else will find the info helpful  

[NikLR 13,227]

Tbh I wouldn’t be worried about 15 to 30 days without insurance unless you plan on partaking in something dangerous during that time. Just stay home, stay safe, and wait it out a little. 

[Sofitalian 134]

I got some info from this forum before I moved to US. I finally bought a short-term insurance that has COVID 19 coverage and allows US "new immigrants" to enroll. 

 

My husband is now shopping insurance for us and it's likely to start from Jan 1. This's the advice given by the insurance broker. I don't worry too much about the short gap (for me it's around 10 days) without insurance. 

[fjxs 133]

If it comes down to it, I'll just accept the gap. (I don't really have a choice, besides just not moving!) But it just seems so silly to me if I can't get insurance: this is a common issue, and health insurance *should* exist for it. Especially when it has been drilled into me as a Canadian that you should *always* have health insurance when you travel into the US, no matter how short. And, if there IS some kind of reasonable solution, I would rather be covered by some kind of emergency-only insurance just in case, especially with covid now 🙃

[NikLR 13,227]

4 hours ago, eketros said:

If it comes down to it, I'll just accept the gap. (I don't really have a choice, besides just not moving!) But it just seems so silly to me if I can't get insurance: this is a common issue, and health insurance *should* exist for it. Especially when it has been drilled into me as a Canadian that you should *always* have health insurance when you travel into the US, no matter how short. And, if there IS some kind of reasonable solution, I would rather be covered by some kind of emergency-only insurance just in case, especially with covid now 🙃

Generally you can get emergency Medicaid should an emergency arise after you have moved to the USA.  You’ll be a US resident as well so not really an issue. You’ll pay it back of course.  We drill into Canadians to have travel insurance because out of pocket costs here can be difficult and emergency Medicaid doesn’t apply to tourists and a hospital isn’t going to work a great deal with a non-US resident. 

[ProbeGT 47]

On 11/20/2020 at 3:07 PM, eketros said:

If it comes down to it, I'll just accept the gap. (I don't really have a choice, besides just not moving!) But it just seems so silly to me if I can't get insurance: this is a common issue, and health insurance *should* exist for it. Especially when it has been drilled into me as a Canadian that you should *always* have health insurance when you travel into the US, no matter how short. And, if there IS some kind of reasonable solution, I would rather be covered by some kind of emergency-only insurance just in case, especially with covid now 🙃

Welcome to the wonderful world of US private health insurance...

 

My suggestion - get a short term insurance plan (United Health, Golden Rule, etc).  You can technically get less than a month, but one of my relatives found that a month was only a few dollars more than a 15 day plan.  Get that plan when you land in the US, to cover any emergencies.  Enroll before the 15th of the month (I believe it has to be before the 15th, but not sure - better safe than sorry) for an ACA plan so it is effective the next month.

 

Regarding subsidies for a new immigrant (you are eligible, contrary to even what the people on the ACA helpline have said), please see my post:

 

[fjxs 133]

Just wanted to update with what I did. I turned out not to be eligible for MSH LivExpat insurance based on the fact that I would be a US resident residing in the US during the insured period. I looked at a few other Canadian travel plans that also excluded me (for example, one required that you be a Canadian Resident, which they defined as someone who had a residence in Canada that they were *returning* to after their trip.) 

 

I ended up getting Tugo Travel Insurance, which included an optional Covid add-on. I was eligible for it based on the fact that I was going to continue to have both my Canadian health insurance AND my Canadian home/address during the full insured period. (In BC, you can keep your health insurance for the balance of the month you move out-of-country. I am not sure if what the rules in other provinces are.) I confirmed with them on the phone that I would be eligible, and the person I spoke with wrote a note in my account as well. 

 

As someone else mentioned, there are US-based short term insurance options which are probably a better option for most people. But what's available is different in every state, and when I spoke with the only one available in WA State (LifeMap), they told me I wouldn't be eligible unless I had *no* other coverage at all. (So if I still had my BC MSP, I wouldn't be eligible. So I could have moved near the end of the month, then let my MSP expire on the last day of the month, and then get LifeMap on the first day of the next month, and that would have also worked.)

Edited December 16, 2020 by eketros