Medical insurance during AOS from B2 for a parent

[BDD 8]

My wife recently became a citizen and though her mother entered the county earlier in the year (before COVID, we got an I-539 extension) with none of us having the intention of her ever applying for a GC. After a change of heart, we filed a I-130 and plan to file a I-485 with supporting forms I-131, I-864EZ, and I-944.

 

We've been through the K1 process and the strange period where one does not have a status as they are adjusting their status. It seems that in early 2021 when my mother in law's B2 visa stay is up that she would be in the same position. One difference between this and the K1 process is we have no opportunity to have my mother in law apply for a SSN or at least that's my understanding.  

 

Not having a SSN and/or not having a status seems like it's going to complicate things for medical insurance for my mother in law. I've searched for answers on this forum and elsewhere, and I'm just the most confused I've ever been during our immigration journey.

 

Now there's the new I-944 form (which really isn't applicable to our situation at all) that asks about medical insurance and though we can say she has (traveler's) insurance at present, we are struggling to understand what our medical insurance options are for going forward. We live in a small state so safe to assume the local agents aren't going to understand this situation so before we reach out to them, I was hoping that some of the experts here might be able to help and/or have been through the same\rare situation.

[HRQX 4,145]

21 minutes ago, BDD said:

my mother in law apply for a SSN or at least that's my understanding.

She can also submit I-765 and consent to USCIS forwarding her info to SSA after I-765 approval. Filing I-765 and I-131 are free for her if she pays the full I-485 fee.

[JFH 12,190]

Travel insurance is unlikely to be valid. Travel insurance is based on the assumption that the person is temporarily in the country and will be returning to the point of origin soon. You will probably also find that the coverage will only apply here for an emergency and will cover enough to “patch her up” and the cost of a ticket to her original country to continue her treatment and rehabilitation there. As soon as the person is gif yo fly, travel insurance will usually stop paying and expect the person to return home. It certainly won’t cover routine and preventative care, treatment for chronic conditions, etc.

[ProbeGT 47]

See my post here:

If you are going though the AOS process and have a valid NOA1 document, you can can apply for insurance through the ACA. 

 

[BDD 8]

On 12/4/2020 at 10:10 AM, ProbeGT said:

See my post here:

If you are going though the AOS process and have a valid NOA1 document, you can can apply for insurance through the ACA. 

 

Thanks so much for such a thoughtful and well articulated post.

 

We are waiting to get in touch from an ACA specialist in our state. I have read through missads' entire thread and I still have a few a questions.

 

My mother in law does have a foreign pension. It's not much, like 3500 USD a year. I'm aware IRS taxes income world wide, but also believe she makes so little that she doesn't need to file taxes at all though I understand we should (evidence for ACA and not claim her as a dependent.)  Do we report $0 for ACA (she doesn't have any income in the US) or $3500; maybe there isn't any difference. I'm mostly asking because in all the great advice I've seen shared on this site, pensions are not acknowledged by anyone who's successfully enrolled a few years in succession.  

 

Secondly, we will soon send in the AOS, but plan to ask our state rep if a NOA for I-130 is already enough for us to file during the open enrollment period...that's probably a long shot, but I've seen some documents from another state list I-130 as acceptable evidence; the marketplace website of course just says 797 are accepted, but not which kind. If that doesn't work, it's my understanding the AOS is a special event (or qualify event in common insurance lingo) so we can enter once we get the NOA for 485.

 

If there's any input you could provide, we would really appreciate it! Thanks again!

[neo_ny 22]

8 hours ago, BDD said:

Thanks so much for such a thoughtful and well articulated post.

 

We are waiting to get in touch from an ACA specialist in our state. I have read through missads' entire thread and I still have a few a questions.

 

My mother in law does have a foreign pension. It's not much, like 3500 USD a year. I'm aware IRS taxes income world wide, but also believe she makes so little that she doesn't need to file taxes at all though I understand we should (evidence for ACA and not claim her as a dependent.)  Do we report $0 for ACA (she doesn't have any income in the US) or $3500; maybe there isn't any difference. I'm mostly asking because in all the great advice I've seen shared on this site, pensions are not acknowledged by anyone who's successfully enrolled a few years in succession.  

 

Secondly, we will soon send in the AOS, but plan to ask our state rep if a NOA for I-130 is already enough for us to file during the open enrollment period...that's probably a long shot, but I've seen some documents from another state list I-130 as acceptable evidence; the marketplace website of course just says 797 are accepted, but not which kind. If that doesn't work, it's my understanding the AOS is a special event (or qualify event in common insurance lingo) so we can enter once we get the NOA for 485.

 

If there's any input you could provide, we would really appreciate it! Thanks again!

Following this as I am considering coverage for my mom, please post what you learn from the ACA specialist.  I understand ACA options are very state specific but I am very interested in what you learn.  I am no expert but I would venture a guess that they are actually talking about a pending 485 when they say NOA for AOS.  Irrespective of whether the NOA is acceptable or not, I would think the approval of EAD and/or the GC would definitely trigger the special enrollment period ...

[ProbeGT 47]

22 hours ago, BDD said:

Thanks so much for such a thoughtful and well articulated post.

 

We are waiting to get in touch from an ACA specialist in our state. I have read through missads' entire thread and I still have a few a questions.

 

My mother in law does have a foreign pension. It's not much, like 3500 USD a year. I'm aware IRS taxes income world wide, but also believe she makes so little that she doesn't need to file taxes at all though I understand we should (evidence for ACA and not claim her as a dependent.)  Do we report $0 for ACA (she doesn't have any income in the US) or $3500; maybe there isn't any difference. I'm mostly asking because in all the great advice I've seen shared on this site, pensions are not acknowledged by anyone who's successfully enrolled a few years in succession.  

 

Secondly, we will soon send in the AOS, but plan to ask our state rep if a NOA for I-130 is already enough for us to file during the open enrollment period...that's probably a long shot, but I've seen some documents from another state list I-130 as acceptable evidence; the marketplace website of course just says 797 are accepted, but not which kind. If that doesn't work, it's my understanding the AOS is a special event (or qualify event in common insurance lingo) so we can enter once we get the NOA for 485.

 

If there's any input you could provide, we would really appreciate it! Thanks again!

I believe that you can put $3500, and it will most likely make no difference in the calculations (noticeable changes happen near 100% of the federal poverty level/FPL).  Since you don't have a tax return yet, you can write on the ACA worksheet as indicated in my post.  I suppose you could also put $0 and then have everything work itself out during taxes, but it is probably better to be upfront if you know you have income (as opposed to someone putting $0 and having unexpected income).  I think missads post indicates that $0 was used.

 

According to the ACA website, if someone is adjusting to permanent residency, they can apply for insurance.  Other posts here on VJ seem to indicate that the NOA1 is sufficient.  You could certainly try and see what happens.  Obtaining residency should qualify as a "life event" IIRC.

 

Don't be surprised if your ACA representative is mistaken regarding the subsidy value.  When I called the official ACA number when helping a relative enroll, they said that there would be no subsidy.  We went through the process ourselves and there was a very large subsidy ($400+), so YMMV.

Edited December 7, 2020 by ProbeGT
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[BDD 8]

@ProbeGT @neo_ny

 

I spoke with the phone rep today and they told me the NOA for I-130 was enough for her to enter during open enrollment, but! I'm not sure I believe it. Like ProbeGT and missads have predicted, the rep pushed us toward Medicaid and after I explained how we are wanting to avoid public benefits, they said they'd need to consult with someone else and get back to me.

 

 

[HRQX 4,145]

16 minutes ago, BDD said:

I spoke with the phone rep today and they told me the NOA for I-130 was enough for her to enter during open enrollment, but! I'm not sure I believe it.

Phone rep is probably misinformed on I-130 receipt acceptance. It should be I-485 receipt.

[neo_ny 22]

On 12/6/2020 at 10:59 PM, ProbeGT said:

I believe that you can put $3500, and it will most likely make no difference in the calculations (noticeable changes happen near 100% of the federal poverty level/FPL).  Since you don't have a tax return yet, you can write on the ACA worksheet as indicated in my post.  I suppose you could also put $0 and then have everything work itself out during taxes, but it is probably better to be upfront if you know you have income (as opposed to someone putting $0 and having unexpected income).  I think missads post indicates that $0 was used.

 

According to the ACA website, if someone is adjusting to permanent residency, they can apply for insurance.  Other posts here on VJ seem to indicate that the NOA1 is sufficient.  You could certainly try and see what happens.  Obtaining residency should qualify as a "life event" IIRC.

 

Don't be surprised if your ACA representative is mistaken regarding the subsidy value.  When I called the official ACA number when helping a relative enroll, they said that there would be no subsidy.  We went through the process ourselves and there was a very large subsidy ($400+), so YMMV.

Are you saying you eventually ended up getting a subsidy even with $0 income?

[neo_ny 22]

13 hours ago, BDD said:

@ProbeGT @neo_ny

 

I spoke with the phone rep today and they told me the NOA for I-130 was enough for her to enter during open enrollment, but! I'm not sure I believe it. Like ProbeGT and missads have predicted, the rep pushed us toward Medicaid and after I explained how we are wanting to avoid public benefits, they said they'd need to consult with someone else and get back to me.

 

 

I know that there is language in the public charge rule that clearly states that getting a ACA subsidy doesn't count as a public benefit but it seemed (to me) that the the IO's have a lot of leeway in determining that.  So, I decided to punt in making a deep dive into it until after her GC approval.  Not right or wrong, if I were to signup for the ACA coverage for my mom now before her AOS is complete - I would not avail of any subsidies jut to be safe.  Currently, I have a travel insurance coverage for her (as comprehensive as I could find) and self-insure until we have her GC and will then take a serious look at getting ACA coverage for her.   

[BDD 8]

Not surprised that they didn't call me back today...

 

https://marketplace.cms.gov/technical-assistance-resources/assister-guide-to-immigration-section.pdf

 

This is what I plan to discuss with them.

 

Quote

2. Special Rules for Immigrants with Income Under 100% of the FPL. In general, financial assistance through the Marketplace is only available for individuals who have income between 100% and 400% of the FPL and are otherwise eligible. However, there is a special rule in the Affordable Care Act that allows lawfully present individuals with income below 100% FPL who are ineligible for Medicaid or CHIP based on immigration status, to get financial assistance through the Marketplace, if otherwise eligible.

Along with

 

https://www.healthcare.gov/immigrants/lawfully-present-immigrants/

 

Quote

In order to get Medicaid and CHIP coverage, many qualified non-citizens (such as many LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after receiving "qualified" immigration status before they can get Medicaid and CHIP coverage. There are exceptions. For example, refugees, asylees, or LPRs who used to be refugees or asylees don’t have to wait 5 years.

 

Edited December 8, 2020 by BDD

[ProbeGT 47]

On 12/8/2020 at 6:10 AM, neo_ny said:

Are you saying you eventually ended up getting a subsidy even with $0 income?

Yes.  Any income made will still be reported on the tax return, and the subsidy will then be adjusted accordingly.

[ProbeGT 47]

16 hours ago, BDD said:

Not surprised that they didn't call me back today...

 

https://marketplace.cms.gov/technical-assistance-resources/assister-guide-to-immigration-section.pdf

 

This is what I plan to discuss with them.

 

Along with

 

https://www.healthcare.gov/immigrants/lawfully-present-immigrants/

 

 

This is exactly the basis for which an LPR can get a subsidy even if they have income levels that would usually result in enrollment in Medicaid. 

[neo_ny 22]

20 hours ago, BDD said:

Not surprised that they didn't call me back today...

 

https://marketplace.cms.gov/technical-assistance-resources/assister-guide-to-immigration-section.pdf

 

This is what I plan to discuss with them.

 

Along with

 

https://www.healthcare.gov/immigrants/lawfully-present-immigrants/

 

 

This is interesting, please update once you've had a chance to discuss!

 

@ProbeGT

 

So when you put in a $0 income (or any income <100% FPL), the online quote showed you no subsidy but when you actually went through the process you eventually ended up with a subsidy?