Future Planning - bringing my elderly MIL here

[hplusj 239]

Just opening this topic as I'm getting the gist, based on some research, that we will need to make significant financial planning happen in anticipation of the future here.

 

My mother in law is a Rhodesian expat in Australia, who is remarried to a lovely man, but his family are not exactly supportive of her.  We are likely going to petition for her to join us in the inevitability that he passes (and my husband has naturalized).  They are already in their 70s so the question of how this will logistically and financially work is stumping us.

 

Has anyone here taken steps to bring over an elderly parent?  My understanding is that healthcare is the biggest hit, since they of course will not be eligible for Medicare with no US employment history.  Are they eligible for programs from their country of origin, while here on a green card?  We just want to give her the support and love she needs in her golden years.  She definitely has health issues though, and of course as one ages that continues to progress.  Just not sure how to prepare.  Any advice would be appreciated.

Edited Thursday at 03:55 PM by hplusj

[JeanneAdil 6,759]

just MIL or both?

Income must be 125 % of poverty for # of residents that will be living with u

 

under Obama care:

Health care has either low premiums with year high deductibles ($3000 to $5000)

bigger premiums the deductible decreases but only slightly

 

we are paying about $550 for CIGNA  (secondary insurance) while for  my MIL as we need good insurance with her diabetes and high blood pressure as Adil added her to family plan at work for $495   / so yeah $1000 a month is what it costs us 

Adil flys to Moroc once a year and gets her medicine as its cheaper than buying it here (one medicine is $600 a month)  $40 in Moroc and round trip is $1100 (that 2 months of the medication)

 

Every state is different so u really need to check out yours 

 

Providers here have no way to bill companies back home but u may be able to pay upfront and try for the reimbersement from home (look into it)

[mam521 2,342]

Is she a naturalized Aussie these days? Or a permanent resident there, too?  

 

Most countries with social programs don't extend social programs to persons who are non-residents.  The only one that typically sticks is a pension because that money was essentially put in trust until retirement.  You'd have to check into it.  

 

Healthcare, as you've identified, is typically a limiting factor for most people, due to cost.  Those costs rise, depending on pre-existing condition.  You might want to speak with a health insurance broker to get a ballpark feel for what that might look like.  

 

Some other considerations may be whether or not she wants to move.  I know you want to take care of her, but sometimes uprooting a person and bringing them to very unfamiliar territory isn't actually as beneficial as finding them assistance where they are and visiting often. I understand Aus is not like a quick hop, skip and a jump away, so that adds to the logistical complications.  

 

Good luck in your research!  Let us know what you learn!

[MMRF 23]

New immigrants can buy on the exchange. Go to Iowa's (the real one, not all the fake ones that come up in a search) ACA exchange and price it out.  

https://www.healthcare.gov/immigrants/immigration-status/

[hplusj 239]

3 hours ago, JeanneAdil said:

just MIL or both?

Just MIL, which is why we're looking ahead.  My step-DIL has his family there, and we hope he lives a good long while but we're attempting to prepare for when he leaves us.  

 

All super useful info, thanks!  We'll do some digging into our state (Iowa).

 

1 hour ago, MMRF said:

New immigrants can buy on the exchange. Go to Iowa's (the real one, not all the fake ones that come up in a search) ACA exchange and price it out.  

Yeah we're on ACA already, my husband and I.  Might have private/through employment by the time she joins us but I don't think most plans allow you to add parents, so ACA will likely be the way to go.  Not sure how far we can get on the marketplace with just a quote search, esp when we have 5+ years til this scenario comes into play, but I'll poke around.

[hplusj 239]

2 hours ago, mam521 said:

Is she a naturalized Aussie these days? Or a permanent resident there, too?

 

Some other considerations may be whether or not she wants to move.  I know you want to take care of her, but sometimes uprooting a person and bringing them to very unfamiliar territory isn't actually as beneficial as finding them assistance where they are and visiting often.

She's naturalized, has an Australian passport.

 

We've talked about it, even if it's a sensitive issue given we're talking in terms of her husband passing.  She does want to join us, she won't have any support from his family and her end of life will be extremely isolating.  None of us, including her, will have community tied to Australia.  She's not an invalid or anything, going into independent living will be a bit of overkill in terms of cost and logistics.  But she does have diabetes, which is a preexisting we'll have to navigate with health costs. 

Edited Thursday at 09:00 PM by hplusj

[jan22 3,076]

17 hours ago, hplusj said:

Just MIL, which is why we're looking ahead.  My step-DIL has his family there, and we hope he lives a good long while but we're attempting to prepare for when he leaves us.  

 

. . . 

You indicate that you have no plans to apply to immigrate your husband’s step-father, but I wanted to share information that might be useful if the situation changes or for someone else who might be in a similar situation.  Sounds like it would be unlikely that your husband would be able to petition him — the marriage to his mother would have had to occur prior to your husband’s 18th birthday.  If not, her husband does not qualify for immigration as the step-parent of your husband.

[JeanneAdil 6,759]

to add my MIL came on tourist visa 3 years ago to test is we wanted to apply for the I 130

she was ill the whole time and homesick

she returned to Moroc and 2 weeks later had appendicitis and Adil paid $1000 for surgery in moroc

Here AI says

Without insurance, an appendectomy (appendix removal surgery) in Georgia can cost anywhere from $7,377 to $10,338 for a laparoscopic procedure, but costs can vary significantly based on the hospital and other factors. 

So, we had to think long and hard about filing a petition out 

she ,  also spends her time talking on whatsapp to people back home and is real homesick

[PGA 278]

17 hours ago, hplusj said:

She's not an invalid or anything, going into independent living will be a bit of overkill in terms of cost and logistics.  But she does have diabetes, which is a preexisting we'll have to navigate with health costs. 

Something to consider. Health can be a very fickle thing and often people don't just die suddenly in their sleep. My father (a US citizen since birth) for example got sick with a cold/flu and got bronchitis and as a result went to the hospital and there he acquired C-diff. To make a long story short, this was the beginning of an almost 3 year long and very unexpected battle which, sadly, he lost in the end. Now, I am pointing this out because in those 3 years it required multiple stays at long term care facilities/rehabs as well as hospital stays and constant battles between private health insurance and Medicare and Medicaid, hiring an attorney to sort it all out, and basically draining him of any penny he had left. The expense of the overall care was enormous and I can't imagine what would have happened if he was an aging, recently arrived immigrant with no or minimal healthcare coverage (and most won't cover LTC).

 

Now, if someone is flush with cash maybe it's not something to be concerned with but the worst case scenarios should be considered carefully when making these kinds of decisions. In any case good luck.     

[hplusj 239]

Lots of great feedback here, and I appreciate the thoughtful concern from all.

 

We are going to have to research the logistics of her pensioner's plan, which begins in Australia next year as she will have been a resident for ten years at that point.

 

Being a Rhodesian is a unique circumstance because the home you're tied to, doesn't really exist anymore.  My MIL escaped to South Africa, married and had a son there, and ultimately ended up relocating again when she remarried.  The family she keeps in touch with is almost entirely in other countries already.  We definitely have her best interests at heart and leaving her in Australia without loved ones, is a concern great enough to warrant a financial plan to get her here.  Perhaps she will even be able to maintain her pensioner's abroad, I'm unsure of the stipulations of that, but rest assured I will be looking into it.

 

We aren't millionaires but we want to include this in our 5 and 10 year plan if we can.  Understanding end of life care and its demands as I just lost my father to an eleven year battle with cancer, I absolutely want to remain pragmatic about this.  So, seeing as most of this advice is well-meaning yet anecdotal, I guess I'll have to take some time to delve into law specific to Iowa, as well as Australia. 

 

My husband is her only child, and I know she will want to be with us.  She confirmed it again last night.  Just need to work out how to make it happen, realistically.

Edited 13 hours ago by hplusj

[hplusj 239]

Just a little update, based on a quick search: The US and Australia have a social security agreement, meaning my MIL can retain all or at least partial pension should she become a resident here.

 

So that's good news.  Unsure if that extends to Medicare but it's at least something supplemental to use towards healthcare.

Edited 13 hours ago by hplusj

[Lil bear 4,385]

55 minutes ago, hplusj said:

Just a little update, based on a quick search: The US and Australia have a social security agreement, meaning my MIL can retain all or at least partial pension should she become a resident here.

 

So that's good news.  Unsure if that extends to Medicare but it's at least something supplemental to use towards healthcare.

You are correct about her being able to receive the Aust aged pension here in the US .. subject to meeting the usual AUST Centrelink financial eligibility. But there is no reciprocal arrangement for health care .. she cannot use Aus Medicare in the US