Boswortha

Hello,

I would like to ask those more experienced in the US healthcare system some advice on the following - I have now lived in NY for 53 days and I will be able to get health insurance through work after working there for 3 months (in just over a months time).
For our first month here, my spouse and I used the Inbound Immigrant cover through Seven Corners and for the past month we have been without any cover, waiting for my employment-based healthcare to kick in.
I spoke to a healthcare gov representative on the phone who mentioned you can incur a fine if you do not have health insurance for longer than a 2 month period.

My question is, has anyone actually been charged a fine before their employment based insurance kicked in? Is 3 months the standard amount of time to wait?
Surely we would have grounds to appeal as we would just be without insurance 1 month longer than the allowed 2 months whilst we waited for employment based health care to kick in..

We are thinking of just paying another month of the Inbound Immigrant cover through Seven Corners which costs around $90 p/month rather than enrolling in a plan which will cost us $700+ p/month.

Also, as I am the only one earning at the minute would there be any chance of financial aid towards the healthcare monthly costs?

Thank you,
Free.

Olly_

The "fine" is determined when you file your taxes, so yes, you will have to pay it.

There are some exemptions which are detailed here but I'm not sure if you'd qualify for any of them.

Inbound Immigrant cover probably won't meet the requirements for the Affordable Care Act so won't qualify as suitable coverage either.

Nutmegger

OP, as it was your choice to seek a visa to work in the US, you can't expect any kind of financial assistance.

SanDiegogirl

You should have taken out cover for the whole of the three months waiting time.

Not having health insurance could cost you a lot more than the monthly premiums should you be taken ill and need hospital coverage.

Financial aid for covering healthcare monthly costs? This is America ! Healthcare costs are one of the highest expenses people have here.

No appeal against not having insurance.

You came over on an O1 visa ..... surely your job would pay enough for you to afford monthly premiums without asking for financial aid?

Pulaski

As others have said, the fine is defaulted when you calculate your taxes

In my, admittedly llimited experience, insurance kicks in at the next quarter, not "after three months". With the benefit of hindsight it might have made a difference to have started near a calendar quarter end, not right at the start of a quarter.

If you apply for ACA coverage to bridge the gap, which has to be the best recommendation (although by waiting a month and relying on your new immigrant policy you might have made that impossible for yourself), you might be eligible for reduced rates based on your income level. I am not certain what the tax/penalty rate is for 2016, but when the ACA was implemented, the penalties escalated each year and within four years were supposed to be high enough to make it a financing no-brainer to take the coverage rather than not have insurance.

In my opinion the best coverage for most people is going to be "high deductible" insurance and a Health Savings Account. .... Search for other threads where I have posted on the subject.

Olly_

The fine is 2.5% of your income or $695 per adult this year, whichever is higher.

Rete

Which is a lot less than most healthcare premiums are per month for an adult.

Pulaski

The penalty is 2.5% of gross salary if greater which is about what our employer-subsidized health insurance premiums are for the entire year.