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-   -   Advise - Moving my Mum from the UK to USA (https://britishexpats.com/forum/usa-57/advise-moving-my-mum-uk-usa-836863/)

Sally Redux Jun 28th 2014 5:06 pm

Re: Advise - Moving my Mum from the UK to USA
 
Not very up on it myself, but I think Medicare is for over-65's, but you need to have been here for 5 years to be eligible?

Medicaid is for people with a very low income.

The healthcare exchanges provide access to plans. The premiums may be subsidised if the income is low enough, when purchased through the exchanges.

MMcD Jun 28th 2014 5:53 pm

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by robin1234 (Post 11307632)
Good thing about being in the donut hole, it at least means you're still alive!

"Twixt optimist and pessimist
the difference is droll
The optimist sees the donut
the pessimist see the (donut) hole"


FWIW...and purely anecdotal..... but:
My Salvadoran (lpr status) housekeeper proudly showed me what she's recently received:
Cards for Medicare and MediCal (this is CA's name for Medicaid) coverage
She's registered with her local Kaiser hospital - goes there weekly for treatments where she sees 1 specific specialist for a particular condition. She pays nothing...nada either for her visits or for any medications. Everything is completely covered and paid for.

I usually hesitate to cite anecdotal cases - because it can be misleading to imply they can be generalized...but if it might be in any way useful or helpful - I'll happily ask her specific questions should anyone think what I've related might be an avenue for them to pursue.

She's over 65 (just) and to qualify for MediCal (which evidently means there are no deductibles or premiums to pay) ones income must fall beneath a given threshold.

durham_lad Jun 28th 2014 6:26 pm

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by jmood (Post 11318177)
So if the state he is living in does not have expanded medicare (which means part D?) he may be eligible for subsidies for the ACA? Did I get that right?
Where do I start investigating?

Edit:
OH, OK, perhaps you actually meant if the state he is living in does not have expanded medicare he may be eligible for subsidies for Medicare? Please help me understand! Eek!

Sorry, I meant expanded Medicaid :rofl:

The idea was to provide subsidies over a range of incomes and the feds offer to initially pay for expanding the State managed Medicaid (for poor people) up to higher income levels at which the ACA would take over.

scrubbedexpat099 Jun 28th 2014 7:12 pm

Re: Advise - Moving my Mum from the UK to USA
 
I think... in this case Medicaid is irrelevant, does not qualify, expanded or otherwise as a new resident, Medicare you have to be here 5 years first and then buy into it.

That leaves private insurance and the exchange. Realistically the exchange aka Obamacare.

Still think that Obamacare may be better than Medicare anyway?

durham_lad Jun 28th 2014 8:51 pm

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by Boiler (Post 11318304)
I think... in this case Medicaid is irrelevant, does not qualify, expanded or otherwise as a new resident, Medicare you have to be here 5 years first and then buy into it.

That leaves private insurance and the exchange. Realistically the exchange aka Obamacare.

Still think that Obamacare may be better than Medicare anyway?

If your income is too low you can't get Obamacare, and I think you can't get Obamacare if you qualify for Medicare.

https://www.healthcare.gov/how-can-i...lace-coverage/

KFF has a good subsidy estimator

http://kff.org/interactive/subsidy-calculator/

robin1234 Jun 28th 2014 10:45 pm

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by durham_lad (Post 11318346)
If your income is too low you can't get Obamacare, and I think you can't get Obamacare if you qualify for Medicare.

https://www.healthcare.gov/how-can-i...lace-coverage/

KFF has a good subsidy estimator

Subsidy Calculator | The Henry J. Kaiser Family Foundation

Exactly. If you qualify for Medicare, then you go for Medicare. There's still enough "choices" down that rabbit hole to satisfy anyone.

scrubbedexpat099 Jun 28th 2014 11:16 pm

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by durham_lad (Post 11318346)
If your income is too low you can't get Obamacare, and I think you can't get Obamacare if you qualify for Medicare.

https://www.healthcare.gov/how-can-i...lace-coverage/

KFF has a good subsidy estimator

Subsidy Calculator | The Henry J. Kaiser Family Foundation

In this case they is no Medicare qualification.

After 5 years you have the ability to buy into Medicare, do you have to? I have no idea. Most people would of course not have to buy in.

In my State, you have to go through Medicaid to get to Obamacare, if you do not qualify for Medicaid, new arrival for example then you end up in Obamacare.

One of the questions asked initially is if you have been a LPR for 5 years or not.

durham_lad Jun 28th 2014 11:59 pm

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by Boiler (Post 11318411)
In this case they is no Medicare qualification.

After 5 years you have the ability to buy into Medicare, do you have to? I have no idea. Most people would of course not have to buy in.

In my State, you have to go through Medicaid to get to Obamacare, if you do not qualify for Medicaid, new arrival for example then you end up in Obamacare.

One of the questions asked initially is if you have been a LPR for 5 years or not.

I've looked and can't see if you HAVE to choose Medicare once you are eligible but I will be surprised if insurance through Obamacare is going to be cheaper or better. For the OP's question then Obamacare or Medicaid would be the option for the first 5 years, then Medicare becomes an option as well.

scrubbedexpat099 Jun 29th 2014 12:55 am

Re: Advise - Moving my Mum from the UK to USA
 
How would you get Medicaid for the first 5 years?

A bronze Obamacare would be essentially free for an oldie who does not have a significant income. Medicare seem to be quite expensive.

I can imagine it would depend a lot on individual circumstances, gives me a headache thinking about it.

jmood Jun 29th 2014 1:09 am

Re: Advise - Moving my Mum from the UK to USA
 
Following the entire thread is doing my head in. I think I will re-read tomorrow in the day, supposedly with a fresher brain.



Originally Posted by durham_lad (Post 11318273)
Sorry, I meant expanded Medicaid :rofl:

The idea was to provide subsidies over a range of incomes and the feds offer to initially pay for expanding the State managed Medicaid (for poor people) up to higher income levels at which the ACA would take over.

So re the above, PLEASE would you re-state what you were saying with a complete sentence (rather than what you meant as just a word). I'm dumb, I've got the entire thing muddled up now. Thank you. :o

durham_lad Jun 29th 2014 1:55 am

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by jmood (Post 11318469)
Following the entire thread is doing my head in. I think I will re-read tomorrow in the day, supposedly with a fresher brain.




So re the above, PLEASE would you re-state what you were saying with a complete sentence (rather than what you meant as just a word). I'm dumb, I've got the entire thing muddled up now. Thank you. :o

Medicaid is means tested so if you have few assets and low income you get healthcare for free, and it varies by State.

To get Obamacare you have to have income above a certain level to qualify. In States like Texas which didn't accept Federal money to increase the Medicaid income level to match the lower level income to get Obamacare then you don't qualify for either. Most folks in this situation will remain with no insurance since private insurance it is not affordable for them.

scrubbedexpat099 Jun 29th 2014 2:24 am

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by durham_lad (Post 11318486)
Medicaid is means tested so if you have few assets and low income you get healthcare for free, and it varies by State.

To get Obamacare you have to have income above a certain level to qualify. In States like Texas which didn't accept Federal money to increase the Medicaid income level to match the lower level income to get Obamacare then you don't qualify for either. Most folks in this situation will remain with no insurance since private insurance it is not affordable for them.

Expanded Medicaid has higher income limits and no assets consideration. Reimbursement is still possible in many States.

No minimum income requirements for Obamacare I know of.

Sally Redux Jun 29th 2014 3:31 am

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by durham_lad (Post 11318486)
Medicaid is means tested so if you have few assets and low income you get healthcare for free, and it varies by State.

To get Obamacare you have to have income above a certain level to qualify. In States like Texas which didn't accept Federal money to increase the Medicaid income level to match the lower level income to get Obamacare then you don't qualify for either. Most folks in this situation will remain with no insurance since private insurance it is not affordable for them.

Post edited.

I was looking up eligibility and wasn't sure if jmood's dad would be an LPR, realized he probably will be.

Pulaski Jun 29th 2014 4:07 am

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by Boiler (Post 11318492)
..... No minimum income requirements for Obamacare I know of.

Me neither, never heard of it, nor can I understand why there would be, or, for that matter why anyone would think there would be. :confused:

ETA. If your income is below a certain (variable) level, (linked to the cost of silver level coverage) you are exempt from the "individual mandate" i.e. the requirement to haveinsurance, but that doesn't mean you are prohibited from buying it, only that you will not be penalised for not buying insurance.

durham_lad Jun 29th 2014 4:18 am

Re: Advise - Moving my Mum from the UK to USA
 

Originally Posted by Boiler (Post 11318492)
Expanded Medicaid has higher income limits and no assets consideration. Reimbursement is still possible in many States.

No minimum income requirements for Obamacare I know of.



If you earn less than the poverty level then you get no subsidy and pay the same amount as someone earning over 400% of the poverty level, which is very expensive and unaffordable to those below the poverty level.

How Will the Uninsured Fare Under the Affordable Care Act? | The Henry J. Kaiser Family Foundation


Because the ACA envisioned low-income people receiving coverage through Medicaid, people below poverty are not eligible for Marketplace subsidies. Thus, in states not implementing the Medicaid expansion, some adults fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for premium tax credits, as shown by the orange shading in Figure 3. People in the coverage gap are ineligible for financial assistance under the ACA, while people with higher incomes are eligible for tax credits to purchase coverage


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