Pulaski

Thanks, I had forgotten about that thread. ...... Seriously, anyone who thinks that health insurance is something that can be fudged or "worked around" doesn't understand the seriousness of what they are playing with. It doesn't matter how careful you think you can be or how healthy you are, or how little healthcare you have needed in the past, THIS IS AMERICA, and it really is DIFFERENT here!

I have historically needed very little healthcare, the last doctor I had closed my file and archived it because I hadn't been to see him for 18 months. When I registered with my current doctor he was amazed, looked at me in sheer disbelief, when I told him I was on no long term medications, and in fact on no medications at all! But seven years ago I came into contact with some poison ivy, which caused an allergic rash and itching like you wouldn't believe, and in scratching it I caused a small infected sore, which caused blood poisoning!

I consulted my doctor, who told me "wait here a moment, I will call the hospital to make arrangements for you, you will need to go straight there today". Early the following morning I was in the operating theater for an "excision and clean", and I spent a total of three nights in hospital on an antibiotic drip. ..... I Ieft with a bill for $20,000! The insurance I had at the time only covered 90% of the cost, so I had to find $2,000 to pay my share.

kodokan

Interesting point - if she has income below about $10k (self-employed income below $400), then she wouldn't have to file a US tax return anyway.

OP, I know you've said about not marrying, but my frugal finance head is wincing: you know that if your partner isn't working, you'd be considerably thousands of dollars better off if married and filing joint, right? Not to mention skipping the complications and risks of the healthcare. Just saying...

Steve_

This is quite an interesting question the OP has asked, because getting an ACA plan on B-2 is going to be tricky. But yet, once she's in the country for 183 days, she will be resident for tax purposes.

This seems to say she can get an ACA plan: https://www.healthcare.gov/immigrant...nt-immigrants/

The problem is whether the people answering the phone are clued up enough to know that it is possible to live in the US on B-2. It does say: "other visas".

Anyway, that's the answer to the question. The only other option I can think of is to get travel insurance from the home country, but that won't work if she's got any kind of chronic condition because of the prescription drug cost.

Steve_

Not sure that's relevant, clearly she would be resident in the US for tax purposes, so for example at the bank she would have to fill in a W-9, so the IRS will be aware of her existence. And to get an ITIN (which you basically end up needing for a variety of reasons) she's got to file a W-7.

What I would say is that it's important to get the visa annotated by the CO with "co-habiting partner" so that CBP issues a one-year I-94 and you can show the DMV relevant documentation, etc.

platypus81

Thanks for warning me about the potential issues with a travel insurance. As I said, we won't get married at least for the first year. You may think we are stupid/crazy and you are probably right (I am also aware of the money we lose by not filling a joint tax declaration), but this is not going to happen now. So could we just assume that she is going to spend the first year on a B2 cohabiting please. I will try to summarize the main points:

1) the first thing I will try to do is see if my health plan accepts her as dependent. From what I have read this is unlikely to happen. If this doesnt work, the only alternative is a travel insurance

2) is getting a travel insurance independent from the fact she is eligible or not for an ACA? She will be in the US from October to December in 2016 and mid January-mid May September-December in 2017. So I guess in any case she won't be eligible for ACA in 2016, maybe in 2017. What is exactly included in an ACA that is not in a travel insurance? My understanding is that ACA covers baseline necessities

3) Could you please summarize what is generally excluded from a travel insurance? My understanding is that they will cover the emergencies but not the rehabilitation period if one is in the condition to go back to his home country. Is any event associated with pre-existing condition not covered? My understanding is that emergencies are covered but they wont provide assistance on a day-by-day basis (say if one needs to take medicines on a daily basis).

Maybe it is worth contacting Patriot America in advance and try to understand exactly what is excluded from the coverage. The information they provide in the website is far from being clear in this respect:

Patriot America - Travel Medical Insurance

Regarding the preexisting conditions, it is stated that "certain contracts do contain a pre-existing condition exclusion and do not cover losses or expenses related to a pre-existing condition". My understainding of this is that there are options available that coves your preexisting condition, but maybe it's better to ask.

As a side note, I am just curious to know how an insurance is able to state that the condition was pre-existing. It is obviously easy for genetic diseases but what about other illnesses? Do they look for exams undertaken in your home country to see if the condition was already present in the past?

scrubbedexpat099

I have found that most providers list their policy wordings on their web sites.

SanDiegogirl

In general terms an ACA policy covers all health issues. It covers exams, checkups, prescriptions, hospital treatment, vaccinations, rehabilitation, emergency treatment, x rays, MRI's, visits to doctors, specialists etc etc

Travel insurance covers emergency treatment - up to stabilisation status. After that its usually repat to home country. No general day to day treatment.

Insurance companies have a way of 'knowing' if your condition is possibly a pre-condition. Plenty of examples of someone becoming ill and being refused re-imbursement of costs as their condition is one which, according to the insurance company, could not have occurred without a prior condition affecting current illness - and yes, they do check up with medical records.

Pulaski

You may be surprised. My employer started offering non-married cohabiting domestic partner health insurance coverage more than a decade ago, and I am in NC.

platypus81

well fingers crossed then!

retzie

Just to be clear for the OP: the risk isn't that she wouldn't be treated for a pre-existing-condition-related emergency (she would be); it's that you will be clobbered with the entire bill afterwards . You should think of this as starting at 5-figures.


Also, be aware that in a medical emergency, as a non-spouse, you may be excluded by the hospital from decision-making. I know we have already harped on about marriage and you have your position, but I just want you to be aware that the US is very (ridiculously) marriage-centric, and you will probably notice it impinging on the unmarried lifestyle you enjoy elsewhere. The hospital issue is state-specific; you can read up on it here.