gametime

Hi all!

So I finally made it to the states! I've been here almost 2 months and I'm trying to figure out healthcare (eurggghhh)

So it seems like there's some sort of thing going on with pre-existing conditions and healthcare if there's been a gap of over 62 days, but there's so much info out there plus changes since Trump has been in, I have no idea what it all means. This was written on the British Expats guide but it's dated in 2015:

1) We came back to the states at the end of April, me on a green card. My wife has called the healthcare company and is looking at plans for us that we can start on the 15th July due to a "special enrollment" period. If I sign up for one of those, will I be denied certain care or be penalized for having a gap of more than 62 days?
2) The woman on the phone says that we would be entitled to tax credits due to the fact that I have only just taken a job on a 1099 contract, am I allowed to have tax credits? this article seems to suggest I am at the moment, but that may change. If it changes, would my potential future citizenship be at risk by getting tax credits at the moment?
3) is there any risk to my future citizenship that I need to look out for when it comes to healthcare, tax credits or similar?

This whole thing is so confusing!

SanDiegogirl

Under Obamacare rules pre-existing conditions were abolished, so the 62 days regulations no longer exists.

You should be able to obtain a health plan when you apply during the special enrollment period.

Whether you are eligible for tax credits, I don't know - that is all down to your financial situation.

Rete

Tax credits are not a means tested benefit. If it were and you received it, then you wife might have to repay the US government but since it isn't, then no problem. No reason why it would affect your ability to naturalize.

Since you are new to the US, why does it have to be a special sign up period? You are or should be eligible to sign up for any healthcare plan regardless of a special enrollment period.
Do either of you plan on being employed in the future by a company rather than as a contractor (working for yourself)? If so, your employer might well have a healthcare plan in place for their employees that you can join which would be better than any private plan you can buy.

Giantaxe

"Special enrollment period" refers to the 60 day window people have after certain "life events" to enroll in the ACA rather than wait to normal enrollment in November or thereabouts. Immigrating, iirc, is classed as one of those events. If the OP moved here "at the end of April" that 60 days is about to expire.

Rete

Thanks, I didn't know that ACA had an annual enrollment period. Thought it was just for medicare recipients changing plans.

GeoffM

I don't know why you can normally only switch plans around New Year but yes, any major life events like switching jobs or immigrating means you can switch (or start) mid-year.

As for tax credits and citizenship, I don't recall tax credits coming up at any stage of the process. All they wanted to know was whether your taxes were filed and paid, not the actual detail.

Giantaxe

To stop people "buying insurance in the ambulance on the way to hospital" as the saying goes... and then cancelling it a month later.

GeoffM

While it sort of makes sense, that would still apply for 1-2 months a year under the current scheme (I think DT shortened the period). But isn't there still a waiting period until the policy becomes effective, like 1-2 weeks?

Giantaxe

Yes, but you've got to let people sign up at some point... ditto with Medicare enrollment. And even though there's a short waiting period (to the start of the following month?) you'd still get people signing up when they had an illness/injury and then subsequently cancelling until the next one. A single enrollment period reduces the possibility of that kind of behaviour.

retzie

Since the tax credits are a bit confusing, the scenario basically goes like this: "According to the projected income data you have provided for this year, come tax time, we expect you will be eligible for $X of subsidies for the year. Therefore, we will grant you a reduction ['tax credit'] of $X/(number of months left in the year) on your monthly premiums in advance." However, come tax time, everything will be calculated according to your actual income. That means that if you had underestimated your income, you could find yourself needing to pay back part of the reduction you had received during the year. Similarly, if you earned less than you thought you would, you might end up being deemed eligible for more of a reduction and receive a refund.

If you mess up the tax credits, it will be reflected in your tax bill and all the usual arrangements/responsibilities apply to paying it back. Don't worry, the IRS won't give you money for free and then not expect it back!