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High Risk Pool Healthcare

High Risk Pool Healthcare

Old May 29th 2011, 2:20 pm
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Default High Risk Pool Healthcare

This isn't really an immigration issue but wasn't sure where else to post this.

I have multiple sclerosis, mild but still enough to mean that I cannot in the state of Arizona get ANY kind of health care coverage except through the federal high risk pool program.

The rules are that I have to legally reside in the US (I am engaged to my US partner) but will first go down on a tourist visa. I am dual Canadian/British and don't want to go the fiancé route to be tied into having to plan a wedding in 90 days. I'll therefore have to marry in the US and then switch to a spousal visa I assume.

Therefore I can take out a standard travel insurance policy which would at least cover me for an accident or something else unexpected while still a tourist. But during the six month period during which I will be on that travel insurance policy, we will be getting married. At that stage I need to move over the high risk pool.

Sorry to drag this on. This is my question, if you have a travel insurance policy does that mean you can't move straight onto the high risk pool? The rules are that you have to insured for six months before being eligible (the sense of this I simply do not get- but that's the rule). Or does that mean only a US health insurance policy, ie a travel insurance policy is not an issue.

I am not keen on being without any health insurance coverage at all, even if its just a travel insurance one.

Are any of you moving to the US with a pre-existing condition? Can anyone advise?
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Old May 29th 2011, 4:35 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
I am dual Canadian/British and don't want to go the fiancé route to be tied into having to plan a wedding in 90 days. I'll therefore have to marry in the US and then switch to a spousal visa I assume.
Hi,

Be careful. You're not permitted to enter as a tourist/visitor with the intention of switching to a "spousal visa" from within the US.

You can marry in the US, or elsewhere, and then apply for an immigrant visa outside the US, get that approved, and then move in with the immigrant visa packet. You should start with that framework and then try to address your health insurance strategy within that framework.

I'm not an expert in health insurance, but hopefully someone else can help with that part of your question and it works out for you.
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Old May 29th 2011, 5:04 pm
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Default Re: High Risk Pool Healthcare

If you immigrate illegally, you're not a tourist and may void the policy anyway.

Insurance Qs go in themain USA forum; I'll move your thread.
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Old May 29th 2011, 5:45 pm
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Default Re: High Risk Pool Healthcare

So you will enter to get married and leave. So perfectly valid use of Travel Insurance.

As a non resident it will not impact on any qualifying period for High Risk Pool.

You then are going to file for a CR1 presumably. So you will enter as a Permanent Resident and will start accumulating presence.

Regarding the Travel Insurance check that they will cover your MS, standard situation would be that it would be excluded.
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Old May 29th 2011, 6:07 pm
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Default Re: High Risk Pool Healthcare

If your wife to be has health insurance via an employer, once you get married you can be added to that policy, Arizona can't stop that.

If you have to be in the high risk pool, Arizona does not have one. There is a federal, temporary one called the pre-existing condition insurance plan for people who have been denied because of pre-existing conditions but you have to be legally resident (based on what you post, you may not be), uninsured for 6 months and you have to have a documented denial for insurance. You don't say where you are currently living but it is very likely that you would not be eligible for this plan immediately because of coverage by a public health plan from a foreign country, like the NHS or Canadian healthcare system. Travel insurance doesn't count so don't worry about it.

It sounds like your options are get on your wifes employer plan, get an employer based plan yourself or wait 6 months and get on the pre-existing condition plan. Keep in mind though, the PCIP is not cheap overall and isn't that fantastic.
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Old May 29th 2011, 9:19 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by Duncan Roberts View Post
It sounds like your options are get on your wifes employer plan, get an employer based plan yourself or wait 6 months and get on the pre-existing condition plan. Keep in mind though, the PCIP is not cheap overall and isn't that fantastic.
Couldn't agree more. I have MS, and I wouldn't sign on to this plan myself due to the coverage unless I really had no other choice. The monthly premium is high, and you still have considerable out of pocket expenses.

Nermil, as has been stated, coming here with the intention to marry and adjust status (apply for Perm. Residency) is illegal. The consequences of doing so, if caught, will not be pleasant.

IMHO, your better plan would be this:

1) Have your fiance apply for the K1
2) Once the K1 is approved, you have 6mo to enter the US on the visa. As soon as you get the approval begin planning your wedding.
3) Before your 6mo is up, enter the US.

Technically, you then have an additional 90 days before you need to get married, so you would have 6mo + 90 days to plan the wedding and have the ceremony. However, if you waited towards the end of your 90 days, that would mean you have to be here all that time w/out insurance.

If I were in your shoes, I would use that 6mo period after the visa approval to get all the wedding plans in place, so that very soon after you enter on the K1 you could get married, and you wife could add you to her insurance. I'd like to hope you could adequately plan a wedding in 6 or 7mo.

If your future wife does not have health insurance through an employer, your options will be limited. I don't think travel insurance will cover a pre-existing condition at all, and if it does, it will be limited cover. Also, due to the fact that you are technically immigrating, that could invalidate any kind of travel insurance.

If your wife doesn't have insurance, then you may just have to gamble on not having any coverage, and focus efforts on you finding a job that will provide it - if you are still able to work.

Last edited by Bluegrass Lass; May 29th 2011 at 9:21 pm.
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Old May 30th 2011, 10:48 am
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Default Re: High Risk Pool Healthcare

Originally Posted by Bluegrass Lass View Post
Couldn't agree more. I have MS, and I wouldn't sign on to this plan myself due to the coverage unless I really had no other choice. The monthly premium is high, and you still have considerable out of pocket expenses.

Nermil, as has been stated, coming here with the intention to marry and adjust status (apply for Perm. Residency) is illegal. The consequences of doing so, if caught, will not be pleasant.

IMHO, your better plan would be this:

1) Have your fiance apply for the K1
2) Once the K1 is approved, you have 6mo to enter the US on the visa. As soon as you get the approval begin planning your wedding.
3) Before your 6mo is up, enter the US.

Technically, you then have an additional 90 days before you need to get married, so you would have 6mo + 90 days to plan the wedding and have the ceremony. However, if you waited towards the end of your 90 days, that would mean you have to be here all that time w/out insurance.

If I were in your shoes, I would use that 6mo period after the visa approval to get all the wedding plans in place, so that very soon after you enter on the K1 you could get married, and you wife could add you to her insurance. I'd like to hope you could adequately plan a wedding in 6 or 7mo.

If your future wife does not have health insurance through an employer, your options will be limited. I don't think travel insurance will cover a pre-existing condition at all, and if it does, it will be limited cover. Also, due to the fact that you are technically immigrating, that could invalidate any kind of travel insurance.

If your wife doesn't have insurance, then you may just have to gamble on not having any coverage, and focus efforts on you finding a job that will provide it - if you are still able to work.
Thanks. I am female, my partner is starting a new business in AZ and so neither of us will be getting the benefit of an employers health plan. I've realised the way I was going about things is wrong. However, if I apply for a K1 visa, or even if we get married in the UK and then apply for a CR1, does that mean I must be outside of the US for the entire time? There seems to be up to an 8 month processing time for these visas. My partner will be in AZ from September/October. Can I not visit as a tourist during this processing time?

I've worked out that to use the high risk pool my costs per year would be capped at circa $11,000. That includes the monthly premium of around $400 and then through the program all costs (co-pays, etc) are capped at just under $6000 per year. It is insane. Even if I did get a job once there, wouldn't they exclude me from coverage because of my MS? Or can they no longer do that now?
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Old May 30th 2011, 11:11 am
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
Thanks. I am female, my partner is starting a new business in AZ and so neither of us will be getting the benefit of an employers health plan. I've realised the way I was going about things is wrong. However, if I apply for a K1 visa, or even if we get married in the UK and then apply for a CR1, does that mean I must be outside of the US for the entire time? There seems to be up to an 8 month processing time for these visas. My partner will be in AZ from September/October. Can I not visit as a tourist during this processing time?

I've worked out that to use the high risk pool my costs per year would be capped at circa $11,000. That includes the monthly premium of around $400 and then through the program all costs (co-pays, etc) are capped at just under $6000 per year. It is insane. Even if I did get a job once there, wouldn't they exclude me from coverage because of my MS? Or can they no longer do that now?
You can visit provided you can prove that you will visit and depart from each entry, that you have not abandoned or intend to abandon your foreign residence, and that the activities you plan to do in the US are consistent with the rules that cover the nonimmigrant classification you are seeking. The burden of proof is on you.
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Old May 30th 2011, 1:55 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
Can anyone advise?
I just wouldn't come here.

sorry to be blunt. but it's not the place to be.
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Old May 30th 2011, 2:00 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
Thanks. I am female, my partner is starting a new business in AZ and so neither of us will be getting the benefit of an employers health plan. I've realised the way I was going about things is wrong. However, if I apply for a K1 visa, or even if we get married in the UK and then apply for a CR1, does that mean I must be outside of the US for the entire time? There seems to be up to an 8 month processing time for these visas. My partner will be in AZ from September/October. Can I not visit as a tourist during this processing time?

I've worked out that to use the high risk pool my costs per year would be capped at circa $11,000. That includes the monthly premium of around $400 and then through the program all costs (co-pays, etc) are capped at just under $6000 per year. It is insane. Even if I did get a job once there, wouldn't they exclude me from coverage because of my MS? Or can they no longer do that now?
Sorry about the gender mixup! Sometimes its hard to tell.

If you get a job with a company that offers health insurance, they cannot exclude you from coverage due to your MS. That is a protection when you join a group health insurance plan, versus paying for your own private policy.

HOWEVER, they likely will have an exclusionary period (usually a year) where pre-existing conditions (but other health issues are covered) will not be covered UNLESS you can prove you've had continuous coverage for a previous period of time (that period of time required may be different for every plan). And NHS does count as coverage. However, the kicker is that once you enter the US, you are no longer covered by NHS and it could take you who-knows-how-long to find a job - which would then leave you open to you the exclusionary period. Which, I know, is a gamble because you could have a relapse. Moving to the US with a pre-existing like MS is definitely an intricate maneuver.

If you go the K1 route, then you can enter the US, before it's approved, as long as you show you have ties to return back home. My DH visited me a couple of times while it processing. However, after the K1 is approved, you cannot enter the US without activating the visa - so if you want that 6mo period to plan the wedding, then you will have to do it from overseas.

If you go the CR1 visa route - which means you have to get married before applying for it, then you have the same requirements to show proof that you will return home (mortgage/rent, employment, school ties, etc).

The benefit, IMHO, to the K1 is that once you are married you don't have to leave the US again. You apply for Adjust of Status (permanent residence) without leaving your new husband. Whereas, with a CR1 you will be separated while married. It may not make a difference to you if you are separated while married or just engaged, but to some couples it does. Also, you make you sound like your partner is not in the US at the moment because he was only going to be in AZ from Sept. Be aware the K1 can only be applied for from the US.

If he is in the UK at the moment, please let us know what status he has and how long he has been there, as a whole new option may be available to you.

Have you confirmed what drugs/treatment options are covered on the plan? I'm not sure what kind of prescription coverage that plan has, so make sure you do your research into what MS drugs are covered (assuming you take the shots at the mo), and how much you may have to pay for them. Yes, the $11k is a big shocker to people from the UK. This is actually one of the reasons why my OH and I are in the process of planning our relocation back to Scotland from the US. Being tied down to (sometimes) a crappy employer just to maintain health insurance is not something I relish having to do the rest of my life.

Good luck!
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Old May 30th 2011, 2:10 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
Even if I did get a job once there, wouldn't they exclude me from coverage because of my MS? Or can they no longer do that now?
They haven't been able to do that for a very long time. There are a few rules though. The plan has to be a qualifying one, group employer based ones are, and they can't deny you a plan. They can deny coverage for pre-existing conditions for up to 12 months if you enroll during a standard enrollment period or up to 18 months if you don't. However, you are able to credit time covered under a qualifying plan (state sponsored healthcare plans like the NHS qualify) towards the pre-existing condition exclusion provided that the coverage didn't end more than 63 days previously. For instance. If you have been covered by the NHS your entire life, you land in the US and get a job with health insurance that starts 30 days after you get here, you have enough time to eliminate the pre-existing condition blackout and you haven't had a significant break in coverage. If you don't get a job for a few months and it's been more than 63 days since you moved to the US you wouldn't be able to credit anything since you would have had a significant break. It's also good to keep in mind the possibility of switching jobs and insurance plans. If you haven't had the plan for 12 months then you will only be able to partially cover the pre-existing condition exclusion.

One other thing to keep in mind, just because your partner will be self employed it doesn't mean they can't get a qualifying health policy for the business. They need to check some of the business insurance brokers or local small business associations to see what might be available. That $11,000 per year you quoted will be small change if you come here without coverage and something happens. It wouldn't be stretching things to say you could add a couple of 0's to that number if you get into real trouble.
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Old May 30th 2011, 4:11 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
I've realised the way I was going about things is wrong. However, if I apply for a K1 visa, or even if we get married in the UK and then apply for a CR1, does that mean I must be outside of the US for the entire time? There seems to be up to an 8 month processing time for these visas. My partner will be in AZ from September/October. Can I not visit as a tourist during this processing time?
The US immigration services are not even slightly interested in the fact that you will be apart from your fiance. They are only interested in whether your actions as regards entering the country are legal or not. If an immigration officer even suspects during your attempt to enter the US on either the VWP or a tourist visa that you are planning to immigrate on that entry, then you may be put on the next plane back, with serious consequences for any future immigration attempts.

If you have a K-1 or CR-1 in process there's no way you'd be granted a B-visa (tourist visa) anyway. And entries on the VWP, while normally allowed, would be scrutinised, and you should expect extra questioning.

The immigration officers at the points of entry have broad and strong powers - don't try and buck the system, you will lose and harm your chances of ever becoming a permanent resident of the US. Being apart for a few months is short term pain compared to the long term plan of being together in the US legally.

Last edited by BritishGuy36; May 30th 2011 at 4:14 pm.
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Old May 30th 2011, 4:29 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by nermil75 View Post
The rules are that I have to legally reside in the US (I am engaged to my US partner) but will first go down on a tourist visa. I am dual Canadian/British and don't want to go the fiancé route to be tied into having to plan a wedding in 90 days. I'll therefore have to marry in the US and then switch to a spousal visa I assume.
Why would you be tied in to planning a wedding in 90 days? My hubby and I applied for my K1 in Feb we got married in Nov, 9 months later.

Be care entering on a tourist visa and marrying... it will not do you any favours with INS.
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Old May 30th 2011, 4:34 pm
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Default Re: High Risk Pool Healthcare

Also, if you pursue the K1, you should consider another option. I know many people, esp us girls, like the idea of having the big wedding, but many peeps on here have actually had 'two' weddings. They have done a civil ceremony within the 90 days to meet the K1 requirements, and had the bigger to-do later with all the family and friends. I know its not as romantic, esp if its your first marriage, but unfortunately dealing with the bureaucracy of immigration sort of takes the romance out of the relationship somewhat! If you went that route, it would make it easier/quicker to join your spouse's insurance plan (if he's able to sort out insurance with a broker as Duncan mentioned), and you then have time to plan out the big wedding of your dreams.

Oh and also, very important for us to know, all of our advice re: immigration also assumes your future hubby is a US citizen. You called him your "US partner" but didn't specify if he does have citizenship. If he's not a citizen, then you have bigger hurdles than health insurance to overcome.

Last edited by Bluegrass Lass; May 30th 2011 at 4:37 pm.
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Old May 30th 2011, 4:35 pm
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Default Re: High Risk Pool Healthcare

Originally Posted by BritishGuy36 View Post
If you have a K-1 or CR-1 in process there's no way you'd be granted a B-visa (tourist visa) anyway. And entries on the VWP, while normally allowed, would be scrutinised, and you should expect extra questioning.
Why all of this talk about VWP and B-2 visas? As a Canadian, the OP doesn't need to use either and only needs a valid passport to seek entry as a visitor.

The OP could always do a quick civil ceremony, return foreign, plan the dream wedding and then have it upon entry as a CR1.
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