Totallyspiffing

Hi all,

Hoping to get some guidance regarding a relatively specific issue we have and hoping those with experience have some helpful insight.

Husband is a US citizen, I am British. We are in the process of applying for my CR-1 visa so i can join him in the US. We are 7 months into this process and expecting it to take at least another 6 months until I will be moving.

I've just been diagnosed by my doctor with kidney disease. Within the next year I will need 2 surgeries for treatment and at sometime in the future I will need my right kidney removed.

Our issue is that we are able to sponsor my visa ourselves, but we are no means wealthy enough to afford out of pocket healthcare in the US. It is also my understanding that I would not be able to recieve Obamacare/medicaid, without being financially liable, until I become a US citizen which I've heard is 10 years after receipt of Greencard.

I guess what I'm trying to establish is if, with my new medical diagnosis, it's worth continuing our visa application to move me to the US or if we should instead decide for my husband to join me here in the UK where the healthcare is free. It's essentially a question of how feasible is it to afford healthcare as an immigrant for a pre-existing condition; what kind of insurance premiums can I be expected to pay? Husband is self-employed so no coverage there. Is it just going to be impossible to afford healthcare for myself in the US?

I feel like it's either I recieve the healthcare and we go bankrupt and not able to financially support ourselves or our family or I go without healthcare for myself entirely and end up eventually getting worse.

I honestly don't know what to think/how to feel and if anyone's been in a similar position I'd appreciate hearing your stories.

TIA

tht

You would normally be added to your husbands health insurance as a dependent. You should be able to look at his current policy to see what’s covered. Now you know about it, it will be a pretty-existing condition so look for that specifically.

Olly_

That's not true, depending on household income you are eligible for ACA subsidies - try running a quote at healthcare.gov.

The only thing you are not eligible for is Medicaid - you have to wait until you are a citizen (you can apply 3 years after becoming a permanent resident if you are married to a US citizen) or have been a permanent resident for 5 years. Some state Medicaid programs (California for one I believe) have different rules and don't use Federal funds so LPRs for under 5 years can still be eligible.

https://www.healthcare.gov/immigrant...nt-immigrants/

SanDiegogirl

What does this mean? Self employed people can obtain health insurance - they have to pay for the whole amount themselves unlike if one is employed and gets a subsidy from the employer.

Even if you had not just found out about your kidney problem, no-one should be contemplating moving to the US without the option of being able to obtain health insurance.

You can get health insurance through your State's health exchange or through health.gov the federal government's health exchange. (The rules brought in by Obamacare means you cannot be refused)

Neither is cheap, but depending on your financial situation you might get subsidies for the monthly premiums.

However, if you have already determined that you will not be able to afford out of pocket expenses (which sound as though they are going to be extensive no matter what policy you get) you should re-think your intention of moving to the States.

Depending on how old you are you should budget for several hundred dollars a month for premiums alone.

tht

not only can self employed people get a policy, they can deduct the entire cost from their income assuming they don’t have more expenses than their income.

scrubbedexpat099

Age and location matter and the financial situation, that defines what sort of subsidies are available, being self employed may give some flexibility in that.

Winston_the_Great_Dane

As a rough guide, anticipate paying $400-$500 per month in premiums and $7k a year out of pocket expenses. If that sounds like too much money then the UK might be the better option, at least in the short term.

Good luck with your choice

Edit to add: this would be for an ACA policy with no subsidy.

civilservant

Personally if I had a serious chronic health condition that will require multiple future surgeries, I would seriously consider remaining in the UK.

Glasgow Girl

I would be thrilled to be paying in the $400-$500 range. Right now I pay almost $800 per month for one person for the cheapest possible plan in my area, with a $7K deductible. My annual expenditure before I would receive any contribution from the heath plan is almost $17,000. I get a “free” annual physical and a “free" flu and Covid shot. I appreciate that I am healthy and rarely need any medical attention but calling the marketplace the Affordable Care Act is not all accurate, the Unaffordable Care Act would be more like it.

Giantaxe

A lot of information missing in the OP's posting. A big one I would be asking is why the OP's spouse doesn't have health insurance. Do they consider it unaffordable? Have they looked at ACA policies/subsidies etc? I mean logically the way to go is an ACA policy for both of them, but without knowing more information, it's hard to judge. I can't say I'd be rushing to join an uninsured spouse in the US unless that situation can and will be rectified.

One ray of light on the ACA is that the cliff of subsidy to no subsidy has gone, at least until 2024, I think. So that means some with higher incomes than 4x the federal poverty level can get a subsidy. But I digress somewhat.

ss120396

This will depend heavily on your age. $400 a month is about right for an entry level unsubsidized ACA plan for a middle aged person, but if you're older $7-800 could be possible with no subsidies.

Winston_the_Great_Dane

that was my price as a 41YO in Ohio, no subsidies. I think it was a silver level plan for that money. With wife and kids it went to $1100 per month. I had to take a proper job just for healthcare and give up the consultancy/bus dev I was doing for a UK company. As an aside, I think affordable healthcare or one that the premium is covered by a PAYE tax would encourage more self employment and entrepreneurs. Shame really.

Giantaxe

Over 60, and unsubsidized coverage is likely over $1k a month. And that’s with the maximum deductible of $6.7k.

ukmd

Some states like NY allow you to go onto medicaid straightaway as GC/LPR holder. It really depends. A lot of new immigrants have health problems you would be shocked what people show up to the country with. I seen so many with like end stage renal failure just show up to hospitals etc etc The hospitals and ultimately the US taxpayer has to eat the cost

Try get your husband to get insurance then join his plan seems the best option

petitefrancaise

my tuppence worth- irrespective of the cost, having to undergo extensive medical care in a system you don't understand and having to make choices that you simply don't have to do in the UK makes everything much more stressful. Adding on top having to deal with the financial side of it all , well, personally, I would stay in the UK until you are through this.