Moving to the USA
 

Hi,
​​​​​​I am after any advice. My wife and I are retiring soon and want to move to the USA, both our children live there. My wife is a us citizen so I should be able to gain entry via her.

I wanted to see if anyone had ideas around medical insurance for us, my wife has not lived in the US for over 25 years and I am a uk citizen.

Thanks

Andy

Re: Moving to the USA
 

I had a quick look at your previous thread, a few years ago, where you asked similar questions. Not sure if you stated then, if your wife had worked in the US long enough to be eligible for Medicare, and also what age the two of you are?

Re: Moving to the USA
 

She should get Medicare as she had worked for 25 years in the USa, we are both 61.

Re: Moving to the USA
 

If wife worked for 25 years and has her 40 qualifying credits then she will qualify for Medicare at 65.
You will qualify for Medicare at 65 based on her record.

Until then, you'll have to get individual policies - probably under Obama care (ACA).
You can do some research and get a ball park figure by looking at:

https://www.healthcare.gov/glossary/...able-care-act/

Depending on which state you are going to your state might have their own insurance policies; and there are always the insurance companies: Blue Shield, Etna, Cygna etc

Re: Moving to the USA
 

So a four year gap until she is Medicare-eligible. You don't say your age, but presumably you'd both have to get an ACA (aka Obamacare) policy until then. The cost would depend on your combined income.

Re: Moving to the USA
 

...both 61 ....

Re: Moving to the USA
 

Thank you

Re: Moving to the USA
 

Be aware a lot of pre-Medicare-eligible retirees play games with their income in order to qualify for subsidies. Basically, if your combined income is less than 400% of the Federal poverty level (about $80k I think), you can qualify for a subsidy on a sliding scale as your income reduces. For the ACA, your income includes practically everything: pensions, interest, dividends, capital gains, Social Security and any employment income. Now, 'playing games' with income mainly involves limiting taxable interest, dividends, capital gains and other investments and taxable pension income, and living on non-taxable pensions and bank savings only if possible. In order to do this, you might have to reduce or forego taxable investment income which may or may not offset the ACA subsidy so it might not be worth playing those games. For me (age 62 and in good health) the cheapest ACA policy in my area with a high deductible ($8k per year) is about $700 per month, without subsidies. With subsidies you can reduce this premium to almost zero, so for two of you that could be a huge savings if you can adjust your income. Note that there is actually a minimum income threshold below which you can't actually buy an ACA policy - you are assumed to be so poor you are expected to apply for Medicaid. If for some reason you have a very very low taxable income and you can't increase it to the Medicaid threshold, but in fact you do have money to afford insurance, you will need to apply for insurance directly with one of the insurance companies, bypassing the ACA/marketplace plans.
Your children live here and your spouse is a US citizen, so you probably already know medical insurance is expensive and complicated. And when you get to Medicare age, it's still complicated and will still cost you thousands a year each, so you are wise to assess and plan ahead for this expense.

Re: Moving to the USA
 

Something to watch out for:

Obamacare subsidies were expanded for coverage from 2021 through 2022 with the passage of the American Recovery Plan Act (ARPA), and extended from 2023 through 2025 with the passage of the 2022 Inflation Reduction Act (IRA).Mar 15, 2024

So the subsidies might end at any time......

Re: Moving to the USA
 

You mean the enhanced subsidies most likely will go away for 2026 onwards. The original subsidies would remain absent legislation to eliminate them and/or the ACA itself (as Trump tried to do in 2017). Perhaps the biggest thing in those enhanced subsidies is that the "subsidy cliff" at 400% of the federal poverty level was eliminated.

https://www.cbpp.org/research/health...vements-expire