Greencard Holders - Short Term Visiting and Obamacare

We receive many inquiries from people whose parents are Green Card holders (permanent residents of the U.S. as per U.S. immigration definition) but try to spend as much time as possible in their native country using the allowed travel duration and also using the re-entry permit etc. Even though they have a Green Card, they are essentially "visiting" the U.S. for a short term and are looking for health insurance.

What is PPACA (Obamacare)?

PPACA stands for Patient Protection and Affordable Care Act, popularly known as Obamacare. It is a law that was signed in March 2010 and went into effect on Jan 1, 2014, at least regarding the provision that almost everyone who legally lives in the U.S. needs to buy the health insurance and keep it for the entire year or pay the tax penalty which depends upon income. On the other hand, insurance companies selling Obamacare-compliant insurance plans can not exclude pre-existing conditions and need to cover them.

Where can I buy Obamacare compliant plan?

If your state has a health insurance exchange, you can buy through that. Otherwise, you can buy from the federal exchange on healthcare.gov. Depending upon your household income, you may be eligible for a federal subsidy on insurance premiums. Alternatively, you can also purchase directly from private insurance companies or through insurance brokers, but mostly in those cases, there are no subsidies.

When can I purchase an Obamacare compliant plan?

You can purchase Obamacare compliant plan only during their open enrollment period which usually starts on November 15th through December 15th. There are some specific situations that could qualify a person for a special enrollment period, which would allow you to enroll in an ACA compliant insurance plan outside of the open enrollment period.

Why can't I purchase Obamacare compliant plan at any time?

As insurance companies are expected to cover pre-existing conditions and you are expected to keep the insurance year round, you can't purchase only when you need it. Otherwise, everyone would wait until they are sick or injured.

My greencard holder parents are going to be in the U.S. for 4 months. What kind of insurance plans can I get for them?

Please look at greencard holders medical insurance to understand what they would be eligible to purchase.

Are any of those plans in the link you specified above Obamacare compliant? If not, why not?

They are all short term travel insurance type products. Short term plans are specifically exempted from being Obamacare compliant.

If a plan is not Obamacare compliant, what does it mean?

That primarily means that it would generally cover any new medical conditions, injuries or accidents that may occur after the effective date of the policy and will not cover any pre-existing conditions, preventive check ups or maternity or anything like that. Some of those plans may cover acute onset of pre-existing conditions, up to some amount, up to some age. Please look into the brochure and other details of each product for further information.

The following questions apply outside the open enrollment period:

Can I get Obamacare compliant plan for my parents?

No, because the open enrollment period is over now.

What should I have done to enroll them into Obamacare compliant plan? Or what should I do now?

You should have enrolled them into a suitable plan during the previous open enrollment period. If you didn't do that earlier, you will need to wait until the next open enrollment period opens up.

My parents were not even in the U.S. during the last open enrollment period and by the time next open enrollment period opens up, they willhave already gone back to their native country. In that case, what can I do?

As mentioned earlier (above), green card holders are permanent residents of the US and are expected to be enrolled in Obamacare compliant plans year round and not only for a short period.

But if they are going to be in the U.S. only for a short period, why should I waste money by enrolling them year round in an Obamacare compliant plan?

That is entirely your choice. If you would like to purchase the insurance for a short term, it is NOT going to be Obamacare compliant and it will not provide some of the benefits you might be looking for.

If I don't enroll them into Obamacare compliant plan year round, do I have to pay the penalty? If I purchase a short term plan from you, do I have to pay the penalty?

Penalty has been eliminated from 2019 onwards.

The following questions apply during the open enrollment period:

If my parents are 65+, what kind of insurance plans can I enroll them into?

That really depends upon the state they are resident of and sometimes it even depends upon zip code.

Approximately, what kind of premiums should I expect to pay for Obamacare compliant plans for my elderly parents?

We can't really tell you exactly as it varies a lot, but you are looking at something like $600 to $800 a month with a high deductible such as $5,000 or so. Again, this is very rough idea.

I looked at some of those Obamacare compliant plans, but their premiums are very high. I can't afford them. Is there something cheaper available?

Not really. What you see are the prices for the kind of plans you are trying to purchase.

Will my parents by eligible for federal subsidy in Obamacare or can they get it for free? They have no income.

First and foremost, Obamacare is NOT free health insurance for everyone. Additionally, people with no income are not even eligible for Obamacare subsidy. Also because you (or your brother etc.) sponsored their green card, your income is considered to be their income. As you already showed that your income is good enough for the household size (at the time of filing I-864, Affidavit of Support), you are unlikely to qualify for any subsidies. Even if there are subsidies, they might be minimal.

Instead of purchasing Obamacare compliant plans, can I just purchase new immigrants health insurance plans?

That is certainly your choice. However, it would be considered the same as not having any compliant insurance plan. Please discuss that with your CPA (accountant) to see what is financially most efficient for you considering the kind of benefits you will have or lack.

Is there any possible way where I can purchase the Obamacare compliant plan for the short term they are visiting and pay small premium?

That is not possible. You can't have your cake and eat it too.

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