a question on healthcare

by MaxEntropy_Man Tue Oct 14, 2014 12:56 pm

has anyone here explored bringing one's elderly parents here on a permanent basis on a green card? have you tried looking at the ACA provisions that will apply to them should they immigrate? it is very difficult to get any definitive answers. if you have dealt with this issue, would you mind sharing it with people here? thanks in advance.

by indophile Tue Oct 14, 2014 1:28 pm

If they have green cards, are not working, and have no assets, they are indigent. So they should qualify for Medicaid. The qualification hoops to go through for Medicaid under ACA are much more liberal than under the old system. My two cents.

by MaxEntropy_Man Tue Oct 14, 2014 1:49 pm

indophile wrote:If they have green cards, are not working, and have no assets, they are indigent. So they should qualify for Medicaid. The qualification hoops to go through for Medicaid under ACA are much more liberal than under the old system. My two cents.

i don't want to do anything that's even borderline unkosher or unethical. if you look at the I-130 form there is another piece of document, the I-864 form that one has to fill out, that says you're responsible for their care and ensuring that they don't become a burden on the state. if i look at the ACA website it sets a certain income limit below which they'll qualify for ACA even if they don't qualify for medicare right away (need to wait five years). this is where things get nebulous. since i will be signing the I-864 form, does my income count as part of their income eligibility? in which case we're out of luck. i am willing to pay reasonable premiums to get some coverage. what i don't want to do is make some dubious decisions and either palm them off on the state (which is really yucky) or get stuck with a bankrupting medical bill. i really would like to get some clarity before i take the first steps. who is a good person to talk to -- an immigration lawyer?

by indophile Tue Oct 14, 2014 3:25 pm

As far as I know, your income does not count as their income. If you signed a sponsor form that said you would take care of them, it is expected that you would initially take care of their medical needs (along with other needs like food/clothing/housing), like for a year two, but not for ever. That said, it's always a good idea to consult a good immigration lawyer on these things. A $100 or $200 for consultation is nothing compared to $100,000 + if one you sponsored suddenly needs a heart operation or something.

by truthbetold Tue Oct 14, 2014 5:47 pm

Max,

I did some research on this long before ACA. Some of the fundamentals could still hold.

1. Medicare and medic aid are only for US citizens ( earlier it used to be green card plus five years but my understanding was that was changed in last decade. One is eligible for citizenship in five years). Special exemptions may be given to refugees and asylum seekers.

2. Medicare is for those who become eligible(age criteria) by paying medicare tax (pay roll tax).

3. Medic aid is for any citizen who is below certain economic level. Children and elderly have much easier acceptability. One has to actively enroll in medic aid.

4. Social security is also limited to those who become eligibe by paying payroll tax. But there is a monthly stipend paid to elderly based on economic status.

5. Economic status is likely to be determined by yearly tax filings. Elderly can file their own tax returns.

6. Prescription coverage is another big cost driver. Bush changed some laws to help the elderly with drug costs.

7. Emergency care is provided irrespective of ability to pay. ( at least that is a foundation principle but application differs significantly by care provider).

8. One option could be , individual could maintain insurance or provision to get medicare in India where possible (scheduled surgery, ex: Knee surgery) for the 5 year period before citizenship.

9. Once a citizen , it is most likely that US health care system will take care of it.

10. It is always a good idea to talk to an expert on the topic.

by MaxEntropy_Man Tue Oct 14, 2014 8:02 pm

got some good answers to my questions. it's good to live in good ole librul mass :-)

by MaxEntropy_Man Tue Oct 14, 2014 8:10 pm

indophile wrote:As far as I know, your income does not count as their income. If you signed a sponsor form that said you would take care of them, it is expected that you would initially take care of their medical needs (along with other needs like food/clothing/housing), like for a year two, but not for ever. That said, it's always a good idea to consult a good immigration lawyer on these things. A $100 or $200 for consultation is nothing compared to $100,000 + if one you sponsored suddenly needs a heart operation or something.

they've explicitly spelled it out in MA as far as healthcare is concerned. signing the I 864 form does not count towards obligation towards elderly parents' healthcare expenses. so my income will not be counted. not sure how it is in other states. i feel much better about the whole thing now than i did in the morning.

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