Health insurance for elderly immigrants

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Ollie123
Posts: 55
Joined: Mon Aug 29, 2016 11:39 am

Health insurance for elderly immigrants

Post by Ollie123 » Wed Jul 11, 2018 10:51 am

Hello all,
Hoping to tap the collective wisdom of the bogleheads for an issue we are trying to sort out. My wife's parents are clearing the final stages of the immigration process right now and we are expecting to move here within the next couple months. They come from a very low-income country. Their savings are relatively sufficient to sustain them there, but nowhere near sufficient to sustain them here (25k + a home they can probably sell for ~30k). They are both around age 65. They are both in relatively good health for their age. Personally, I love the idea of having them here. Especially as my wife and I discuss starting a family, the notion of having grandparents around to help sounds wonderful. Financially, I am terrified at the implications of this. This primarily relates to healthcare - they will live with us initially and I'm fairly confident we can cover their living expenses quite easily. I'm not sure if there is anyone on this board who has done something like this, but I would be very interested to hear what options folks may have uncovered for healthcare insurance in these circumstances

- They would need to work 9-10 years before they qualify for medicare. We're hoping at least one of them can do so, but don't want to bank on it.
- After 5 years, they "could" qualify for medicaid assuming they become citizens and did not have income
- Assuming we are able to find them jobs, we need something to cover the interim. My wife is pushing for this: https://www.insubuy.com/new-immigrant-insurance/. My reading is that these are NOT true insurance and would still leave us very much high and dry in the event of a serious health problem. I'm wondering about combining it with catastrophic coverage, though I'm unclear if they meet criteria (certainly not the age requirements, but there are hardship exemptions too...though those seem to assume SOME income with the presumption that otherwise one would be covered by medicaid).
- I "believe" they can buy insurance on the marketplace, but again without some income they would not qualify for subsidies since it is assumed they would get medicaid.

Anyways - I'm feeling a bit stuck in the middle. We earn a good living, but not enough that we can readily afford unsubsidized health insurance for them. At this point just trying to figure out all conceivable options. Open to any and all ideas that folks here might be able to offer - especially if anyone has been in a similar situation.

*Note, I understand this is a hot political topic right now. I would appreciate if we could avoid diving into that aspect of it and keep focused on the financial and "how-to" pieces of this. We're interested in paying their way as best we can. We're not planning to subvert the system or do anything illegal. They will be here legally. I'm just asking what options exist that may make this financially realistic.

niceguy7376
Posts: 2103
Joined: Wed Jul 10, 2013 2:59 pm
Location: Metro ATL

Re: Health insurance for elderly immigrants

Post by niceguy7376 » Wed Jul 11, 2018 10:54 am

What visa status do they come in as? Green Card or something else?

Rupert
Posts: 3562
Joined: Fri Aug 17, 2012 12:01 pm

Re: Health insurance for elderly immigrants

Post by Rupert » Wed Jul 11, 2018 10:56 am

I thought lawful immigrants over age 65 could buy into Medicare after 5 years? There have been prior threads on this issue, which you might search for, OP.

masonstone
Posts: 136
Joined: Thu Feb 01, 2018 4:01 pm

Re: Health insurance for elderly immigrants

Post by masonstone » Wed Jul 11, 2018 11:09 am

Ollie123 wrote:
Wed Jul 11, 2018 10:51 am
Hello all,
Hoping to tap the collective wisdom of the bogleheads for an issue we are trying to sort out. My wife's parents are clearing the final stages of the immigration process right now and we are expecting to move here within the next couple months. They come from a very low-income country. Their savings are relatively sufficient to sustain them there, but nowhere near sufficient to sustain them here (25k + a home they can probably sell for ~30k). They are both around age 65. They are both in relatively good health for their age. Personally, I love the idea of having them here. Especially as my wife and I discuss starting a family, the notion of having grandparents around to help sounds wonderful. Financially, I am terrified at the implications of this. This primarily relates to healthcare - they will live with us initially and I'm fairly confident we can cover their living expenses quite easily. I'm not sure if there is anyone on this board who has done something like this, but I would be very interested to hear what options folks may have uncovered for healthcare insurance in these circumstances

- They would need to work 9-10 years before they qualify for medicare. We're hoping at least one of them can do so, but don't want to bank on it.
- After 5 years, they "could" qualify for medicaid assuming they become citizens and did not have income
- Assuming we are able to find them jobs, we need something to cover the interim. My wife is pushing for this: https://www.insubuy.com/new-immigrant-insurance/. My reading is that these are NOT true insurance and would still leave us very much high and dry in the event of a serious health problem. I'm wondering about combining it with catastrophic coverage, though I'm unclear if they meet criteria (certainly not the age requirements, but there are hardship exemptions too...though those seem to assume SOME income with the presumption that otherwise one would be covered by medicaid).
- I "believe" they can buy insurance on the marketplace, but again without some income they would not qualify for subsidies since it is assumed they would get medicaid.

Anyways - I'm feeling a bit stuck in the middle. We earn a good living, but not enough that we can readily afford unsubsidized health insurance for them. At this point just trying to figure out all conceivable options. Open to any and all ideas that folks here might be able to offer - especially if anyone has been in a similar situation.

*Note, I understand this is a hot political topic right now. I would appreciate if we could avoid diving into that aspect of it and keep focused on the financial and "how-to" pieces of this. We're interested in paying their way as best we can. We're not planning to subvert the system or do anything illegal. They will be here legally. I'm just asking what options exist that may make this financially realistic.
Can you hire them as nannies for your children?

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HueyLD
Posts: 5960
Joined: Mon Jan 14, 2008 10:30 am

Re: Health insurance for elderly immigrants

Post by HueyLD » Wed Jul 11, 2018 11:33 am

The OP’s parents in law can qualify for the ACA premium tax credit (PTC) if they are not eligible for Medicaid in the first five years. They have to meet other requirements for the PTC.

“Lawfully present immigrants and Marketplace savings

If you’re a lawfully present immigrant, you can buy private health insurance on the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income.

If your annual income is 400% of the federal poverty level or below: You may be eligible for premium tax credits and other savings on Marketplace insurance.

If your annual household income is below 100% federal poverty level: If you’re not otherwise eligible for Medicaid you’ll be eligible for premium tax credits and other savings on Marketplace insurance, if you meet all other eligibility requirements.”

For additional guidance, see IRS form 8962 instructions. https://www.irs.gov/pub/irs-pdf/i8962.pdf
Last edited by HueyLD on Wed Jul 11, 2018 11:35 am, edited 1 time in total.

masonstone
Posts: 136
Joined: Thu Feb 01, 2018 4:01 pm

Re: Health insurance for elderly immigrants

Post by masonstone » Wed Jul 11, 2018 11:35 am

HueyLD wrote:
Wed Jul 11, 2018 11:33 am
The OP’s parents in law can qualify for the ACA premium tax credit (PTC) if they are not eligible for Medicaid in the first five years. They have to meet other requirement for the PTC.

“Lawfully present immigrants and Marketplace savings

If you’re a lawfully present immigrant, you can buy private health insurance on the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income.

If your annual income is 400% of the federal poverty level or below: You may be eligible for premium tax credits and other savings on Marketplace insurance.

If your annual household income is below 100% federal poverty level: If you’re not otherwise eligible for Medicaid you’ll be eligible for premium tax credits and other savings on Marketplace insurance, if you meet all other eligibility requirements.”

For additional guidance, see IRS form 8962 instructions. https://www.irs.gov/pub/irs-pdf/i8962.pdf
Wouldn't the parents be considered dependents of the child who sponsored them for the immigrant visa?

User avatar
HueyLD
Posts: 5960
Joined: Mon Jan 14, 2008 10:30 am

Re: Health insurance for elderly immigrants

Post by HueyLD » Wed Jul 11, 2018 11:37 am

No, it is not automatic.

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