does having foreign health insurance mean you are not gapping in the US?

November 8, 2010 6:30 AM

does having foreign health insurance mean you are not gapping in the US?

an (american) friend just moved to abu dhabi and expects to be covered on her husband's health insurance -- he works for a local paper in abu dhabi. will they have a significant gap in coverage when they return to the US? i've read the HIPPA definitions of credible coverage and they don't say anything about foreign insurance.

thanks!

posted by nanhey to Travel & Transportation (4 answers total)

Best answer: IANYL
It is not clear whether plans of foreign employers count as creditable coverage under HIPAA. Under ERISA § 733(a), a group health plan is a welfare plan that provides medical benefits to employees and dependents. A welfare plan, defined in ERISA § 3(1), is an employer-sponsored plan that provides such benefits.

Plans maintained by foreign employers technically meet the definition of welfare plan and group health plan, so it seems that coverage under such plans should count as creditable coverage.

What's confusing is that ERISA § 4(b)(1) contains an exemption from Title I of ERISA (which includes HIPAA) for plans maintained outside the US "primarily for the benefit of persons substantially all of whom are nonresident aliens." It does not appear, however, that this alters the definition of what counts as creditable coverage.

In the absence of an express exception, conservative (as far as the law is concerned) employers and their insurers in the US will probably treat foreign coverage as creditable coverage.
posted by thatguyjeff at 6:48 AM on November 8, 2010

Best answer: I have never dealt with a healthcare broker but I hear they are great for finding affordable insurance in the U.S. I'd call one and pose this question. I'm guessing, based on how efficient and wily most health insurers are at not covering people that it would count as a gap. Perhaps a broker could help answer the question which may require finding a very low cost insurance to keep on. Not sure about that, though.
posted by amanda at 8:24 AM on November 8, 2010

Maybe relevant, or have some good starting points for research:
Can I get affordable insurance with a preexisting condition after living abroad?
(In this case, the short answer was no)
posted by whatzit at 10:04 AM on November 8, 2010

To follow up on whatzit's link, the temporary health insurance I had while on a year-long working holiday did not qualify as credible coverage. That year-long gap meant I was denied coverage for very minor pre-existing conditions when I returned.
posted by lunalaguna at 10:48 AM on November 8, 2010