Is a Canadian eligible for American Health Insurance? If not now, when?
August 23, 2016 11:23 AM Subscribe
My American husband's brand new job offers health insurance for the entire family. We (me and our child) are here in the US with him but we are Canadian and our present status is as B2 visitor (we are working on the paperwork for immigration). Are we covered by his plan, can we see a doctor here? More detailed questions inside.
My husband is an American, our child and I are Canadian. We were all living in Canada. We came to the US on a vacation, my husband was offered a job in California, and he took it! So we are now in the process of Adjustment of Status and an I-130 for me, and acquiring US citizenship for our child. We are generally clear on this process.
We are currently covered by our Canadian travel insurance for tourists, which covers emergencies. I assume (but don't know?) that when we apply for a green card for me and US citizenship for our child that this insurance will no longer be valid (as we will no longer be tourists). If we aren't eligible for my husband's insurance, what do we do in this waiting period?
Obviously I want to make sure we have the right coverage in case of any accidents, heaven forbid.
Also in general I am just confused about what a person needs in order to see a doctor. My son needs to continue his vaccination schedule and now that we are going to be here indefinitely it would be my preference not to wait the 9 months or whatever until he has his paperwork comes through, especially if he could be covered with my husband's insurance.
If this all sounds confused, it is, and I have had little luck finding the answer on the Internet. Any clarification would be much appreciated. Thanks!
My husband is an American, our child and I are Canadian. We were all living in Canada. We came to the US on a vacation, my husband was offered a job in California, and he took it! So we are now in the process of Adjustment of Status and an I-130 for me, and acquiring US citizenship for our child. We are generally clear on this process.
We are currently covered by our Canadian travel insurance for tourists, which covers emergencies. I assume (but don't know?) that when we apply for a green card for me and US citizenship for our child that this insurance will no longer be valid (as we will no longer be tourists). If we aren't eligible for my husband's insurance, what do we do in this waiting period?
Obviously I want to make sure we have the right coverage in case of any accidents, heaven forbid.
Also in general I am just confused about what a person needs in order to see a doctor. My son needs to continue his vaccination schedule and now that we are going to be here indefinitely it would be my preference not to wait the 9 months or whatever until he has his paperwork comes through, especially if he could be covered with my husband's insurance.
If this all sounds confused, it is, and I have had little luck finding the answer on the Internet. Any clarification would be much appreciated. Thanks!
Your husband should ask his HR department for clarification on what the employer-sponsored plan covers in terms of spouse/children if one or more of them are not US citizens (though, assuming your husband is your child's father, your child is already an American citizen, even if they were born outside the US).
posted by rtha at 11:51 AM on August 23, 2016 [3 favorites]
posted by rtha at 11:51 AM on August 23, 2016 [3 favorites]
You need to call and ask, but when you do, they key thing you want to point out is NOT that you are not a citizen, but that you are not a resident. On a visitor's visa you are a non-resident alien. As a resident you'll qualify for anything a citizen would (PITA health insurance that will make it more work to get your healthcare and get it paid for than the actual healthcare itself). So if you call and say you're a non-citizen they may assume you have a greencard. Make it clear that you do not.
One option depending on where you are in the US is to just go back to Canada for your healthcare at first. I lived in the US for 7 years and though I had health insurance there (student visa status), being on student visa status meant that I still qualified for healthcare on OHIP in Ontario, so as much as possible I got my healthcare from my own doctor in Toronto when I visited. You won't be able to do that for years and years, but until you've been outside of Canada for 6 months, you should still qualify for healthcare in your home province, so you could just use that if you're nearby and plan to visit. I remember paying for vaccinations in the US and kicking myself afterwards, realizing that the money I paid for vaccinations would have covered a plane ticket to Toronto. I could have had a short vacation and gotten my vaccinations for free and with less hassle.
posted by If only I had a penguin... at 12:18 PM on August 23, 2016 [1 favorite]
One option depending on where you are in the US is to just go back to Canada for your healthcare at first. I lived in the US for 7 years and though I had health insurance there (student visa status), being on student visa status meant that I still qualified for healthcare on OHIP in Ontario, so as much as possible I got my healthcare from my own doctor in Toronto when I visited. You won't be able to do that for years and years, but until you've been outside of Canada for 6 months, you should still qualify for healthcare in your home province, so you could just use that if you're nearby and plan to visit. I remember paying for vaccinations in the US and kicking myself afterwards, realizing that the money I paid for vaccinations would have covered a plane ticket to Toronto. I could have had a short vacation and gotten my vaccinations for free and with less hassle.
posted by If only I had a penguin... at 12:18 PM on August 23, 2016 [1 favorite]
I don't have any answers for most of your questions but I wonder if there might be a public health clinic near you that will give your son whatever immunizations he needs. (I used to work in one such clinic.) Look up your city or county health department and call them. If you're near a medical school you might also call them.
posted by mareli at 12:19 PM on August 23, 2016
posted by mareli at 12:19 PM on August 23, 2016
Best answer: So we are now in the process of Adjustment of Status and an I-130 for me, and acquiring US citizenship for our child. We are generally clear on this process.
First, you may want to seek further clarity on this. IANYIL, but the way that I understand US birthright citizenship, your child probably is a US citizen, and was from birth (assuming your husband left the US after his teen years). From wikipedia: "If one parent is a U.S. citizen and the other parent is not, the child is a citizen if the U.S. citizen parent has been "physically present" in the U.S. before the child's birth for a total period of at least five years, and at least two of those five years were after the U.S. citizen parent's fourteenth birthday."
Regardless of your son's citizenship status, HR at your husband's new company should know whether the two of you can be covered (mainly because if they are taking paycheck deductions for his portion of an Employee+Family plan they better be damn sure that Family is actually covered).
Barring that, your husband's actual insurance company will know. He will probably get insurance cards, which will have a Group # and Policy # on them. Call the insurance company with those numbers and they will tell you for sure.
Based on my experience with American insurance companies (as a Canadian, but who immigrated on work visas), as long as you and your child have social security numbers the insurance company will not care what your immigration status is. In fact -- I just checked the open enrollment forms for my employer's plan and while they do ask for SSN for dependents, they say it is only for ACA coverage mandate reporting (so, technically optional if you aren't considered mandated under ACA). They don't ask anything about immigration status.
I'm unclear whether you can get an SSN with an just an approved I-130 (But I know that the SS office can and will issue you a social security card that says "not valid for work without separate authorization" or similar if you don't have permanent work authorization yet -- I can show you a picture of mine if you'd like).
Also in general I am just confused about what a person needs in order to see a doctor. My son needs to continue his vaccination schedule and now that we are going to be here indefinitely it would be my preference not to wait the 9 months or whatever until he has his paperwork comes through, especially if he could be covered with my husband's insurance.
Once you find out that your child is covered by your husband's plan, identify doctors/clinics that are covered by the plan (usually the plan's website is good for this) and make the necessary appointments. All you should need are a photo id for yourself and the relevant insurance card. Plus whatever documentation is normal for parents seeing a new pediatrician (vaccination records, etc).
If you find out that your child is not covered, you still might want to choose a doctor who is on your husband's plan's list (so that you can stay with them when you get your papers). But you'll probably need to plan to pay out of pocket (unless your child somehow qualifies for the Obamacare exchanges). You should let the clinic know this when they make the appointment, and they might be able to structure things to keep the costs reasonable for you (only give the necessary vaccines, foregoing well-child exams, etc.) You should plan to pay the full cost up front, but many clinics will prefer to bill you.
posted by sparklemotion at 2:07 PM on August 23, 2016
First, you may want to seek further clarity on this. IANYIL, but the way that I understand US birthright citizenship, your child probably is a US citizen, and was from birth (assuming your husband left the US after his teen years). From wikipedia: "If one parent is a U.S. citizen and the other parent is not, the child is a citizen if the U.S. citizen parent has been "physically present" in the U.S. before the child's birth for a total period of at least five years, and at least two of those five years were after the U.S. citizen parent's fourteenth birthday."
Regardless of your son's citizenship status, HR at your husband's new company should know whether the two of you can be covered (mainly because if they are taking paycheck deductions for his portion of an Employee+Family plan they better be damn sure that Family is actually covered).
Barring that, your husband's actual insurance company will know. He will probably get insurance cards, which will have a Group # and Policy # on them. Call the insurance company with those numbers and they will tell you for sure.
Based on my experience with American insurance companies (as a Canadian, but who immigrated on work visas), as long as you and your child have social security numbers the insurance company will not care what your immigration status is. In fact -- I just checked the open enrollment forms for my employer's plan and while they do ask for SSN for dependents, they say it is only for ACA coverage mandate reporting (so, technically optional if you aren't considered mandated under ACA). They don't ask anything about immigration status.
I'm unclear whether you can get an SSN with an just an approved I-130 (But I know that the SS office can and will issue you a social security card that says "not valid for work without separate authorization" or similar if you don't have permanent work authorization yet -- I can show you a picture of mine if you'd like).
Also in general I am just confused about what a person needs in order to see a doctor. My son needs to continue his vaccination schedule and now that we are going to be here indefinitely it would be my preference not to wait the 9 months or whatever until he has his paperwork comes through, especially if he could be covered with my husband's insurance.
Once you find out that your child is covered by your husband's plan, identify doctors/clinics that are covered by the plan (usually the plan's website is good for this) and make the necessary appointments. All you should need are a photo id for yourself and the relevant insurance card. Plus whatever documentation is normal for parents seeing a new pediatrician (vaccination records, etc).
If you find out that your child is not covered, you still might want to choose a doctor who is on your husband's plan's list (so that you can stay with them when you get your papers). But you'll probably need to plan to pay out of pocket (unless your child somehow qualifies for the Obamacare exchanges). You should let the clinic know this when they make the appointment, and they might be able to structure things to keep the costs reasonable for you (only give the necessary vaccines, foregoing well-child exams, etc.) You should plan to pay the full cost up front, but many clinics will prefer to bill you.
posted by sparklemotion at 2:07 PM on August 23, 2016
Your hubs needs to talk to the new employer's HR people about family coverage. This stuff is so employer-dependent that nobody can really say anything meaningful about it without knowing the ins and outs of the employer and their coverage. Usually, family coverage is available but expensive.
You should not expect your status in the US to be relevant, or at least not once you file your 485 (and 765 if you want to get a proper social security number). If the employer makes a big fuss about you not being a citizen or LPR, congratulations! You have learned that this employer is a weapons-grade asshole who will probably be difficult to deal with for lots of other things too.
It is possible that either the employer doesn't offer family plans or that they are just not a very good deal. In that case, the obamacare pages make it clear that people in adjustment-of-status are eligible for the obamacare markets.
To go to the doctor, you will need (1) your insurer's list of which doctors to go to, (2) your insurance information, usually a card, and (3) money -- even with coverage, using medical services in the US usually requires paying a "copay" of \$20-50 for a normal visit and \$50-250 for urgent-care and emergency room visits.
If the new employer has multiple plans available, and many do, you and your hubs should talk to other employees and their families about which plans they like and why. Some will be more expensive but cover more physicians or cover more stuff or have a lower deductible. Some will just be more expensive for no obvious reason and with no obvious benefit.
posted by ROU_Xenophobe at 2:27 PM on August 23, 2016 [1 favorite]
You should not expect your status in the US to be relevant, or at least not once you file your 485 (and 765 if you want to get a proper social security number). If the employer makes a big fuss about you not being a citizen or LPR, congratulations! You have learned that this employer is a weapons-grade asshole who will probably be difficult to deal with for lots of other things too.
It is possible that either the employer doesn't offer family plans or that they are just not a very good deal. In that case, the obamacare pages make it clear that people in adjustment-of-status are eligible for the obamacare markets.
To go to the doctor, you will need (1) your insurer's list of which doctors to go to, (2) your insurance information, usually a card, and (3) money -- even with coverage, using medical services in the US usually requires paying a "copay" of \$20-50 for a normal visit and \$50-250 for urgent-care and emergency room visits.
If the new employer has multiple plans available, and many do, you and your hubs should talk to other employees and their families about which plans they like and why. Some will be more expensive but cover more physicians or cover more stuff or have a lower deductible. Some will just be more expensive for no obvious reason and with no obvious benefit.
posted by ROU_Xenophobe at 2:27 PM on August 23, 2016 [1 favorite]
They ask for SSN because Americans have gotten used to using SSNs as their go-to identification number. This doesn't actually hook up to some government social security data base. Anyway, because they're used to using this as their go-to identification number, Americans are confused if you tell them you don't have an SSN. If you are insistant, however they can normally set up something without the number. They will tell you they can't. the computer won't do it. It's impossible. The system requires it, etc. etc. But if you keep insisting you don't have one, eventually they set you up. This is everything: Your health insurance, your phone and utilities, your credit cards and bank accounts. Just keep insisting you don't have an SSN and they will eventually figure out how to make their computers deal.
I got my health insurance in the US before I had an SSN and I think I set up my phone before then too. After I got my SSN I just kept telling everyone but my employer and the tax forms that I didn't have one because I don't like giving it away to everybody and their uncle.
posted by If only I had a penguin... at 3:14 PM on August 23, 2016 [1 favorite]
I got my health insurance in the US before I had an SSN and I think I set up my phone before then too. After I got my SSN I just kept telling everyone but my employer and the tax forms that I didn't have one because I don't like giving it away to everybody and their uncle.
posted by If only I had a penguin... at 3:14 PM on August 23, 2016 [1 favorite]
« Older A wedding venue to get married in the southwest of... | Please don't drink in our home. Newer »
This thread is closed to new comments.
You need to read the health plan benefits information as to limitations. In some plans there are no such limitations and will offer a "family" plan that allows the spouse and children of the employee to benefit from the plan. While I haven't come across restrictions on non-US citizens benefiting from the plan of their spouse, given the diversity of plans it's something you have to check directly with the provider.
Also in general I am just confused about what a person needs in order to see a doctor. My son needs to continue his vaccination schedule and now that we are going to be here indefinitely it would be my preference not to wait the 9 months or whatever until he has his paperwork comes through, especially if he could be covered with my husband's insurance.
You can find any doctor/pediatrician you like that continue his vaccination schedule, but whether the visit will be covered by insurance depends on 1) your insurance plan and how they cover vaccinations and 2) the structure of your insurance plan (i.e. HMO? PPO?) in which you may be limited to certain doctors in network in order to be covered. Again, something that you can find out by reading carefully the insurance plan.
Outside of that, you may stuck paying out of pocket for these visits. It would benefit you to ask around with doctors you're interested in seeing and asking how much it would cost without insurance. You may also qualify for free vaccinations through programs like VFC.
posted by Karaage at 11:40 AM on August 23, 2016