NY State + Covid + uninsured in the US = ?
May 21, 2020 3:51 PM   Subscribe

If a US citizen with Canadian health insurance gets Covid in NY State and needs hospitalization... then what?

(Hello Hive Mind! Please trust that the person asking this question is a mature, responsible, considerate and careful human being, behaving as admirably as physically possible in the time of Covid, who nonetheless has responsibilities which require actions that do not fit the Platonic model of pandemic stay-at-home behavior. I ask this question despite nervousness that it will draw attack, because your knowledge and your brilliant problem-solving minds would be enormously helpful. Thank you.)

I (dual US/Canada citizen) am currently living in Canada (where I very recently moved for work). I must travel to my house / not quite former home in New York State in June. I want to ensure that I can be responsible and safe on this trip, and one thing has me stumped: Is there any way for me to get Covid coverage for the several weeks I will be there? And if not, then if I got Covid and needed hospitalization, what should I do?

Canada has suspended all international health coverage, so I'm not covered as I would usually be. I cannot purchase temporary health insurance, as NY State doesn't allow it. I can purchase traveler's insurance, but it doesn't cover Covid. NY State does have an open enrollment period for permanent health insurance right now, but I can't access the site from Canada, so I can't figure out whether I'd be eligible, whether I could pay for only a couple months (probably not?), etc.

I do see suggestions that NY State may have protections in place for uninsured people who end up in the hospital with Covid, and I figure that as a US citizen with a residence in NY I'd perhaps be eligible for such protections, but I can't find anything specific, and I don't know whether my Canadian insurance, useless as it is right now in NY, might nonetheless throw a wrench into that.

This is a puzzle! Does anyone have knowledge of how this might play out, and how I can navigate it so that I can be confident I won't end up in enormous medical debt in the (vanishingly small -knock on wood- but of course still existent) chance that I end up in the hospital due to Covid?
posted by marlys to Travel & Transportation around New York (13 answers total)
You have to be a NY resident to apply for NY Marketplace plans. You're not a NY resident anymore, even though you still own property here. (Also, the special pandemic enrollment period for non-Medicaid/CHIP plans has ended.)
posted by praemunire at 4:11 PM on May 21, 2020

I would operate under the assumption that you will be uninsured, with all the consequences that entails. How long do you need to stay in NY? Can your backup plan be "drive back to Canada as soon as you experience mild Covid symptoms, before they get bad enough for hospitalization"? As you're a Canadian citizen, I think you'll still be allowed into the country and required to self-isolate. Definitely drive rather than fly, because airlines will rightly deny you boarding if you have symptoms.
posted by serelliya at 4:36 PM on May 21, 2020 [1 favorite]

There are travel insurance plans which will cover COVID- maybe not standard ones but have you talked to an insurance broker about the options?
posted by peacheater at 4:43 PM on May 21, 2020 [1 favorite]

OHIP no longer covers you while you travel. Check your provincial plan but I’d buy insurance.
posted by warriorqueen at 5:11 PM on May 21, 2020

I think the first question would be: are you going to be allowed to cross the border and if so are you going to be allowed back into Canada?
posted by miles1972 at 5:32 PM on May 21, 2020 [1 favorite]

U.S. citizens are allowed to enter the U.S., and vice versa (but not the reverse--you have unrestricted entry only into your own country of citizenship).
posted by praemunire at 5:41 PM on May 21, 2020

Most likely, the hospital would consider you uninsured. There's a program that just opened up for facilities and providers who treat uninsured Covid patients to file for reimbursement.

I work (in northern Virginia) with Covid patients who are discharging from the hospital. Many of them need supplemental oxygen for a few weeks after discharge. We do ask our uninsured patients if they're able to self-pay for the oxygen (about $250/month); if not, it gets covered by our charity budget.
posted by shiny blue object at 5:48 PM on May 21, 2020

https://nystateofhealth.ny.gov/ ("the official Website of NY State of Health / The Official Health Plan Marketplace") also offers a Helpline at 1.855.355.5777 (TTY: 1.800.662.1220), Monday - Friday, 8 a.m. - 8 p.m. and Saturday, 9 a.m. - 1 p.m., that may be able to assist you. You may want to ask if you qualify for the Special Enrollment Period or any other exceptions due to your circumstances.

There is a section for Help with Health Insurance on the MeFi Wiki ThereIsHelp page that is US-focused and offers a list of resources, including Community Health Workers in New York (you can search the database at the link to find one near your NY residence) that you can also try to contact for assistance before you travel if possible.
posted by katra at 6:19 PM on May 21, 2020

There are certain situations where not having insurance is better than having it, and I think this is one. Any plan you buy is gonna have a huge deductible or premium or both, and you’ll pay through the nose. Come in without insurance, they’ll figure out how to put you on whatever special coverage is available to cover COVID patients (still evolving) or they’ll just eat it. What are they gonna do, sue you? You live in Canada!
posted by ThePinkSuperhero at 7:03 PM on May 21, 2020

What are they gonna do, sue you?

AskMe can't give you legal advice tailored to your specific situation, but if you have legal questions related to health care costs, including what might happen if you get sued to collect them, you can consult with a lawyer (MeFi Wiki), especially if you own property in New York.
posted by katra at 7:35 PM on May 21, 2020 [2 favorites]

Any of the public hospitals (New York City Health and Hospitals) will treat you on a very reasonable sliding scale based on your income.
posted by Waiting for Pierce Inverarity at 3:39 AM on May 22, 2020

Ah, just realized you said NY State, not city. May not apply then.
posted by Waiting for Pierce Inverarity at 3:42 AM on May 22, 2020

Response by poster: Thank you all - this is much information from many angles! It is good to know too (thank you katra) that there is a MeFi page on this the topic of health insurance - I didn't realize that existed.

Also, someone had asked a question last night about my statement re: Canada's suspension of international coverage. The question is gone, but I'm following up because in my question I stated that part too broadly. Here's a bit more nuance (to the best of my knowledge - no doubt it is more complex still) in case anyone else reads and is startled by that.

After Canada's March 13 global travel warning, Canadian health and travel insurance plans either limited or suspended international coverage (depending on the province and provider) for new international travel. The two relevant bits of federal-level information are an advisory on international travel (which warns about possible limits in health coverage) and a page on travel insurance, which states that "Travel insurance providers no longer cover travel booked on or after March 13, 2020". Exactly what this means for each individual will depend on their province, existing supplementary coverage, and the date that any purchased travel coverage began.

OK! Thanks again to all. Pursuing your leads...
posted by marlys at 10:12 AM on May 22, 2020

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