Repatriating and US health insurance Q

Hi, everyone,
Started a new thread because I couldn't find a recent one on this issue - so apologies if there's a similar discussion running somewhere else!

Am seriously considering moving back home to the US after almost 20 year in the UK (far, far, far too long!!!) - never meant to stay for so long, but life takes over, right?? Have had indefinite leave to remain since 1993.  I'm single again now and am a US citizen, so will just sell the house, pack a few bags, and get on that plane!

Here's the Q:  anyone have any advice about health insurance?  I know 2014 is supposed to be a big year for the Affordable Health Care Act, but then I read somewhere that this might all be pushed back to 2015.  Problem is that I had cancer a few years ago, and although I am fine now, this will put me in the "pre-existing condition" nightmare scenario.  Will be hoping to move back to MA or RI, depending on where I can get a job.  Should I go for the job first, before the move, so I can try to get health insurance, or wait til I am over there and take my chances?

Has anyone experienced this?  If anyone has any advice, much appreciated -

Glad I found this forum - thanks in advance, all!

I went back to the US after 20 years of NHS (about 15 years ago).  I managed to find a job in a book shop that gave me and my son Blue Cross/Blue Shield coverage, which was fine.  Then I landed a job in my field which did not provide insurance so I had to do COBRA (expensive).  The company I worked for eventually offered me some weird insurance coverage, for which it was difficult to find a physician.  Thankfully I found a job with a large university and once again had BC/BS.
 
By this time my son had joined the workforce and had some kind of coverage from various jobs. You are probably aware that Massachusetts has had "Romney-care" for some time, requiring everyone to have some kind of health insurance.  When my son started his current retail position he had to opt for the state insurance.  Again it was difficult to find a doctor in our area who took the state coverage.  After the required period of employment he was eligible for benefits from his employer.  The catch is that (with the downturn) he's been given fewer hours so is no longer eligible.  He cannot go back on the state system as theoretically he could get insurance from the employer.  So he's had to do COBRA!  This may or may not be the same with the federal AHCA.

If you can find a job which provides benefits before you go, by all means, take it!  And remember that it's not like NHS: you will still have to pay for part of your insurance, co-pays, deductibles and so on.  I cannot advise on the pre-existing issue but it could be a problem.

Good luck.

As far as I'm aware, I think things will go into high gear starting Jan 2014.  Cvg for pre-existing conditions is one of the things this program is supposed to help with.  This website is managed by the Centers for Medicare & Medicaid, so I think it should be fairly reliable.  Take a look  https://www.healthcare.gov/how-does-the-health-care-law-protect-me/

All of the states are going to be handling their healthcare a bit differently, so you should visit the MA and RI sites. I know here in Maryland they're planning on rolling out the new healthcare in October 2013. The website that CWrummy provided should hopefully get you most of the general information you need. As for pre-existing conditions, you will no longer be denied and you won't have to spend an extortionate amount due to your previous illnesses. You'll pay the same as everyone else. That's part of the Affordable Health Care Act.

Of course, having a job before you move would be the ideal situation (for many reasons). We didn't have jobs when we repatriated and at first I was freaking out about health insurance. But then, well, you get lazy. I started a job 3 months after we moved back and we didn't have health insurance during that time.

Here's a summary of how the ACA will work (assuming it gets started on schedule for enrollment this October and coverage to begin next January):

The law no longer allows insurers to deny coverage due to pre-existing conditions, so that should be good news for you.

If your income is between 100-400% of federal poverty level you will be eligible for subsides if you don't have employer coverage to buy insurance on the new exchange. (If you're in poverty you'd be eligible for the expanded Medicaid coverage in states that choose to expand; if you live in some other state you'd unfortunately be without coverage due to the way the bill was written and how the SCOTUS ruled on the expansion, however you'd be exempt from the penalty.) If your income is too high you can still buy from the exchanges, but you won't get any subsidies.

There is a tax penalty (but no criminal sanctions like some have rumored*) for not having coverage (unless you fall under one of the exemptions) that will be phased in up through 2016. *Based on the SCOTUS ruling if there were that would indeed be unconstitutional, but in the light that the government can use tax incentives to sway behavior in other ways the penalty was upheld as a tax to encourage people to buy health insurance.

Thanks, everyone, for all the great advice.  I think I am "freaking out" a bit about the health insurance issue, and will just have to take the plunge and take my chances.  Will try to get that job before I go, however, just in case.  I'm in my mid-forties now, and if I don't go soon, I'll probably never go, and I don't want to spend the rest of my life in Britain!  (Don't get me wrong, some bits are great - including all my great friends, networks, etc - but it's just not for me and never really was.  I stayed for the marriage and career, I guess, but I don't have to worry about that now).  Time to start over...  Thanks again, all.  Am feeling very encouraged!

If you can find a job with a large corporation, denying you coverage for pre-existing conditions is already illegal, so the work will help. If you're in a small employment or individual policy, it's easier for them to stick it to you for now.

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If you moved from UK to USA and didn't have a job straightaway does that mean your income would be 0% and, therefore, eligible for subsidies as per the ACA?  I assume being below or near the poverty level subsidies was designed to help people on minimum wage and whatnot, but it'd be interesting to know what happens to unemployed people - god knows there's enough of them in the USA right now.
Perhaps they look at your overall financial situation?  So if you, say, independently wealthy and didn't have a job with an income as opposed to someone who was poor and out of work.

If you moved from UK to USA and didn't have a job straightaway does that mean your income would be 0% and, therefore, eligible for subsidies as per the ACA?  I assume being below or near the poverty level subsidies was designed to help people on minimum wage and whatnot, but it'd be interesting to know what happens to unemployed people - god knows there's enough of them in the USA right now.
Perhaps they look at your overall financial situation?  So if you, say, independently wealthy and didn't have a job with an income as opposed to someone who was poor and out of work.

It appears they only look at your income, not your assets. However, if you had a foreign job and earned income in the time period they're looking at, that income would count just like U.S.-sourced income.

My problem with employer offered coverage, is finding a place where that is affordable. At my current job it is not offered, but at my last job it was. For hubby and me together it would run $700 a month, THEN we'd each have a $500 deductible per year. There was no way we could afford that.

My problem with employer offered coverage, is finding a place where that is affordable. At my current job it is not offered, but at my last job it was. For hubby and me together it would run $700 a month, THEN we'd each have a $500 deductible per year. There was no way we could afford that.

It's my understanding that should change once this ACA gets rolling.

I certainly hope so. I haven't studied up on it, but there has to be a better way. Fortunately we are both in relatively decent health, but it would be a comfort to know we had insurance if we need it. I try to not worry about 'what if', but the thought does pop up from time to time. Plus it would be cheaper to go to a doctor, than to go to Urgent Care with no insurance, for something like poison ivy in the eye. The visit and medication set us back $230. Granted, that has only happened once in my life, but little incidental things do come up from time to time in life.

I certainly hope so. I haven't studied up on it, but there has to be a better way. Fortunately we are both in relatively decent health, but it would be a comfort to know we had insurance if we need it. I try to not worry about 'what if', but the thought does pop up from time to time. Plus it would be cheaper to go to a doctor, than to go to Urgent Care with no insurance, for something like poison ivy in the eye. The visit and medication set us back $230. Granted, that has only happened once in my life, but little incidental things do come up from time to time in life.

As I said in an earlier post to this thread, chances are you'll qualify for the subsidies given to people who will buy insurance from the exchanges.

If you'd like to learn more you can browse around on www.healthcare.gov (the federal government's official site on healthcare).

And if your current job doesn't offer health insurance at all, you would definitely qualify for the low cost individual policies being offered by the ACA. They're being created exactly for people like you!