Health Insurance for International Students + dependents

[skydiamonds]

Hey all,

 

I'm an international student that will be attending a Masters program in the States this Fall. With regards my health insurance for myself and my two dependents, paying for the university health insurance program seems to me to be my only option. And it is expensive: an annual premium of $12,555 for the 3 of us, compared to $3,021 for me alone. 

 

 

It is my understanding that as a non-US citizen I am ineligible for any Marketplace plans through healthcare.gov. I also am made ineligible through the resident requirement since we would move to the States only in September.

 

I've looked into premium travel insurance which is a lot cheaper than the university plan, but this won't cover doctors visits and more general health maintenance. This seems to me to be unwise with a 1-year old son. The travel insurance typically covers unplanned or emergency hospital visits, along with other non-health related benefits.

 

So this is a message to anyone that has been through this, can you perhaps recommend an alternative to the expensive university plans? Or are they my best option and I just need to factor that cost into my budget?

 

[TakeruK]

Hi, 

 

It's think it is not true that you are ineligible for the ACA plans (aka Obamacare, aka Marketplace plans through heathcare.gov), but as a non-American, a lot of this is new to me so there may be a lot of differences from state to state. However, I am in California and my spouse is eligible for these plans! In California at least, you need to be legally residing in the US and for us to not have employer provided health care. 

 

So, for me, the school pays 85% of my health insurance premium on the student plan which means I am not eligible for ACA since I have an affordable alternative. For my spouse, she has been on my plan as a dependent until ACA plans opened. The school does not subsidize dependent health insurance so we were paying $7200/year for her. Her job (she is J-2 status) does not cover insurance either, so she is eligible for the ACA plans, which will have premiums of about $2400/year, and we estimate our total out of pocket to be something like $4000 including the premiums. 

 

The school told me the reason that dependent health care is so expensive is that very few people enroll in it. My school recently showed us the numbers on their plans. Basically, the insurance company wants to make it so that all of the money they pay out to students is equal to about 70% or 80% of the money they collect in premiums. So if only say a small number of students have dependents, then even if say 10 dependents have serious health costs, this would really cut into the insurance company's profits so they charge a very high rate to ensure they still make money. I am not defending this at all, I think it's a terrible system, but it is what it is.

 

Don't use travel insurance! As you said, it covers very very little. 

 

The problem with ACA plans is that I think March 31 is the last day to enroll for this open enrollment period. I am not 100% certain but I don't think you can enroll again until October 2014. This means you might have to be on your school's plan for awhile or maybe travel insurance for a month?

 

Alternatively, you can get your own plan directly from the major insurance providers, e.g. Anthem Blue Cross, BlueShield, etc. Their plans were way more affordable than my school's plan for dependents but they only insure healthy people or they might raise costs if they suspect you are unhealthy and will cut into their profits. My school plan was a flat rate for all, no denying coverage for pre-existing conditions. But the ACA might also have changed the rules for these private plans too. I would advise calling one of their agents in the summer and figuring out a plan!

[biisis]

I would also like to learn more about this! Besides Blue Cross/BlueShield, what are some other insurers I should research outside of my school's (ridiculous) dependent plan? Also, does health insurance costs vary from city to city in the USA? Private health care is confusing and scary!

[TakeruK]

I would also like to learn more about this! Besides Blue Cross/BlueShield, what are some other insurers I should research outside of my school's (ridiculous) dependent plan? Also, does health insurance costs vary from city to city in the USA? Private health care is confusing and scary!

 

This page has a list: http://en.wikipedia.org/wiki/List_of_United_States_insurance_companies (Scroll down to medical insurance companies). Some of them are better than others of course. I don't know enough to tell you which ones are good though, so you'll probably have to check up on these companies yourself!

 

Yes, cost of insurance varies from place to place! Basically, health insurance is sold like car insurance in the US, where the goal is for the company to collect more money in premiums than they pay out in benefits--they usually want to pay out only like 70% of their collected premiums. 

 

Another thing you need to know is PPO vs. HMO plans. In a PPO plan, you are free to use any provider you want. However, there is a network of doctors etc. that have agreed to be on your insurer's "network". When you go to a plan in "network", there is a reduced fee that the doctor agreed to charge in accordance with their contract with the insurer and your plan will cover more of the costs. If you go out of network, your doctor may charge you more and also your plan will cover much less. For example, in my PPO plan, if I go to a doctor in network, I pay 20% of the cost of treatment. If I go out of network, I pay 40% of the cost of treatment!

 

In a HMO plan, you have a lot fewer choices in your provider. You have to select from providers in their network and have to choose a primary care provider. If you go outside of your network, you will not be covered at all! Maybe someone else who is on a HMO plan can explain it better. I know that in general, they tend to be a bit cheaper. Both PPO and HMO plans are available through the ACA ("Obamacare") marketplace.

 

I agree that health care in the US is confusing and scary! We've made a couple of mistakes that probably cost us about $1000 more than it would if we had known what we were doing. Being from Canada, we're not used to an environment where health care is a business instead of a public service, but we're learning =/

[biisis]

Thanks for the excellent advice, fellow Canadian!

[TakeruK]

Glad to be helpful!

[Vene]

Just saw this thread and want to say, as an American (damn, that sounds pretentious), what I'd do is look to see if the state you're moving to set up their own exchange and call their help number with any questions. Otherwise, check out the healhcare.gov website for a contact number and call them to see what information they can offer you. Our system is kind of a mess and I don't think anybody really knows what is going to be happening with our healthcare system for the next few years. I just wouldn't expect much when you're coming in as an international because there was a lot of political bickering over the idea of US tax dollars to fund healthcare for non-Americans.

[biisis]

But we have to pay taxes too... Taxes without proper free healthcare....

: (

[TakeruK]

I feel confident about saying that California at least will cover ACA plans for non-Americans. Since my first post here, we have successfully enrolled my spouse (non-American too) on the California marketplace plans. During this process, we have to upload proof of legal presence, which was our DS-2019 forms (or I-20 if you will be on F-1 status). 

 

US tax dollars are spent on tons of things non-Americans use . US tax dollars make the roads I drive on, pay for the grants that my supervisor uses to pay me, subsidizes the corn I buy at the store, pays the DMV employees that process my paperwork etc. Non-Americans in America should basically have all the same rights (except for basic citizenship things like voting of course) because it is pretty unethical to allow/welcome outsiders into the US yet treat us as second class people. And Americans that go abroad get benefits in countries they are visiting too It's part of "playing nice" with other countries! (I know that few people here actually think America should keep international people out, but just saying!)

[Vene]

I feel confident about saying that California at least will cover ACA plans for non-Americans. Since my first post here, we have successfully enrolled my spouse (non-American too) on the California marketplace plans. During this process, we have to upload proof of legal presence, which was our DS-2019 forms (or I-20 if you will be on F-1 status).

I'm pleasantly surprised, hopefully it's more than just California who is doing this.