Obamacare in Thailand

tac · July 11, 2014

I'm an American citizen living in Bangkok. I can't buy insurance in Thailand because of pre-existing conditions. Does anyone know if there are ant ACA (Obamacare) policies I could buy in the US which would cover me while living here?

ClutchClark · July 11, 2014

My understanding of the ACA is it only applies for medical treatment received in the US or a US territory.

There are some threads that discussed ObamaCare here on thaivisa so a search might help:

http://www.thaivisa.com/forum/topic/705761-enroll-in-obamacare/

Jingthing · July 11, 2014

Absolutely NOT.

Sorry.

Also note being a bona fide, you are not REQUIRED to obtain U.S. based health insurance. In other words, living abroad provides an exemption from any fines for not being covered.

tac · July 11, 2014

Jingthing,

You sound certain that I can't buy any Obamacare policy that will cover me here. May I ask how you came to be so sure? Do you work in the insurance industry? Have you done some research into this? I'm not trying to be disrespectful, it's just that I really want to buy a policy, if that's at all possible.

Jingthing · July 11, 2014

U.S. citizens living outside the U.S.
U.S. citizens living in a foreign country for at least 330 days of a 12-month period are not required to get health insurance coverage under the Affordable Care Act for that 12-month period. If you're uninsured and living abroad under this definition, you don't have to pay the fee that other uninsured U.S. citizens may have to pay.

See question 12 on this IRS document to learn more about the rules for people living abroad.

Generally, health insurance coverage in the Marketplace covers health care provided by doctors, hospitals, and medical services within the United States. If you're living abroad, it's important to know this before you consider buying Marketplace insurance.

Questions? Call 1-800-318-2596, 24 hours a day, 7 days a week. (TTY: 1-855-889-4325)

https://www.healthcare.gov/am-i-eligible-for-coverage-in-the-marketplace/

Perhaps you want to call the phone number if you can't accept this information. Also, the 2014 open enrollment period is OVER even for U.S. based coverage.

If you're not really living abroad as a full time expat and have a U.S. state residence, I think you COULD get into this program during OPEN ENROLLMENT and be covered for when you are actually in the U.S.

Cheers.

Edited July 11, 2014 by Jingthing

ClutchClark · July 11, 2014

Perhaps you want to call the phone number if you can't accept this information. Also, the 2014 open enrollment period is OVER even for U.S. based coverage.

If you're not really living abroad as a full time expat and have a U.S. state residence, I think you COULD get into this program during OPEN ENROLLMENT and be covered for when you are actually in the U.S.

Cheers.

OP, I notice you have re-opened the old thread I linked above when you would have been better off not splitting up any future responses.

jingthing is the go-to guy for this subject and you should have seen that by reading the thread I linked.

The only thing I might add to Jingthings post is that a very FEW states are allowing applications for the ACA to be approved even though the Open Enrollment is over. You will need to check with your specific State Exchange. The cost for this mid-term coverage is substantially higher than if you had started coverage during Open Enrollment.

tac · July 11, 2014

I just got off the phone with HMSA in Hawaii. They will cover me in Thailand! Thank you, Obama!

Thank you Jingthing for the telephone number.

Jingthing · July 11, 2014

I just got off the phone with HMSA in Hawaii. They will cover me in Thailand! Thank you, Obama!

Thank you Jingthing for the telephone number.

Great! Surprising ... but great. So I assume you are claiming to be a Hawaii resident, yes? Many bona fide expats deliberately divorce themselves from any U.S. state residency for state tax purposes, etc. I'm really curious what you told them. Did you actually suggest you would be living permanently abroad? Because if so, that's quite surprising.

ClutchClark · July 11, 2014

I just got off the phone with HMSA in Hawaii. They will cover me in Thailand! Thank you, Obama!

Thank you Jingthing for the telephone number.

Could you provide some of these details AGAIN:

1) Did you qualify through Hawaii Health Connector (the ACA subsidized Plan)?

2) What is your first day of enrollment/coverage?

3) You are enrolled in an "Indivudual" Plan?

4) They said "Out of Network" coverage "includes" Thailand?

5) What instructions did they provide to process a claim? You pay and they reimburse you?

Thanks

Edited July 11, 2014 by ClutchClark

ClutchClark · July 11, 2014

Option 2: Hawaii Health Connector (ACA)

Open Enrollment Period ended on March 31, 2014. The next open enrollment period will be November 15, 2014 through February 15, 2015, with coverage taking effect no earlier than January 1, 2015.

The life events that may qualify an individual for a Special Enrollment Period (SEP) include:

Adoption

Foster care

Birth of a child

Marriage

Divorce

Gain of citizenship, national or lawfully present status

Loss of health insurance coverage*

Newly eligible or ineligible for tax credits or having a change in eligibility for cost-sharing reductions for individuals already enrolled on Hawaii Health Connector

Changes in the cost or benefits of employer-provided coverage

Permanent address change which provides new Qualified Health Plan choices

Enrolled member of a federally recognized tribe

Option 2: MEDQUEST

You can enroll in MedQuest (Hawaiiis Medicaid and the Childrens Health Insurance Program) any time of year. Theres no limited enrollment period for these programs. You can apply any time. If you qualify you can enroll immediately.

MedQuest provides health coverage for some individuals, families and children, pregnant women, the elderly with certain incomes, and people with disabilities. In some states the program covers all adults below a certain income level.

Edited July 11, 2014 by ClutchClark

spidermike007 · July 11, 2014

My understanding of the ACA is it only applies for medical treatment received in the US or a US territory.

There are some threads that discussed ObamaCare here on thaivisa so a search might help:

http://www.thaivisa.com/forum/topic/705761-enroll-in-obamacare/

Yet, that same law requires you to maintain an American insurance policy, while living in Thailand, that you cannot use here. Or you will be subject to an annual fine that goes up to 96,000 baht per year. Yes, Obama gave into the mandatory provision, as he gives into everything the lobbyists ask for. There is a real stink in the senate over this, but from what I hear it is still in effect. Want to hear the real kicker? An American who lives overseas for over 330 days per year is exempt. Want to know how the insurance companies worked around the exemption? You have to be paying income tax in your country of residence, in order to qualify for that exemption. Can you believe that? How many Americans do you think pay income tax in Thailand? This leader of ours is bought and paid for. He is owned by the lobbyists. He works for them, and not for the citizens of his country.

Spidermike

Sent from my iPad using Thaivisa Connect

tac · July 11, 2014

1) Did you qualify through Hawaii Health Connector (the ACA subsidized Plan)?
yes

2) What is your first day of enrollment/coverage?
I can't enroll until Nov 15 and coverage doesn't begin until 1/1/15. I don't know if I qualify for a subsidy or not.

3) You are enrolled in an "Indivudual" Plan?
yes

4) They said "Out of Network" coverage "includes" Thailand?
yes - using Blue Cross there will be direct payment. Otherwise I must pay and they will reimburse me.

5) What instructions did they provide to process a claim? You pay and they reimburse you?
see #4

The cheapest plan is $350/mo with a $6,350 deductible - then 100% payment. The plans get more liberal and max out at $830/mo. I'm more interested in the cheap plan - in case something catastrophic occurs.

ClutchClark · July 11, 2014

OP,

Thank you for returning and answering my questions.

I am glad it worked out for you !

Edited July 11, 2014 by ClutchClark

tac · July 11, 2014

My understanding of the ACA is it only applies for medical treatment received in the US or a US territory.

There are some threads that discussed ObamaCare here on thaivisa so a search might help:

http://www.thaivisa.com/forum/topic/705761-enroll-in-obamacare/

Yet, that same law requires you to maintain an American insurance policy, while living in Thailand, that you cannot use here. Or you will be subject to an annual fine that goes up to 96,000 baht per year. Yes, Obama gave into the mandatory provision, as he gives into everything the lobbyists ask for. There is a real stink in the senate over this, but from what I hear it is still in effect. Want to hear the real kicker? An American who lives overseas for over 330 days per year is exempt. Want to know how the insurance companies worked around the exemption? You have to be paying income tax in your country of residence, in order to qualify for that exemption. Can you believe that? How many Americans do you think pay income tax in Thailand? This leader of ours is bought and paid for. He is owned by the lobbyists. He works for them, and not for the citizens of his country.

Spidermike

Sent from my iPad using Thaivisa Connect

I am not required to buy this coverage. Since I am a non-resident of the US. I am required to pay taxes in Thailand, but I do not because I have no income. But, even though it's not required, I am exceedingly grateful I'm allowed to buy this insurance despite my pre-existing conditions. For me, this is a very good law.

thailand49 · July 12, 2014

I am no expert on this manner. But I finally was able to sign up and obtain Obamacare and be official covered as of May of this year. Being from California I sign up with what is called Cover California.

Because I have already have coverage in Thailand due to me having a plan just so I can buy for my son. But not signing up for Obamacare i get a hit on my taxes if I do not. So I sign on to the cheapest plan based on the official income I received each year and declare on my taxes just to have something which is the Bronze plan. This plan has a 5,000 USD deductible thereafter everything is covered but it is with a Hospital group in my neighborhood. The plan is like Kaiser so outside of that group treatment is not covered. I pay $1.00 a month.

I believe if you log on they will give you all the details and if you pick a higher plan that does not required you to join a group it might be covered outside the net work like most private insurance plan if you would working and traveling or on vacation and got sick or had a accident. That is where I'm heading and this is me...... They do not need to know you are living here! no one is checking unless you open you big mouth! Pay for it first and then submit the claim and get your money back! I believe there are plans available at a higher cost as long as you do not pick something like me or Kaiser? I saw plans that allow you to see or visit any Doctor and Hospital of your choice?

Good luck..

curtklay · July 12, 2014

I hope the OP is correct, but I am skeptical.

Everything I have read about ACA clearly states that coverage is not available to full-time expats, and that treatment is only available within the US. If I am missing something, I would certainly appreciate being directed to further information.

Also, when I have researched pricing for various plans, I have not seen any that are as high as what the OP quotes ($350 per month with a $6K deductible).

As said, for the OP's sake I hope he is correct, but I suspect there is a misunderstanding somewhere. Please correct me if I am wrong.

Suradit69 · July 12, 2014

I just got off the phone with HMSA in Hawaii. They will cover me in Thailand! Thank you, Obama!

Thank you Jingthing for the telephone number.

Great! Surprising ... but great. So I assume you are claiming to be a Hawaii resident, yes? Many bona fide expats deliberately divorce themselves from any U.S. state residency for state tax purposes, etc. I'm really curious what you told them. Did you actually suggest you would be living permanently abroad? Because if so, that's quite surprising.

"Many bona fide expats deliberately divorce themselves from any U.S. state residency for state tax purposes, etc."

Things have probably been tightened up over the years, but during my working years I had a foreign earned income exclusion when filing US taxes, did not file or pay Illinois income taxes, but on two separate occasions I did post-grad degrees at the University of Illinois paying reduced tuition as a bona fide Illinois resident , I'm registered to vote absentee in Cook County and until it recently expired I had an Illinois driver's license.

I wouldn't try to claim any insurance based on my nebulous Illinois residency. Divorcing oneself from a state isn't all that clear-cut, but I had no problem getting reduced tuition charges (an example of the odious dual pricing) as a "resident."

willyumcr · July 12, 2014

I maintain a residence in States. I am enrolled in Kaiser Senior Advantage and am covered for "Emergency" and "Urgent" care while out side of my plan area (Thailand). As long as I am not outside the plan area for more than 6 months I am covered. I travel to States twice a year (maintain 6 months) and I go anyway to visit family and also visit Kaiser doctor. Really emergency and urgent care is all I need for catastrophic causes as stuff under $300 I just pay out of pocket to keep under the radar. Cost is $39 a month. I file US income taxes as I am retired and income is not high enough where it is an issue. I don't profess to live in Thailand, just vacation (long term).

ClutchClark · July 12, 2014

I am no expert on this manner. But I finally was able to sign up and obtain Obamacare and be official covered as of May of this year. Being from California I sign up with what is called Cover California.

Because I have already have coverage in Thailand due to me having a plan just so I can buy for my son. But not signing up for Obamacare i get a hit on my taxes if I do not. So I sign on to the cheapest plan based on the official income I received each year and declare on my taxes just to have something which is the Bronze plan. This plan has a 5,000 USD deductible thereafter everything is covered but it is with a Hospital group in my neighborhood. The plan is like Kaiser so outside of that group treatment is not covered. I pay $1.00 a month.

I believe if you log on they will give you all the details and if you pick a higher plan that does not required you to join a group it might be covered outside the net work like most private insurance plan if you would working and traveling or on vacation and got sick or had a accident. That is where I'm heading and this is me...... They do not need to know you are living here! no one is checking unless you open you big mouth! Pay for it first and then submit the claim and get your money back! I believe there are plans available at a higher cost as long as you do not pick something like me or Kaiser? I saw plans that allow you to see or visit any Doctor and Hospital of your choice?

Good luck..

I still don't understand...are you saying that your healthcare costs received in Thailand are reimbursed by your California ACA Plan (assuming you have met your annual deductable and out-of-pocket limits)? Or is your coverage in Thailand only available from your Thai health insurance?

And are you saying your CA Bronze Plan only costs you $1/month premium? I am assuming your AGI (gross income) is very low?

Edited July 12, 2014 by ClutchClark

ClutchClark · July 12, 2014

I just got off the phone with HMSA in Hawaii. They will cover me in Thailand! Thank you, Obama!

Thank you Jingthing for the telephone number.

Great! Surprising ... but great. So I assume you are claiming to be a Hawaii resident, yes? Many bona fide expats deliberately divorce themselves from any U.S. state residency for state tax purposes, etc. I'm really curious what you told them. Did you actually suggest you would be living permanently abroad? Because if so, that's quite surprising.

"Many bona fide expats deliberately divorce themselves from any U.S. state residency for state tax purposes, etc."

Things have probably been tightened up over the years, but during my working years I had a foreign earned income exclusion when filing US taxes, did not file or pay Illinois income taxes, but on two separate occasions I did post-grad degrees at the University of Illinois paying reduced tuition as a bona fide Illinois resident , I'm registered to vote absentee in Cook County and until it recently expired I had an Illinois driver's license.

I wouldn't try to claim any insurance based on my nebulous Illinois residency. Divorcing oneself from a state isn't all that clear-cut, but I had no problem getting reduced tuition charges (an example of the odious dual pricing) as a "resident."

So what residency requirements did you meet in IL? Were you a graduate of an IL High School? Did your parents still reside in the State? Did you not have a residency in any other State?

As for State HC Exchanges being picky about enrollees, I bet its just the opposite since they are trying to get as many people enrolled as possible to build up their coffers. Ofcourse, if you choose a State with a State Income Tax then you are likely to get a knock on your door for State Taxes owed--which I read is now at 5% of AGI !!

Edited July 12, 2014 by ClutchClark

ClutchClark · July 12, 2014

I maintain a residence in States. I am enrolled in Kaiser Senior Advantage and am covered for "Emergency" and "Urgent" care while out side of my plan area (Thailand). As long as I am not outside the plan area for more than 6 months I am covered. I travel to States twice a year (maintain 6 months) and I go anyway to visit family and also visit Kaiser doctor. Really emergency and urgent care is all I need for catastrophic causes as stuff under $300 I just pay out of pocket to keep under the radar. Cost is $39 a month. I file US income taxes as I am retired and income is not high enough where it is an issue. I don't profess to live in Thailand, just vacation (long term).

So you are not on medicare yet?

If I understand correctly, your plan is subsidized as part of ObamaCare based on your limited income and thats why your payment after subsidy is only $39/month--and you can receive coverage for medical costs in Thailand as long as its an "emergency"?

Interesting, I guess "out-of-network" can include medical care outside of the US.

Thanks

rotary · July 12, 2014

Absolutely NOT.

Sorry.

Also note being a bona fide, you are not REQUIRED to obtain U.S. based health insurance. In other words, living abroad provides an exemption from any fines for not being covered.

Thank God, That's good news

willyumcr · July 12, 2014

Yes, I am on medicare as Kaiser Senior Advantage is offered as a supplement to Medicare. Nothing to do with income.

ClutchClark · July 12, 2014

Yes, I am on medicare as Kaiser Senior Advantage is offered as a supplement to Medicare. Nothing to do with income.

OK, thanks for clarifying for me--I missed the Senior part.

So you are not participating in any ObamaCare type Exchange.

Edited July 12, 2014 by ClutchClark

willyumcr · July 12, 2014

No, but I believe medicare covers the ObamaCare requirement. This post was more to clarify that there are alternatives to having insurance here in Thailand.

nkh95 · July 12, 2014

Clements International offers health, auto, property, and umbrella insurance for those US citizens living abroad. We use some of their policies.

Pundi6446 · July 12, 2014

Even living in the US, it's really much good over there, coverage wise, so forget it over here.

haikurd · July 12, 2014

The best way to be sure is to contact insurance providers on the exchange (I guess in your home state or state you were last living in) and ask them - the health care exchange people themselves probably won't be able to answer this. The cheapest HMO coverage is only for standard care "in network" but still covers emergency care in Thailand (or anywhere else I am). The more expensive plans which allow out-of-network doctors might cover care overseas.

Doc50 · July 12, 2014

" I'm an American citizen living in Bangkok. I can't buy insurance in Thailand because of pre-existing conditions. Does anyone know if there are ant ACA (Obamacare) policies I could buy in the US which would cover me while living here? " THE OP

I seriously doubt that there are any ACA policies that cover treatment outside the USA. I think you are mixing up coverage and treatment. You may be covered for whatever time period you signed up for but treatment in Thailand reimbursed or paid by your insurance carrier "show me the exact wording that says that." I think your coverage ends at the US border.

I could be wrong but I have to see it in writing.

Doc

richard10365 · July 12, 2014

I tried to sign up but was told I can't because I live in Thailand.

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