Obamacare in Thailand

[spidermike007]

Bona fide expats are completely EXEMPT from any obligation to have/purchase U.S. insurance coverage. Now on the other hand, if you don't meet the definition of bona fide expat, you indeed ARE required to have U.S. insurance coverage or be subject to penalties.

For example, a state resident of Texas who lives 10 months in Texas and 2 months in Thailand is NOT an expat. Such a person is required to have U.S. coverage. He is not required to have coverage in Thailand.

ACA/Obamacare is NOT nationalized/government health care!

An "ACA" policy is just a policy from a FOR PROFIT private insurance company that meets the requirements of the ACA law.

Private policies under ACA are subsidized based on income ... wealthier people pay full freight.

Government health care programs that already existed still exist such as Medicare (for elders over 65) and Medicaid (a poverty program).

In the U.S. states controlled by right wing republicans for the most part they have refused to cooperate with "EXPANDED" medicaid. Basically Medicaid is for people in severe poverty and expanded medicaid includes millions of Americans who are somewhat less poor. In effect, most of these people remain uncovered even with ACA going into effect. That's politics for you.

I think too many people think ACA is nationalized health care like in Canada or the U.K. NOT EVEN CLOSE!

In this case bona fide means living at least 330 days per year in Thailand, and paying income tax in this country. I ask again, how many Americans fit that description? It was a sell out. Agreeing to this exemption was a way to allow these companies to collect a premium, under penalty of a fine if the premium is not paid. So, essentially Obama became an insurance company schill in exchange for votes. Or, a $35 street whore.

Spidermike007

[Jingthing]

This isn't a thread about how great and fair the ACA is. It's about how we as expats (and semi-expats) are supposed to deal with it, specifically can it really cover people in Thailand who have a policy from the US.

If anyone thinks I'm defending ACA, nope, I've been for REAL universal health care for decades now.

Anyone, since it was brought up, here is some excellent info on who does and does not have to have U.S. coverage under the law (or face penalties). It's rather complicated:

http://blogs.angloinfo.com/us-tax/2013/11/11/us-citizens-abroad-and-obamacare/

Edited July 13, 2014 by Jingthing

[h90]

This isn't a thread about how great and fair the ACA is. It's about how we as expats (and semi-expats) are supposed to deal with it, specifically can it really cover people in Thailand who have a policy from the US.

If anyone thinks I'm defending ACA, nope, I've been for REAL universal health care for decades now.

Anyone, since it was brought up, here is some excellent info on who does and does not have to have U.S. coverage under the law (or face penalties). It's rather complicated:

http://blogs.angloinfo.com/us-tax/2013/11/11/us-citizens-abroad-and-obamacare/

off topic

coming from a country with universal health care I complete agree and it is possible and cheaper.

You only need good politicians who aren't corrupt, have a vision and are populist enough to sell it for the masses. While on the other hand restrict any abuse.

Such are as common as pink elephants...

[OMGImInPattaya]

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.

I doubt very much that you are covered by any ACA plan...either from a state or federal exchange. Most (all?) of the plans have lists of approved doctors/hospitals and I highly doubt, in fact I'm 99.99999% sure there are no Thai doctors or hospitals on any of those lists. As was said originally, the ACA is for Americans living and/or working IN the good o'le USofA. Like Medicare, us stupid federal taxpayers who live outside the fatherland are not covered for any treatment for illness or injury outside the United States. Now, if you were a member of the US military-industrial complex, and spent any time since WWII killing yellow, brown, and black-skinned people on Uncle Sam's orders, they you would of course be covered. You figure that one out.

But getting back to the ACA, I'm sure what whoever you spoke with in HI thought you were a HI legal resident and was under the impression you were traveling to Thailand short-term for vacation, work, family visit, etc. and not living full-time there. Therefore, you would be covered (like a private travel health policy) for illness and accidents. It's the same for all the other exchange policies...they provide overseas coverage provided one is there for the aforementioned reasons. The policies do not provide health insurance for Americans who are basically full-time expatriates (either working or retired).

I believe you are correct. There are massive provisions that compel expat Americans to pay into the system, without receiving any benefits. The compulsory clause is still in effect, I am fairly certain. And the fact that he does not pay income tax in Thailand, despite the fact that he does not earn enough to have to pay, I would guess would be enough to disqualify. Do not forget. These laws were written to enrich the insurance companies, and were written by the companies themselves. Did Obama vet these laws? Yes. Did he say no to any of the most egregious aspects of these laws? No.

And in regard to your comment about a veteran of war getting coverage, while that is true on paper, what about the millions of vets who have been waiting months to get in to see a doctor? The VA secretary was fired for a reason. His department was doing horrendously bad work. And though these thoughtless presidents lobby hard to put our men in harms way, they do not put the same amount of vigor into seeing that they are taken care of, when they return homes with limbs blown off. Shame on them for that. Shame on Obama for that. He cares little for these men in uniform. He has shown that repeatedly.

Don't let your hatred for our first black president cloud your thinking...or the facts. The budget of the veterans administration, including the VA healthcare system, has more than doubled under the Obama presidency. The management of the agency may be f-up but that's hardly the president's fault and don't forget, he great majority of these wounded soldiers were made by George Bush's wars which Obama has ended. But I don't want to debate politics, my main point in makin e statement was if the government can provide healthcare coverage for vets living outside the States, then why not for other retirees?

[ClutchClark]

In this case bona fide means living at least 330 days per year in Thailand, and paying income tax in this country. I ask again, how many Americans fit that description? It was a sell out. Agreeing to this exemption was a way to allow these companies to collect a premium, under penalty of a fine if the premium is not paid. So, essentially Obama became an insurance company schill in exchange for votes. Or, a $35 street whore.

Spidermike007

Mike, I usually agree with you but in this case you could not be more wrong. Over 30 politician/architects of Obamacare have received far more than $35 for services. Each have landed $1 million or more annual salaries as lobbyists for major firms.

Back to topic...thanks to all for the responses to the OP thus far but I still have not read whether anyone has successfully used their ACA/Obamacare Plan while in Thailand. Has anyone used the HC system in Thailand and been reimbursed by their insurer for "out-of-network" coverage and were the services rendered for emergency-life threatening circumstances?

It sounds like TV needs to hire a lobbyist to help us navigate the system.

Edited July 13, 2014 by ClutchClark