Insurance-Policy

Coverage for Senior Inbound Visitors and Immigrants

If you haven’t thought about the inbound senior market (age 65 and up), you might want to add them to your target market. This group falls between the cracks in many cases when it comes to options for health care insurance, and they are likely looking for guidance on coverage.   

What about Medicare?
Lawful immigrants who have been in the U.S. less than 5 years cannot receive Medicare, so they must look for other coverage.    

If a lawful immigrant has been here for 5 consecutive years, he/she can buy Medicare if he/she has not worked the required number of quarters (40). For 2016, the cost for Part A is $411, and the cost for Part B is $121.80 (this can fluctuate based on income and other factors), making the minimum investment likely $532.80 per month. 

What about Obamacare?
Healthcare.gov states that lawfully present immigrants are eligible for coverage through the Marketplace. However, upon digging further, we discovered it’s often difficult to find options for anyone 65 and older.   

Plans from Seven Corners
All this means that lawful immigrants 65 and older, who have not been here for 5 consecutive years have limited choices for health care insurance. Seven Corners has two strong options that fit this market.

Green Cover — This is a choice that offers benefits in a format similar to Medicare, and it can cover anyone age 60 through 95. You must have lived in the U.S. less than five years to buy this.   

Key points include:

  • It contains two parts, similar to Medicare, Part A and B. Part A covers hospitalization, hospice, skilled nursing facilities, and home health care. Part B covers physician and surgeon benefits, supplies, therapy, and ambulance services.
  • Coverage can range from 5 days to 364 days with an option to rebuy at the end of 364 days.
  • Quick purchase process with no medical history questions to answer — applicants receive their ID card and plan document immediately.
  • Provider Network —  We have a large network with quality care and discounted pricing.
  • Pre-existing conditions are not covered.
  • Green Cover is not ACA compliant, so it’s possible that a lawfully present immigrant may be subject to a penalty.  

Inbound Immigrant — This is an option for lawful immigrants age 14 days through 99 years who have not been in the U.S. for more than 24 months.

Key points include:

  • Scheduled Benefit protection (this means there is a stated limit for each type of covered medical treatment such as hospital room and board, and the plan will not pay more than this limit) 
  • Economical pricing
  • Coverage length from 5 days to 364 days, renewable for up to 5 years, with proof of continuing eligibility,
  • Quick purchase process with no medical history questions to answer — applicants receive their ID card and plan document immediately.
  • Pre-existing conditions are covered on a limited basis with a specific benefit, Acute Onset of a Pre-existing Condition.
  • Inbound Immigrant is not ACA compliant, so it’s possible that a lawfully present immigrant may be subject to a penalty.  
Please note: Your clients should consult with an attorney or tax professional to determine how the ACA requirements apply to them.

Jun 28, 2016


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