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Partial year ACA? Half year overseas
Old 05-04-2022, 02:38 PM   #1
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Partial year ACA? Half year overseas

I was wondering if anyone under age 65 has a situation where they were splitting their time between the US and another country and therefore only needed to pay for health insurance for, say, 6 months.

We are looking to retire soon and wanted to model the cost of health care if we went down the ACA routeÖbut only 6-9 months of the year.

We have dual citizenship and can get free healthcare for the 6 months outside the US.

Not sure how we would get ACA coverage for only part of the year, or if that is even possible. Perhaps instead we go to another health care provider (not thru ACA) for the 6 months?

Thanks
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Old 05-04-2022, 03:21 PM   #2
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Moving into the US from another country is a valid basis to qualify for a Special Enrollment Period for ACA plans.

https://www.healthcare.gov/coverage-...llment-period/

You may be able to do what you are asking. You may need to prove you actually established residency in both locations.

I’m not sure about the impact on any ACA subsidies.
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Old 05-04-2022, 03:38 PM   #3
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Kind of curious what your second country your passport is. The UK doesn't grant NHS based on citizenship. It is based on being "ordinarily resident". I read a Jamaican woman who worked in England for decades and had citizenship thought that would grant her free NHS. She retired to Jamaica , got cancer, flew back for treatment. They billed her for everything. Treated her like a visitor.

As far as the ACA I would think it would be treated like a move and open up a Special Enrollment Period.
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Old 05-04-2022, 03:47 PM   #4
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Kind of curious what your second country your passport is. The UK doesn't grant NHS based on citizenship. It is based on being "ordinarily resident". I read a Jamaican woman who worked in England for decades and had citizenship thought that would grant her free NHS. She retired to Jamaica , got cancer, flew back for treatment. They billed her for everything. Treated her like a visitor.

As far as the ACA I would think it would be treated like a move and open up a Special Enrollment Period.
To be eligible for the NHS you have to have the right to permanently live in the UK and also be a tax resident.

When we decided to split our time 50/50 in the UK and USA we rented a house in the UK then claimed UK tax residency the day we arrived and registered with the NHS that first week.

We had US health insurance through my ex employer and continued to pay. We made no attempt to stop paying for the months we were in the UK.
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Old 05-04-2022, 03:58 PM   #5
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To be eligible for the NHS you have to have the right to permanently live in the UK and also be a tax resident.

When we decided to split our time 50/50 in the UK and USA we rented a house in the UK then claimed UK tax residency the day we arrived and registered with the NHS that first week.

We had US health insurance through my ex employer and continued to pay. We made no attempt to stop paying for the months we were in the UK.
"Ordinary Residence means, broadly, living in the UK on a lawful, voluntary and properly settled basis for the time being."

Since your purpose is "settled" for the time being you are covered. Someone who just takes a flight in and visits doesn't show being settled and isn't covered. Take a flight in and get a lease or occupy a house you own shows a settled purpose and gets covered from day one.
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Old 05-04-2022, 04:08 PM   #6
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Originally Posted by Retireby45ish View Post
I was wondering if anyone under age 65 has a situation where they were splitting their time between the US and another country and therefore only needed to pay for health insurance for, say, 6 months.

We are looking to retire soon and wanted to model the cost of health care if we went down the ACA routeÖbut only 6-9 months of the year.

We have dual citizenship and can get free healthcare for the 6 months outside the US.

Not sure how we would get ACA coverage for only part of the year, or if that is even possible. Perhaps instead we go to another health care provider (not thru ACA) for the 6 months?

Thanks
If the US residency period begins Jan 1 this can work easily. Annual open enrollment gives you the opportunity to enroll, use, then cancel when you leave the US.

If the intended US residence dates are later in the year you might consider consulting with an insurance agent. As Paunchy Pirate pointed out, you need to requalify each year for special enrollment, and an agent will be helpful. No cost to you, they collect their fees from the insurer.
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Old 05-04-2022, 04:20 PM   #7
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Originally Posted by jim584672 View Post
"Ordinary Residence means, broadly, living in the UK on a lawful, voluntary and properly settled basis for the time being."

Since your purpose is "settled" for the time being you are covered. Someone who just takes a flight in and visits doesn't show being settled and isn't covered. Take a flight in and get a lease or occupy a house you own shows a settled purpose and gets covered from day one.
I agree. Being resident, ordinary or otherwise, means you pay taxes. We used to make extensive visits to the UK after we retired in rented houses and were very careful not to become ordinarily resident. We used our US health insurance for healthcare during those extended stays.

https://www.gov.uk/tax-foreign-income/residence
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Old 05-04-2022, 04:32 PM   #8
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I agree. Being resident, ordinary or otherwise, means you pay taxes. We used to make extensive visits to the UK after we retired in rented houses and were very careful not to become ordinarily resident. We used our US health insurance for healthcare during those extended stays.

https://www.gov.uk/tax-foreign-income/residence
Taxes residency and NHS ordinary residency are two distinct things. One is defined in tax law, the other is defined in case law. "Right to reside" is also part of "ordinarily resident".

https://en.wikipedia.org/wiki/Ordina...esident_status
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Old 05-04-2022, 04:40 PM   #9
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Taxes residency and NHS ordinary residency are two distinct things. One is defined in tax law, the other is defined in case law. "Right to reside" is also part of "ordinarily resident".

https://en.wikipedia.org/wiki/Ordina...esident_status
Fair enough. It will be a tricky line to walk to get free NHS treatment by being ordinarily resident and not pay taxes. I must admit that the first time I went to our local hospital (2017) I had to bring my passport (my proof to be allowed to reside) and a utility bill as proof of residence but I didnít have to prove I was a tax payer.
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Old 05-04-2022, 04:45 PM   #10
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Fair enough. It will be a tricky line to walk to get free NHS treatment by being ordinarily resident and not pay taxes. I must admit that the first time I went to our local hospital (2017) I had to bring my passport (my proof to be allowed to reside) and a utility bill as proof of residence but I didn’t have to prove I was a tax payer.
On a side note, to get benefits one has to be "habitually resident", even British citizens. That means three months of residency. NHS is not considered "benefits".

Taxes paid actually has nothing to do with an NHS entitlement. Neither does citizenship.
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Old 05-04-2022, 06:03 PM   #11
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Originally Posted by Retireby45ish View Post
I was wondering if anyone under age 65 has a situation where they were splitting their time between the US and another country and therefore only needed to pay for health insurance for, say, 6 months.

We are looking to retire soon and wanted to model the cost of health care if we went down the ACA route…but only 6-9 months of the year.

We have dual citizenship and can get free healthcare for the 6 months outside the US.

Not sure how we would get ACA coverage for only part of the year, or if that is even possible. Perhaps instead we go to another health care provider (not thru ACA) for the 6 months?

Thanks
You can get ACA for only part of the year, because moving (either into or out of, or even within) the US will generally get you a special enrollment period and allow you to add or drop coverage appropriately.

ACA coverage is on month boundaries, and you have to start the paperwork the month before in order for it to go into effect.

The subsidies (APTC) would be paid monthly, and reconciled on your tax return just like a full year situation. The only difference is that you would have some rows on your 8962 that would be zero'ed out.

So basically it works (assuming you meet the qualifications to be an applicable taxpayer, which is generally being here legally and having the appropriate income level - see the instructions for Form 8962 for all the gory details) and is all pro-rated on a monthly basis.

ETA: Of course, there is the paperwork and billing hassles of signing up and switching back and forth. And if you're transits don't coincide with the first of a month you'll either have to overlap coverage or risk a short gap. Finally, your annual deductibles and OOP max will reset every time you start US ACA insurance.
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Old 05-04-2022, 07:49 PM   #12
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Itís an EU citizenship. I donít believe I need to prove residency or anything as long as Iím a citizen in that country.

Of course Iím also a US citizen.

I might ask on an expat board or something. But I know people who I believe do this 50/50 split and are covered. They are over 65 and so covered under Medicare so no ACA issue.
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Old 05-05-2022, 04:11 AM   #13
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What EU country is this?
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