We take a look at the key concerns for expatriates seeking ACA-compliant health insurance coverage while residing in the USA.
What is the ACA (PPACA)?
On March 23, 2010, President Barack Obama signed the health care reform bill, also known as the Patient Protection & Affordable Care Act (PPACA or ACA), into law. The ACA has made sweeping changes to the U.S. health care system and how individuals receive access and coverage for medical care. Many of the ACA’s health care reforms are primarily focused on reducing the uninsured population and decreasing insurance and health care costs. The law consists a number of different provisions and mandates that affect US citizens or residents alike.
What is the Individual Mandate?
A key provision implemented under the ACA requires most individuals to obtain acceptable health insurance coverage or pay a penalty, beginning in 2014. The penalty will start at $95 per person for 2014 and increase each year. The penalty amount increases to $325 in 2015 and to $695 (or up to 2.5 percent of income) in 2016, up to a cap of the national average bronze plan premium. After 2016, dollar amounts are indexed. Families will pay half the penalty amount for children, up to a cap of $2,250 per family. Individuals may be eligible for an exemption from the penalty if they cannot obtain affordable coverage.
Does The ACA and Individual Mandate Effect Expats?
Yes. Foreign nationals and expatriates residing or moving to the US, whom maintain residency for 11 months or more, must abide by all provisions and mandates of the Affordable Care Act.
Please note that these provisions or mandates do not apply when seeking medical services in your country of origin or outside of the USA.
How do I avoid the penalties?
As mentioned above, the Individual Mandate will penalize those who DO NOT obtain acceptable health insurance coverage.
To avoid paying penalties, it is recommended that you purchase and maintain health insurance coverage that meets Minimum Essential Coverage (MEC) as determined by the Center of Medicare Services (CMS).
What is Minimum Essential Coverage?
Minimum Essential Coverage (MEC) is determined by CMS and the Department of Health & Human Services. It includes a set of standards and requirements to be meet by all plans sold to individuals residing in the USA.
In order for your coverage to be recognized as MEC, CMS must first determine approve that the insurance coverage be sold by the insurance company meets substantially all the requirements of the Affordable Care Act. The plan or coverage offered must comply with the following provisions
Prohibition on premium rating based on gender.
Prohibition on pre-existing condition exclusions.
Prohibition against discrimination based on health status; Genetic Information Nondiscrimination Act
Provision of essential health benefits
Prohibition against lifetime and annual limits
Prohibition against rescissions
Coverage of preventive health services
Extension of dependent coverage
Includes an Appeals Process
Includes Patient Protections
Adheres to the Newborns’ and Mothers’ Health Protection Act
Adheres to the Mental Health Parity and Addiction Equity Act; and
Adheres to the Women’s Health and Cancer Rights Act
WellAway is one of the first insurance companies to offer an expatriate health program that has been approved to meet Minimum Essential Coverage by CMS. Learn more here.
WellAway Now Offers ACA-Compliant Coverage for US-Bound Expats
For expats seeking ACA-compliant coverage, it is important you have a full understanding of the requirements your plan should meet. WellAway offers a variety of plans for foreign nationals coming to the USA that have already been approved to meet MEC and are fully ACA-compliant, meaning there is no need to worry about gaps in coverage or potential penalties. Those interested in learning more about our ACA-compliant expat plans should check out our latest programs below, now open for enrollment.