A Complete Guide to H1B Visa Holders’ Health Insurance

Updated: November 9, 2022
Health insurance for h1b visa holders
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Whether or not you are an immigrant, having sufficient insurance coverage is a requirement. But what particular applies to health insurance for H1B visa holders and health insurance? Do you require health insurance if you have an H1B visa or not? What does the law say about this, most importantly? In the following paragraphs, we’ll try to answer some frequently asked questions.

 

Do H1B visa holders in the US require health insurance?

Yes, it should go without saying that it is required to have health insurance in the US. In essence, the US healthcare system isn’t free; it’s pretty expensive. Due to this, you will probably pay a high price if your health insurance coverage lapses or you go without any coverage at all.

 

One such example is that many US firms stipulate a minimum amount of time workers must work to be eligible for health insurance. You should obtain a suitable health insurance plan for that time if such a situation arises.

Alternatively, there are instances where small business owners choose not to offer health insurance as a benefit. In this situation, you must compare various health insurance plans and pick the one that best suits your requirements. You can purchase an insurance plan through the US healthcare exchange if you have an H1B visa.

 

What is covered under H1B health insurance?

Long-term or domestic health insurance policies typically cover a more comprehensive range of services, including pre-existing conditions, childbirth, hospitalization, emergency treatment, and doctor visits.

The Essential Health Benefits (EHB) under Obamacare must be covered by health insurance policies obtained via employers or the Health Insurance Marketplace.

There are ten types of essential health benefits (EHBs) that each eligible health plan must provide:

  1. Hospitalization
  2. Non-hospital care
  3. Emergency assistance
  4. Newborn and maternity care
  5. Services for mental health
  6. Prescription medication
  7. Testing services
  8. Management of chronic diseases and preventive care,
  9. Children’s pediatric services, including dental and eye care
  10. Services for rehabilitation and habilitation

Contrarily, pre-existing diseases and maternity coverage are not covered by short-term or temporary health insurance.

 

What is H1B health insurance?

The price of a health insurance plan for an H1B visa depends on a number of factors, including:

  • The H1B visa holder’s age: The older the H-B visa holder, the more expensive their medical insurance will be.
  • The highest level of medical insurance selected: The larger the quantity of coverage, the more expensive the premium.
  • The deductible you’ve selected: A “deductible” is the sum of medical costs paid by the client before the start of any insurance coverage. The deductible is lower the higher the premium.
  • The coinsurance plan: The portion of medical expenses the customer is liable for after the deductible has been met is referred to as “coinsurance.” This is crucial for comprehensive strategies and often represents an 80/20 or 90/10 split.
  • Medical history: Your insurance underwriter may raise your rate if you have any pre-existing medical conditions.

 

What kinds of health insurance network plans are available to H1B visa holders?

Before choosing a medical insurance plan, you should be familiar with the following four fundamental types of health insurance network plans:

 

Organizations that provide health maintenance (HMOs)

HMOs typically offer you a local network of participating medical professionals from which to choose, including hospitals, clinics, and other care facilities.

Additionally, you must select a primary care physician (PCP) from the network under these insurance plans. Your PCP serves as the hub of your medical treatment. They get to know you and help organize your medical care. They must also suggest a specialist who is part of their network.

As long as you adhere to the network, an HMO plan’s copays and coinsurance are typically lower than other health insurance types.

 

Organizations that provide only one service (EPOs)

You can choose from a network of suppliers with an EPO. Except in cases of emergency, the majority of EPO plans do not provide out-of-network coverage.

This suggests that you will be liable for paying the full cost of services yourself if you visit a provider or facility outside the plan’s service area.

Depending on the plan you select, you may or may not be required to select a PCP (primary care physician). You don’t need a PCP recommendation to consult a specialist in your network.

 

Point of service strategy (POS)

HMO and PPO insurance plans are combined in point-of-service plans. Similar to an HMO, the provider network is typically narrower than that of a PPO plan, and in-network care expenses are frequently less expensive.

Additionally, you are required to choose a primary care physician from the specialists in the network of the plan. You’ll receive most of your medical care and guidance from your PCP. They get to know you and your medical needs so they can meet all of your requirements after getting to know you.

If you want to consult a specialist, you must get a recommendation. You may choose to see specialists who are in-network or out-of-network, just like with a PPO. Your part of the expenditures will be higher, and you’ll be in charge of filing any claims if you go to a doctor who isn’t in the plan’s network.

 

Preferred provider organizations (PPOs)

Compared to HMOs, PPOs offer a wider selection of participating healthcare providers. If you register for a PPO, you can choose from a wide range of physicians, hospitals, and other medical institutions.

However, be prepared to pay more out of pocket if you decide to travel beyond the plan’s network.

With these plans, you can visit specialists without a referral and are not required to select a primary care physician (PCP).

 

What kind of health insurance policy is ideal for those with H1B visas?

It depends on your healthcare demands, financial situation, and present medical requirements.

In order to get the best healthcare plan for you and your family, consider what kind of medical insurance is appropriate for you by evaluating your medical needs, your need for prescription drugs, and your financial situation.

If you’re in good health and rarely see the doctor, high-deductible health plans with lower premiums can save you money. If you expect or want more than just preventative care, you should also consider lower deductible and coinsurance rates.

An HMO or EPO may be the best option for you if you are healthy, have a low deductible, and cannot afford any out-of-pocket expenses.

If you require a comprehensive policy, an HMO or PPO plan with a POS option would be the best option. This will allow you to leave the network without incurring significant out-of-network expenses. You can also include other perks like coverage for your dental and eye needs.

 

Long-term domestic insurance is different from visitor insurance.

Every nation has a different health insurance law. You can pick between visitor insurance and long-term domestic insurance in the US, for instance, if you are a non-US citizen and holder of an H1B visa.

In essence, the length of your stay will be crucial for this decision. Therefore, visitor insurance, also known as short-term insurance, is designed for brief periods of time. In other words, it doesn’t offer as comprehensive of a range of benefits as domestic health insurance in the US would.

It also means that it doesn’t address PCPIA or ObamaCare regulations because it is intended for transient visitors.

The temporary nature of visitor insurance is one way the two vary. It offers protection for a brief window of time between 5 and 3 days. However, domestic health insurance plans enable coverage from one month to 65 years.

Additionally, visitor insurance is less expensive than domestic insurance policies. The majority of domestic policies don’t cover foreign travel, but visitor health insurance does.

 

Temporary or Short-Term Visit Insurance

In general, it makes sense for H1B visa holders to purchase temporary or visitor insurance when it comes to health coverage. If you want peace of mind in the event of an emergency, it is wise to invest in short-term health insurance.

In addition, having insurance will be useful when traveling abroad. Furthermore, it will be helpful when you are still adjusting to life in the US.

 

Insurance for Extended Stay

However, if you intend to spend enough time in the US, it may make more sense to invest in a domestic insurance policy covering a longer duration of stay. Before doing this, you might wish to bring up the subject with your employer.

Basically, you’re looking to check if your employer offers health benefits. The business should also say whether or not you are eligible for it in your job.

It may be smart to purchase individual health insurance coverage if your employer does not offer health benefits. Whether you want to complete this through a private health insurance business, a resident state market, or online, you have a choice.

 

Required H1B Health Insurance

You need to familiarize yourself with the rules that apply in this case when it comes to health insurance for H1B visa holders. The truth is that the healthcare laws may be unclear to non-citizens; in fact, they may also be unclear to citizens of the United States. ObamaCare’s passage has altered the US healthcare system to that end.

In essence, the law mandates that both US citizens and legal permanent residents obtain health insurance that complies with the ACA. A fine will be imposed on the opposing party when filing the tax return.

Health insurance requirements for H1B visa holders vary depending on whether or not you are a US citizen or a resident alien. Despite the fact that you are a non-resident immigrant, you are not compelled to continue your ACA coverage. However, once you are granted the status of a resident alien, you must adhere to the same ACA rules as any other US citizen or lawful permanent resident. However, in order to better grasp what is required of you, let’s take a closer look at these two distinct scenarios.

 

Status of Non-Resident Alien

Therefore, there are two main ways to obtain an H2 visa. First, non-US citizens are studying in the US. They must take part in OPT. After that, they might decide to request an H1B sponsorship from a company. The second situation involves non-US citizens who have just entered the country on an H1B visa.

Both scenarios involve a time when your H1B visa is just being started, during which you will still be considered a non-resident alien. You won’t be subject to the ACA throughout this time. Six to ten months may pass throughout this.

Your arrival in the US and the precise moment you effectively lost your status as a student will determine when you change from a non-resident alien to a resident alien. If you are unsure, you can always do this test to figure it out.

In essence, as we previously indicated, you must choose short-term insurance coverage if you are a non-resident immigrant. This will take care of your needs until you become eligible for ACA insurance. Concurrently, until your company provides alternative coverage, this insurance plan will be useful.

 

Status of Resident Alien

Moving on to the resident alien status, we can see that there are certain differences. As soon as you achieve this status, the ACA applies to you. So, in accordance with the law, you are obligated to have an acceptable insurance plan, just like any other US citizen or resident.

There are two options available for insurance plans that comply with the ACA. First, there is the option of insurance provided by the workplace. The second option would be to obtain insurance through state and federal taxes.

The third choice is actually not covered under the ACA. In essence, you buy a short-term plan while you wait for the insurance plan for your company to apply, but this will result in a fee when you file your taxes. Let’s take a deeper look at each of these three options.

 

Employer-provided Health Insurance is Available.

The reality is that this isn’t always an option, so to speak, for H1B visa holders in terms of health insurance. But it’s reasonable to say that obtaining insurance via your job is an effective strategy to guarantee that you abide by the ACA standards.

On a side subject, certain US businesses offer suitable insurance coverage to their staff, including H1B visa holders. You should cover a few important points with your employer when you talk about this subject. You should first learn what your share will be and what your employer will provide.

You should also talk about the waiting period or the amount of time you have to wait until the plan takes effect. It is advised to purchase short-term coverage while you wait.

Additionally, the issue of ACA compliance needs to be addressed. The fees of the coverage, as well as out-of-pocket expenses, are other concerns. Your company ought to give you a summary of the plan, ideally.

 

Purchase a Policy on the Marketplace for Insurance

You can always purchase an insurance plan on the Marketplace, which is actually the website HealthCare.gov, if your job doesn’t offer insurance or if the cost is very high for you as a resident alien. This enables you to look through many insurance plans and select the one best suits your requirements.

HealthCare.gov makes it simple to find what you need in the same manner that you can browse on Stilt to find the best financing for buying gold jewelry or any other acquisition you could have in mind. The ACA policies, on the other hand, are simple to purchase during the open enrollment period.

Getting a short-term strategy might be an alternative to think about if you are outside of this window.

 

Get a Short-Term Insurance Plan and File Your Taxes Late to Avoid a Fine

Even though it’s not the best option, some people go with it to save money. However, the obvious drawback is that you will incur a fine. This cost was set in 2015 at 2 percent of the household’s yearly income, or $325 per person, per year.

However, keep in mind that these prices will probably rise yearly. Basically, you might choose this option if your employer doesn’t offer health insurance benefits, the market is closed, or there is a short waiting period before your employer’s coverage plan takes effect.

 

Conclusion

Since the system is different from most other nations, it might be time-consuming and challenging to comprehend the subject of health insurance for H1B visa holders. However, because healthcare in the US is so expensive, it is crucial not to undervalue the significance of insurance, as we have attempted to explain. The likelihood that you couldn’t afford medical care if you ever needed it is, therefore, high. For this reason, you ought to buy insurance.

Make sure you don’t ignore this aspect whether you are an overseas student, a worker in the US, or you are thinking about visiting your parents.

FAQs

Can foreigners obtain health insurance in the USA?

Can a visitor to the USA obtain health insurance? Yes, tourists can and should get visitor health insurance in the United States. Traveling to the US without the finest health insurance for foreigners is unsafe due to the high expense of healthcare there.

 

How much time can you spend away from us on h1?

As a result, even after six years have passed from your H-1B-related entry, you will still have 120 days remaining to continue living and working there. Your H-1B maximum permitted time has been increased by 120 days.

 

h1b1 spouse employment possible?

If their spouse’s H1B visa is still in effect, spouses of H-1B visa holders can work or launch a business in the US. H-4 visa holders must first apply for an employment authorization document (EAD) that will allow them to work in the US before they may start a paid job.

 

What occurs if a visitor to the USA becomes ill?

Contact the closest US Embassy or Consulate for a directory of regional healthcare organizations and hospitals. Consular officials can aid you in finding medical care if your condition is critical, and they can also notify your loved ones if you so choose.

 

How many H1 are B visa lotteries there each year?

A total of 85,000 visas are awarded each year, with 20,000 going to people who earned their master’s or doctoral degrees at US universities.

 

Visit our website NewHealthInsurance.com to learn more.

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