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Author Topic: Potentially moving to Florida  (Read 486 times)

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Offline Delby

  • Member
  • Posts: 118
Potentially moving to Florida
« on: August 18, 2014, 10:54:33 AM »
Hi All,

I currently live in the UK and my wife and I are currently debating whether to move to Florida and emigrate for good. We don't have a green card, but we would need to purchase a small business and stay on a working visa (3 yrs) until we can qualify for a green card.

In the UK we are extremely fortunate to receive care and medication via the National Health Service (NHS) for free. I don't pay for any doctor appointments, tests etc unless I want to see a consultant privately.

I'm sorry, but I don't know how it works in the US or Florida. Would I have to pay for my medication? If so what would be average monthly costs? Would insurance cover it, even if I have a preexisting illness (HIV). Sorry for all the questions, but we need to calculate whether this is economically feasible. And how would it work if we aren't even classed as Citizens, but migrants on a working visa.

We'd love to move but we need to understand how it works.

Many Thanks

Delby  :)

Offline Since1993

  • Member
  • Posts: 108
Re: Potentially moving to Florida
« Reply #1 on: August 18, 2014, 02:17:55 PM »
Hi All,

I currently live in the UK and my wife and I are currently debating whether to move to Florida and emigrate for good. We don't have a green card, but we would need to purchase a small business and stay on a working visa (3 yrs) until we can qualify for a green card.

In the UK we are extremely fortunate to receive care and medication via the National Health Service (NHS) for free. I don't pay for any doctor appointments, tests etc unless I want to see a consultant privately.

I'm sorry, but I don't know how it works in the US or Florida. Would I have to pay for my medication? If so what would be average monthly costs? Would insurance cover it, even if I have a preexisting illness (HIV). Sorry for all the questions, but we need to calculate whether this is economically feasible. And how would it work if we aren't even classed as Citizens, but migrants on a working visa.

We'd love to move but we need to understand how it works.

Many Thanks

Delby  :)

Hi, Delby,

As a "lawfully present" immigrant in the US (work visa to green card included), you are eligible to purchase an Affordable Care Act (ACA) Medical Insurance Plan, regardless of HIV-status:

https://www.healthcare.gov/

http://www.nilc.org/immigrantshcr.html

When applying for an ACA plan, if your income falls within 400% of the Federal Poverty Level (FPL)(Determined during the application process) and you are "lawfully present", you would be eligible for Advance Premium Tax Credits (APTC) which would help pay for your insurance premiums.  If your income falls within 250% of the FPL (Determined during the application process), you would also be eligible for Cost Sharing Reduction (CSR) which provides reduced insurance co-pay, annual deductible and maximum annual out-of-pocket associated with your insurance health plan.

Because you are HIV+, you are eligible to receive additional assistance in paying your health insurance premiums and medication co-pays associated with HIV medications from Florida's Ryan White Part B/AIDS Drug Assistance Program (ADAP):

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/aicp1.html

This assistance will essentially pay for any remainder of insurance premium and cost of HIV-related medications (as long as the prescribed HIV medication is listed on the states ADAP formulary):

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/ADAP-formulary.html ) up to $750/month.

Eligibility Requirements for Ryan White Part B/ADAP in Florida:

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/adap-enrollment.html

Contact information for Florida Ryan White Part B/ADAP Program:

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/ADAP-contact-us.html

Ryan White Part B/ADAP state programs essentially pay for remaining insurance premiums and any medication co-pay associated with HIV-related medications to heavily reduce and/or eliminate the cost of outpatient HIV services for those living with HIV/AIDS in the United States.


Offline Delby

  • Member
  • Posts: 118
Re: Potentially moving to Florida
« Reply #2 on: August 19, 2014, 08:48:44 AM »
Hi, Delby,

As a "lawfully present" immigrant in the US (work visa to green card included), you are eligible to purchase an Affordable Care Act (ACA) Medical Insurance Plan, regardless of HIV-status:

https://www.healthcare.gov/

http://www.nilc.org/immigrantshcr.html

When applying for an ACA plan, if your income falls within 400% of the Federal Poverty Level (FPL)(Determined during the application process) and you are "lawfully present", you would be eligible for Advance Premium Tax Credits (APTC) which would help pay for your insurance premiums.  If your income falls within 250% of the FPL (Determined during the application process), you would also be eligible for Cost Sharing Reduction (CSR) which provides reduced insurance co-pay, annual deductible and maximum annual out-of-pocket associated with your insurance health plan.

Because you are HIV+, you are eligible to receive additional assistance in paying your health insurance premiums and medication co-pays associated with HIV medications from Florida's Ryan White Part B/AIDS Drug Assistance Program (ADAP):

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/aicp1.html

This assistance will essentially pay for any remainder of insurance premium and cost of HIV-related medications (as long as the prescribed HIV medication is listed on the states ADAP formulary):

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/ADAP-formulary.html ) up to $750/month.

Eligibility Requirements for Ryan White Part B/ADAP in Florida:

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/adap-enrollment.html

Contact information for Florida Ryan White Part B/ADAP Program:

http://www.floridahealth.gov/diseases-and-conditions/aids/adap/ADAP-contact-us.html

Ryan White Part B/ADAP state programs essentially pay for remaining insurance premiums and any medication co-pay associated with HIV-related medications to heavily reduce and/or eliminate the cost of outpatient HIV services for those living with HIV/AIDS in the United States.

Thank you for coming back to me. It all seems so complicated (as i'm sure it actually is!). But from what you've written, it would seem that actually most of the costs for treatment (medication) and outpatient appointments, bloods etc are all covered in the most part?

Many Thanks

Delby

Offline Since1993

  • Member
  • Posts: 108
Re: Potentially moving to Florida
« Reply #3 on: August 19, 2014, 02:10:24 PM »
Thank you for coming back to me. It all seems so complicated (as i'm sure it actually is!). But from what you've written, it would seem that actually most of the costs for treatment (medication) and outpatient appointments, bloods etc are all covered in the most part?

Many Thanks

Delby

All assistance is means-tested so the amount of assistance is based upon your income.  Let's once again recap:

1.  Advanced Premium Tax Credits (APTC)  if your household income falls between 100-400% of the Federal Poverty Level (FPL), you are eligible for assistance helping to pay monthly Affordable Care Act (ACA) insurance premiums.  For a household of two, your income would have to fall between $15,730 - $62,920 USD to receive this credit.  The more you make, the less assistance you receive as a rule.

2.  Cost-Sharing Reductions (CSR)  if your household income doesn't exceed 250% of the FPL, you are eligible for assistance for your ACA health plan which reduces the amount of co-pays, annual deductible and maximum out-of-pocket expenses you might incur.  For a household of two, your income couldn't exceed $39,325 USD to receive this assistance.

3.  Ryan White Care Act Part B/AIDS Drug Assistance Program (ADAP) Every individual state administers their own programs.   Each state has varied levels of income eligibility requirements, ranging anywhere from 100% to 400% of FPL.  In Florida, for a household of two, your income cannot exceed 400% of the FPL, $62,920 USD for ADAP assistance (medications).  In order to receive Ryan White Part B assistance which would pay the remainder of your insurance premiums, each state typically has asset limits by which you can't exceed.  This can range anywhere between $2000 - $4000 USD.

4.  There are also patient co-pay assistance programs offered by the individual drug manufacturers which help those who fall outside of Ryan White/ADAP income requirements.


Offline Delby

  • Member
  • Posts: 118
Re: Potentially moving to Florida
« Reply #4 on: August 21, 2014, 06:33:01 AM »
All assistance is means-tested so the amount of assistance is based upon your income.  Let's once again recap:

1.  Advanced Premium Tax Credits (APTC)  if your household income falls between 100-400% of the Federal Poverty Level (FPL), you are eligible for assistance helping to pay monthly Affordable Care Act (ACA) insurance premiums.  For a household of two, your income would have to fall between $15,730 - $62,920 USD to receive this credit.  The more you make, the less assistance you receive as a rule.

2.  Cost-Sharing Reductions (CSR)  if your household income doesn't exceed 250% of the FPL, you are eligible for assistance for your ACA health plan which reduces the amount of co-pays, annual deductible and maximum out-of-pocket expenses you might incur.  For a household of two, your income couldn't exceed $39,325 USD to receive this assistance.

3.  Ryan White Care Act Part B/AIDS Drug Assistance Program (ADAP) Every individual state administers their own programs.   Each state has varied levels of income eligibility requirements, ranging anywhere from 100% to 400% of FPL.  In Florida, for a household of two, your income cannot exceed 400% of the FPL, $62,920 USD for ADAP assistance (medications).  In order to receive Ryan White Part B assistance which would pay the remainder of your insurance premiums, each state typically has asset limits by which you can't exceed.  This can range anywhere between $2000 - $4000 USD.

4.  There are also patient co-pay assistance programs offered by the individual drug manufacturers which help those who fall outside of Ryan White/ADAP income requirements.

Thanks Since1993

You are certainly extremely knowledgeable about this subject. I would like to thank you for all your help and time explaining this to me.

I understand - the level of cover one receives is based on ones income. If our combined income exceeds 400%  of the FPL and our assets exceed $4000 USD, is there a way to calculate approximately how much it is going to cost me (monthly or annually) for my medication?

Kind Regards

Delby

Offline JR Gabbard

  • Moderator
  • Member
  • Posts: 258
  • Union Jacks
Re: Potentially moving to Florida
« Reply #5 on: August 21, 2014, 11:11:47 AM »

I understand - the level of cover one receives is based on ones income. If our combined income exceeds 400%  of the FPL and our assets exceed $4000 USD, is there a way to calculate approximately how much it is going to cost me (monthly or annually) for my medication?

Kind Regards

Delby
Hi Delby!
I think you've gotten the wrong end of the stick.
What Since1993 has been posting is information about subsidies to defray the cost of your insurance premiums and co-pays.
American health insurance works like this:  Health insurance is a contract between you and an insurance company.  You pay a monthly premium to the insurance company, and in exchange they cover the cost of office visits, lab tests, medications, surgeries and hospitalizations.
Your costs will be based on the plan you chose.  There are 3 categories of costs; the monthly premium, co-pays, and a deductible.  Premiums are self-explanatory, co-pays are a payment you must make when you access a service (generally $20-$30 per instance), and the deductible is the amount of money you must pay (or someone else pays on your behalf--enter the above-mentioned subsidies) before the insurance company is responsible for all charges presented (no more co-pays!).  In general, higher monthly premiums means lower out-of-pocket expenses.  You'll have to weigh those factors to decide which plan works best for you.  But you should be able to get a good enough idea of your medical expenses to make a budget.
A couple other issues.  Since you plan to open a small-business, you will be able to purchase a small-business plan that might offer a more savings, and would be a good idea to have if you plan to employ anyone (outside the family).  Also, as a small-business owner, I guess you'll want to aim for an income higher than 400% of poverty level.  So by all means explore any option available, but don't get too bogged down on subsidies.  You most likely won't be eligible.
So you know, I'm an American barrister!  PM me if you have a more specific concern.  Enjoy your new home!  The weather will certainly be an improvement.  Just know, when it rains in Florida, it's likely to be a hurricane!
Best of luck.
It goes like this
The fourth, the fifth,
The minor fall, the major lift,
The baffled king composing Hallelujah!

L. Cohen

Offline Delby

  • Member
  • Posts: 118
Re: Potentially moving to Florida
« Reply #6 on: August 26, 2014, 08:57:42 AM »
Hi Delby!
I think you've gotten the wrong end of the stick.
What Since1993 has been posting is information about subsidies to defray the cost of your insurance premiums and co-pays.
American health insurance works like this:  Health insurance is a contract between you and an insurance company.  You pay a monthly premium to the insurance company, and in exchange they cover the cost of office visits, lab tests, medications, surgeries and hospitalizations.
Your costs will be based on the plan you chose.  There are 3 categories of costs; the monthly premium, co-pays, and a deductible.  Premiums are self-explanatory, co-pays are a payment you must make when you access a service (generally $20-$30 per instance), and the deductible is the amount of money you must pay (or someone else pays on your behalf--enter the above-mentioned subsidies) before the insurance company is responsible for all charges presented (no more co-pays!).  In general, higher monthly premiums means lower out-of-pocket expenses.  You'll have to weigh those factors to decide which plan works best for you.  But you should be able to get a good enough idea of your medical expenses to make a budget.
A couple other issues.  Since you plan to open a small-business, you will be able to purchase a small-business plan that might offer a more savings, and would be a good idea to have if you plan to employ anyone (outside the family).  Also, as a small-business owner, I guess you'll want to aim for an income higher than 400% of poverty level.  So by all means explore any option available, but don't get too bogged down on subsidies.  You most likely won't be eligible.
So you know, I'm an American barrister!  PM me if you have a more specific concern.  Enjoy your new home!  The weather will certainly be an improvement.  Just know, when it rains in Florida, it's likely to be a hurricane!
Best of luck.

Thanks so much for all your help and advice. I may just be contacting you for advice in the near future once we're closer to moving. At the moment it's just an idea and something we'd like to follow through with. We'd like to move in the next couple of years.

Thanks again for all your help.

Delby

 


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