Even if you now know what the ACA stands for (Affordable Care Act), you still might be filled with questions about what it means for you as an international student. In today’s blog, we are going to explore the top questions international students have about the ACA.
1. What is the Affordable Care Act?
The Affordable Care Act is legislation that essentially overhauled the US health insurance and health care systems. It required US carriers to offer plans to US citizens/permanent residents that have “essential health benefits”. These benefits are often costly causing insurance under the ACA to soar as high as 25%. With the goal to insure every US citizen and permanent residents, the IRS institutes a tax penalty for those who do not have a plan that is ACA compliant.
2. How does the ACA impact international students?
If you are an international student in the US, chances are it won’t affect you at all. If you are an international student on a F1 or J1 visa and have been in the US for less than 5 calendar years, then you are exempt from the ACA and can choose any plan you’d like (as determined by you and your school). If you have been in the US for longer than 5 calendar years, then you’ll have to look at your taxes. If you are a non-resident alien for tax purposes, then you are exempt from the Affordable Care Act and it’s up to both you and your school to determine what insurance plan you will have. If you are a resident alien for tax purposes, you will be required to purchase an ACA compliant plan, otherwise you’ll be subject to the tax penalty.
3. What’s the difference between a non-ACA and ACA plan?
ACA plans are required to have “essential health benefits” which provides coverage for:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
- 100% Birth control coverage
- Breastfeeding coverage
In addition to these benefits, plan must offer unlimited coverage and cover pre-existing conditions from day 1. Because these plans on the exchanges are extremely comprehensive they tend to have high deductibles oftentimes starting at $1,000, and they also have a high price tag as well. Most international student plans are not ACA compliant so they will often have a maximum coverage (often ranging from $100,000 to $500,000), have a waiting period before pre-existing conditions are covered, and are designed to cover new accidents and illnesses that occur on the plan. They typically have low deductibles often ranging from $25 to $250, and also are low in cost (often less than $1,000).
4. Which plan is right for me?
For most international students, the need is quite simple: an affordable plan that covers accidents and illnesses that could happen while studying in the US. If you aren’t sure which option is better for you, you’ll want to consider:
- How much are you looking to spend on your insurance plan (premium)?
- How much can you afford to pay out of pocket when seeking care (deductible/coinsurance/copay)?
- Do you have a pre-existing condition that will require continuous care beyond the medications you bring from home?
Just looking at these questions will help narrow down your options as to whether an ACA or non-ACA compliant plan would be best suited for you.
5. Where can I get more information on the ACA?
If you have more questions on the ACA, please be sure to check out our article on the Impact of the ACA on international students as well as this article which talks more specifically on international students and the ACA. You can also go directly to the source and learn about how it affects you at Healthcare. gov.
If you are trying to decide on your options, it can be quite complicated. Be sure to contact our Customer Service Representatives with any questions you have, as we are always happy to help guide you so that you can make the best decision regarding your health insurance needs. You may also want to keep in mind that this could all change with the new Trump administration. As changes are made, we will of course keep you updated.