Does Foreign insurance Count as Minimum Essential Coverage?
A US citizen that resides 3/4 of the year in France and has an insurance policy with travelers insurance through the French system. How do I determine if the policy meets the minimum essential coverage?
You don't need Minimum Essential Coverage unless you are filing a tax return in the US. There are two criteria that qualify you as having minimal essential coverage (even if you choose to be uninsured) if you are filing in the US, but primarily live abroad:
- If you spend at least 330 days outside the country, you are exempt. This is called the Physical Presence Test (PPT)
- If you are considered a bona fide resident in a foreign country for the entire tax year, you are exempt. Many dual citizens who primarily live abroad will be able to or already have established residency in a foreign country. This is called the Bona Fide Resident Test (BFR)
Certain foreign insurance counts as minimum essential coverage if it meets certain criteria.
A self-insured group health plan (like from an employer) is considered minimal essential coverage for the months you are living abroad no matter where the plan is located, so long as it is regulated by the foreign government. It is also considered minimal essential coverage for the months you are in the US if it provides health benefits to you when you are within the US. However, the insurance plan's sponsors or government agency must apply for recognition from Health and Human Services, and that means the insurer should know if they are recognized.
As of September 2016 a number of foreign insurers have been approved:
- Swiss National Health Insurance System
- Bermuda - WellAway Limited
- Canada - Aetna Life Insurance Company (Canadian Branch)
- Guernsey - Cigna Global Insurance Company Limited
- Belgium (Switzerland and Singapore) - Cigna Europe Insurance Company S.A. - N.V.
- Belgium - Life Insurance Company of Europe S.A. - N.V.
- Hong Kong - Worldwide Life Insurance Company Limited
Foreign nationals who live in the United States for a short enough period and usually do not become resident aliens for federal income tax purposes. They are not subject to the individual shared responsibility payment even though they may have to file a U.S. income tax return.
You only owe the fee for months you didn't have coverage but were required to based on the criteria above. However, there are additional options:
- You may also be exempt due to income.
- There is also a three-month coverage gap exemption for up to 3 months in a row without coverage.
- You can also consider applying for a Hardship exemption or Special Enrollment period because of moving so you can get covered through the Marketplace when you'll be in the US.
- Consider Catastrophic insurance if you qualify for a Hardship exemption or are under 30. Especially if you are not planning to be located within a specific coverage network for any length of time, but you still want coverage for emergency and urgent care. Plans must cover emergency care out of network. You also get preventative care before the deductible, so you'll want to consider getting a plan whose network includes your primary care provider or one whose network is near the family or friends you would depend on in a Catastrophic health situation.
Generally, travelers insurance won't count as the minimum essential coverage.
If you have foreign coverage that counts as minimum essential coverage, you probably won't be eligible for cost assistance on Marketplace plans.
On that same note, if you are required to get coverage, but don't have access to the minimum essential coverage, you can use the Marketplace and be eligible for cost assistance.
Feel free to call HealthCare.Gov for more information:
Call to start or finish an application, compare plans, enroll or ask a question.
Available 24 hours a day, 7 days a week. Closed Memorial Day, July 4th, and Labor Day.
You can also see the IRS Q&A on the mandate for more information.
You can also find more information on minimum essential coverage in Publication 974 Premium Tax Credit (PTC)
I have a client with a SMLLC , she is covered by her husband foreign insurance because he works for a foreign government.
Does this qualifies for the minimum essential coverage.
Look on form 8965, for the ways foreign insurance can count. I haven’t been 100% clear on how to sum up the rules on this.
Check out these sources:
Interesting and informative. My case is again similar but different.
I am a dual nationality citizen (NL and US), currently living in the US. Once I retire, I plan to live and travel most of the year (summer and autumn) on a sailboat through Europe (EU), moving from country to country for a number of years.
Those years I will not officially live in any EU country and continue to file US federal taxes. In the winter period, I plan to visit family and friends in the US for periods likely exceeding three months each year.
Dutch law allows me (as a Dutch citizen) to buy for Dutch health insurance, while traveling in Europe but without officially living in the Netherlands. This Dutch health insurance also covers medical costs worldwide while on vacation abroad, including in the US. It even covers medical needed repatriation to the Netherlands. Hence there would be no reason to have additional medical insurance in the US. In the base case I would not even sign up for (US) Medicare.
My US taxable income will be above the minimum filing requirements and there will be no foreign earned income exclusion, since I will not file foreign taxes.
Although I will neither have a US residence nor a US address, I will not meet the requirement of being a “bona fide foreign resident”, since while traveling on a boat from country to country, I will not live in a particular EU country or pay income tax in any particular EU country. In addition while staying over three months in the US over the winter I will not meet the 330 day minimum requirement for being abroad. Based on these rules I would not meet the work-around requirement for the Minimum Essential health Coverage (MEC).
Health insurance is expensive enough everywhere and I don’t want to pay it in two countries. Since Medicare does not cover medical expenses in Europe and will be there more than half the year, I do need medical insurance there.
The only way out appears to show that the Dutch insurance plan(s) meet the MEC requirements.
I read the requirements needed to qualify for the Minimum Essential health Coverage (MEC). I did not go through them with a fine comb, but the minimum required coverage standards in the Netherlands for the standard comprehensive health insurance are more comprehensive than for most US plans meeting MEC, while they cover urgent medical expenses while on vacation abroad, including the USA. Based on this I would expect the standard Dutch government approved medical insurance plans to meet the MEC standards.
What do I have to do to get such a foreign health insurance plan recognized to meet MEC standards?
If I bought a foreign plan as part of an association that covers me worldwide due to continuod travel, how do I know if my flan is compatible with the Obama care act?
The best way to find out if a foreign insurance is considered minimal essential coverage under the Affordable Care Act is to ask the insurer. As mentioned in the answer above, generally foreign employer or group plans are considered minimal essential coverage as long as it is regulated by a government agency. However, the insurer or the regulatory agency would have to apply for recognition. I’ve added this link to the answer above and it the list insurances that have been approved as of September 2016 and includes coverage from other countries.