Can I Get Marketplace Coverage in the US Virgin Islands?
I currently live in the US Virgin Islands and I see there is no coverage option here however, I used to reside in NY and have a family address there. Can I qualify for coverage?
You can only use the Marketplace if you are a lawfully Permanent Resident or meet other immigration guidelines. The Virgin Islands doesn't offer Marketplace coverage, but you can find your options on CMS.Gov.
The rules for Puerto Rico, the U.S. Virgin Islands, American Samoa, Guam and the Northern Mariana Islands (which are considered territories and not states for the purposes of the ACA) have already changed more than once. Currently some benefits, rights, and protections apply while others don't. This is all subject to change, especially in light of the recent ruling on subsidies which downplayed the importance of the word "state".
For instance all residents of the territories are automatically exempt from the requirement to get coverage or pay a fee! All bona fide residents of the United States territories are treated by law as having minimum essential coverage. Individuals who qualify for this rule should file Form 8965, Health Coverage Exemptions, with their federal income tax returns.
Because insurers can deny preexisting conditions and all residents of territories are exempt from the mandate, it doesn't look like HealthCare.Gov or tax credits apply in the territories. That is the gist, but again this may change and other rights do apply in the territories.
CMS letter clarifying rules for US territories.
We will continue to update this page with the correct information. If anyone else has an update please post it below.
I also live in the Virgin Islands. When will MarketPlace be available here? If the Virgin Osland is a territory of the USA, why isn’t it available as soon as it was implemented?
We updated the answer to reflect this question. We don’t know if and when healthcare.gov or a Virgin Island specific marketplace would operate. The answer may be “never” considering the fact that the territories are exempt from a number of ACA related rules that all depend upon each other to function. That being said, the recent ruling on subsidies may shake things up a bit since it and the justification for the way the rules are in the territories both rely heavily on the usage of the word “state”.
I don’t see the sense in not making coverage available in the territories. after all they’re American citizens. I wonder what is the real justification for this
Still the question remains. If a US citizen of NY moves to USVI where ACA marketplace does not exist, can this person use their prior residence in NY to obtain ACA? And obtain the subsidy offered as if they lived in NY?
So if you move somewhere where there is no marketplace, you use the federal marketplace healthcare.gov or whatever the option is in your region. I can fully understand why you would want to keep your NY insurance or keep the subsidy when moving to USVI. But that isn’t how it works, unfortunately. The only way around this really would be to keep your primary residence in NY and then get a plan that had coverage somehow in USVI. I don’t think PPOs really even cover this though.
Not good. I want to know if I can get affordable healthcare coverage in the US Virgin Islands and it seems impossible. Your own wording above says “it looks like.” If you can’t give me a better answer than that, where else should I go?
I can’t find where I used the language “it looks like,” but the information above is correct. There is no marketplace coverage with cost assistance for the US Virgin Islands, just Medicaid and CHIP. With that said, here is an official page that offers resources on assistance https://www.cms.gov/CCIIO/Resources/Consumer-Assistance-Grants/VI. Also, you can contact a broker or an insurer like United Healthcare and hear about private insurance options you do have.
Hope that helps.