F1 PhD学生可以考虑不买学校保险 - Marketplace上买保险用Tax Credit合法且不影响绿卡

最近打开了新认知，楼主是PhD在读博士，每年交税。之前都是被强制要求买学校保险，然而从来没用过，今年涨价到2200刀了。最近刚知道可以在marketplace上买保险，然后可以使用tax credit抵税减免费用，最便宜的Bronze等级保险每月仅需1美元！！！成功waive掉学校保险。震惊于之前周围的人都不知道这个东西，网上信息也很有限。所以这里记录分享一下。也欢迎更懂的人来说说有什么问题。所有申请流程均按照事实提交，符合法律规定，且应该不影响绿卡申请。完全不懂的人先看下这个帖子： https://gonglue.us/47356  

• 首先谁可以在Marketplace上买保险，见官方解释： https://www.healthcare.gov/immigrants/immigration-status/
  

很明显student visa符合要求。 Individual with Non-immigrant Status, includes worker visas (such as H1, H-2A, H-2B), student visas, U-visa, T-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau

• 符合资格就可以去官网： https://www.healthcare.gov/ 注册。步骤参见：https://gonglue.us/obamacare。按照真实情况填写即可，提供SSN,I-20 SEVIS ID,护照，预估收入等真实信息，流程走完，会告诉你是否eligible，以及多少tax credit可以用。应该是收入越少，tax credit越高。Marketplace上最便宜的Bronze等级保险也要每月200多刀，并不比学校保险便宜。所以最关键的是使用premium tax credit（PTC）抵税。关于这个以及是否qualify，具体可以参见这里： https://www.healthcare.gov/glossary/premium-tax-credit/ 点击下方的“Will you qualify for a premium tax credit?”去测试。简单地说，因为博士学生收入基本在100%-400%联邦贫困线，基本是符合的。
• 搜索结果保险介绍：marketplace保险都是符合楼主学校要求(必须符合ACA)的。这里说一下之前我知道的学生自己买的保险基本都不符合我们学校要求：ISO, PSI, PGH Global, Seven Corners, Tokio Marine and Student Medicover are popular companies that market their plans to international students. Plans issued by these companies do not meet the waiver requirements and are not accepted.。楼主选择了最便宜的符合学校要求的（annual deductible <6000)，显示最便宜的Bronze等级搜索结果是200多刀，在使用tax credit之后，仅仅需要每月1刀！！！
• 大家担心的最关键问题是会不会影响未来的绿卡申请，根据我搜到的信息是：不会。再次参见：https://gonglue.us/47356 。2019年川普政府出台过一个政策Inadmissibility on Public Charge Grounds，A Rule by the Homeland Security Department on 08/14/2019，原文参见这里：https://www.federalregister.gov/documents/2019/08/14/2019-17142/inadmissibility-on-public-charge-grounds 。 注意Matketplace上买的保险是Private Health Insurance，​不是Medicaid。所以在原文D-4 section- Totality of the Circumstances Determination里提到“Heavily Weighted Positive Factor for Private Health Insurance. In this final rule DHS added a new heavily weighted positive factor for when the alien has private health insurance appropriate for the expected period of admission, and for which the alien does not receive subsidies in the form of premium tax credits (including advance premium tax credits) under the ACA. This heavily weighted positive factor is in addition to the positive factor that would apply in circumstances where an alien has sufficient household assets and resources (including health insurance not considered to be a public benefit under 8 CFR 212.22(b)) to cover reasonably foreseeable medical costs, including costs related to a medical condition that is likely to require extensive medical treatment or institutionalization or that will interfere with the alien's ability to provide care for himself or herself, to attend school, or to work.” 简单地说就是虽然使用PTC不是negative factor （使用medicaid超过12个月是negative factor）, 但不是positive factor。然而在2021年拜登政府已经把川普的政策作废，原文这里：https://www.federalregister.gov/documents/2022/09/09/2022-18867/public-charge-ground-of-inadmissibility#h-13。
• 所以现在的问题是，移民局还会不会考虑使用过PTC作为考量因素呢。楼主查到的信息是不会。根据USCIS官网： https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge/public-charge-resources 里面提到：Q: What public assistance programs does USCIS not consider? 这里面明确说明Premium Tax Credit (PTC)不作为考量。而且美国的政策应该是在出台后才生效，就算下一届政府改变政策，在之前的人应该不受影响。
• 当然最保险的选择是在成功waive掉学校保险后，可以取消购买marketplace上的保险。当然学校保险覆盖范围肯定要更好一些。这个方法更适合常年不生病，基本用不到医保的人。
• 另外，marketplace上保险enrollment period是每年November 1到次年的Feb 1。那么必须说8月份想买怎么办呢? 那么就是使用special enrollment period。另外一个问题是想更改收入来测试tax credit额度。解决办法相同，都是进入到 Report a life change  (参见https://gonglue.us/obamacare）修改信息。楼主确实7月份搬过家，所以选择了Move，然后就符合special enrollment period了。
• 欢迎大家理性讨论，欢迎专业人士评论下是否有其他问题。大家自行考量可行性。楼主不负责任。
  

补充内容 (2023-08-19 03:12 +08:00):

补充：可能只适合交税满五年的resident alien (NRA)，因为https://www.healthcare.gov/quick-guide/eligibility/这里解释  How is “live in the United States” defined?
If you’re considered a “resident” of the United States for tax purposes, you’re eligible to use the Marketplace.

补充内容 (2023-08-19 03:12 +08:00):

补充：可能只适合交税满五年的resident alien (RA)，因为https://www.healthcare.gov/quick-guide/eligibility/这里解释  How is “live in the United States” defined?
If you’re considered a “resident” of the United States for tax purposes, you’re eligible to use the Marketplace.

yserae 发表于 2023-8-19 08:55
这个不就是用tax return的钱买保险吗。。还是用自己的钱呀

是用你交的税抵免。就像买电车退tax credit一样。

帮顶。之前Dept包保险，不要也不退钱。所以没怎么关心过。

这个不就是用tax return的钱买保险吗。。还是用自己的钱呀

The Premium Tax Credit (PTC) is a tax credit provided in the United States to help individuals and families with the cost of health insurance premiums purchased through the Health Insurance Marketplace, also known as the Health Insurance Exchange. Here's an example to illustrate how the Premium Tax Credit works:

Let's say you are an individual with a moderate income and you purchase health insurance coverage through the Health Insurance Marketplace. The cost of the health insurance premium for the year is $6,000.

Calculate the Applicable Percentage: The Premium Tax Credit is based on your household income and the federal poverty level. Let's assume that your household income corresponds to 250% of the federal poverty level for your household size. The applicable percentage for this income level is, let's say, 8.5% (these numbers are hypothetical and may not reflect the current rates).

Determine Your Maximum Contribution: Your maximum contribution is the percentage of your income that you're expected to pay for health insurance. In this example, your income is $30,000. Therefore, your maximum contribution is $30,000 * 8.5% = $2,550.

Calculate the Premium Tax Credit: The Premium Tax Credit is the difference between the actual cost of the health insurance premium and your maximum contribution. In this case, it's $6,000 (premium cost) - $2,550 (maximum contribution) = $3,450.

Claiming the Premium Tax Credit: When you file your federal income tax return for the year, you can claim the Premium Tax Credit. This credit directly reduces the amount of tax you owe. If the credit amount ($3,450) is greater than your tax liability, your tax liability will be reduced by that amount. If your tax liability is already zero or if the credit exceeds your tax liability, you might be eligible for a refund of the excess credit.

It's important to note that the Premium Tax Credit is based on your estimated annual income, and if your actual income for the year turns out to be different, you may need to reconcile the credit when you file your tax return. If you received an advanced premium tax credit during the year to help pay for your health insurance premiums, any difference between the advanced credit and the actual credit you're eligible for will also be adjusted on your tax return.

This example provides a simplified illustration of how the Premium Tax Credit works. The actual calculations and eligibility criteria can be more complex, so it's a good idea to use official resources or consult a tax professional to determine your specific eligibility and credit amount.

请问楼主今年在healthcare.gov 上申请了么？ Plan大概每月多少钱？
我临毕业没有assistantship了已经，暂时没收入，income填的很低会不会被给Medicaid啊？我看Reddit上好多unemployed被给了白卡又改不了。如果提交了申请通过了，但是最后没在Marketplace上买保险可以么？application可以撤回么？
我只是想看一看用PTC 的话plan会便宜多少。。。。

Sylviabc 发表于 2024-1-16 19:39
请问楼主今年在healthcare.gov 上申请了么？ Plan大概每月多少钱？
我临毕业没有assistantship了已经，暂 ...

我今年没申请 因为预计今年收入超了。你这种情况有点复杂，不太好建议，我也不是专业的。你临近毕业得考虑下万一下半年毕业工作后 报税年总收入超出的情况。另外这种medical plan应该是可以随时取消的。