Cigna International Health Insurance

Obamacare 911- What US Expats Need to Know About Coverage & US Taxes Abroad

By David McKeegan

Summary: For US residents, Obamacare has wide-reaching implications and will affect both the financial landscape of healthcare as well as coverage options. US expats, on the other hand, may be exempt. To help you understand how this Act may affect you and your US taxes abroad, we have outlined the 3 critical components of Obamacare you need to know.

Obamacare 911 - What US Expats Need to Know About Coverage & US Taxes Abroad

The Affordable Care Act (ACA, or more popularly known as Obamacare) will go into effect January 1, 2014 and Americans are polarized on whether or not it's a positive or negative change to US healthcare. But no matter what your personal beliefs, it has been passed by Congress and it is, indeed, happening. The best thing to do is to fully understand its impact and ensure you are compliant. For US residents, Obamacare has wide-reaching implications and will affect both the financial landscape of healthcare as well as coverage options. US expats, on the other hand, may be exempt. To help you understand how this Act may affect you and your US taxes abroad, we have outlined the 3 critical components of Obamacare you need to know.

Obamacare and the US Expat

The basic premise of Obamacare is that Americans have a shared responsibility to ensure health care coverage for everyone. Every US resident must obtain minimum health care coverage or be subject to additional taxes (which help support the program's ability to provide coverage for those individuals who cannot afford it on their own).

Since US expats aren't generally residents of the US while living overseas, the majority of expats will be exempt from the Obamacare health insurance requirements. But in order to be exempt you must prove residency in another country through one of two tests:

  • The Bona Fide Residence Test- To qualify through this test you must have been living abroad for at least one year and have no immediate plans to return to the US.
  • The Physical Presence Test- Most expats will qualify for this test, as you simply need to have foreign earned income and be physically out of the US for 330 days out of a 365 day period.

Once you qualify for foreign residency, you are said to have the ‘minimum essential coverage' and are not required to purchase any additional coverage. Whether or not you hold coverage in your current country of residence or through a US expatriate plan is irrelevant—you are still considered to be exempt from Obamacare by simply qualifying as a resident of another country.

Contractors or Employees on Short-Term Assignments Overseas

If you are an expat on a short-term assignment and do not qualify for exemption through one of the residency tests, you will need to comply with Obamacare regulations. This means you have 2 choices: enroll in a US expatriate plan that provides the minimum essential coverage (if you qualify) or pay an additional tax.

By definition, the minimum essential coverage includes:

  • Employer-sponsored coverage (including COBRA coverage and retiree coverage)
  • Coverage purchased in the individual market, including a qualified health plan offered by the Health Insurance Marketplace (also known as an Affordable Insurance Exchange)
  • Medicare Part A coverage and Medicare Advantage plans
  • Most Medicaid coverage
  • Children's Health Insurance Program (CHIP) coverage
  • Certain types of veterans health coverage administered by the Veterans Administration
  • Coverage provided to Peace Corps volunteers
  • Coverage under the Nonappropriated Fund Health Benefit Program
  • Refugee Medical Assistance supported by the Administration for Children and Families
  • Self-funded health coverage offered to students by universities for plan or policy years that begin on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these programs may apply to HHS to be recognized as minimum essential coverage)
  • State high risk pools for plan or policy years that begin on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these program may apply to HHS to be recognized as minimum essential coverage)

It is important to note that if you do not make enough money to be required to file a tax return (the filing threshold is currently $9,750) then you do not need to comply with Obamacare. It is important to check with a tax professional about your filing requirements if you are unsure. The Penalties for Not Maintaining the Minimum Essential Coverage

If you are in a situation where you need to pay the ACA penalty taxes, they are calculated on a yearly basis, but assessed only for the months in which you don't have the required coverage. If you are on a qualifying plan for even one day in a month, you are considered covered for that month and will not be taxed. The tax rate is graduated, and increases in each of the next 3 years:

  • In 2014 - The greater of $95 per adult and $47.50 per child (up to $285 for the family) OR 1% of your family income (defined as income over and above the filing threshold)
  • In 2015 - The greater of $325 per adult and $162.50 per child (up to $975 for the family) OR 2% of your family income (defined as income over and above the filing threshold)
  • In 2016 and beyond - The greater of $695 per adult and $347.50 per child (up to $2085 for the family) OR 2.5% of your family income (defined as income over and above the filing threshold)

US Expatriate Health Plans and Obamacare

Many expats are covered under a US-based expatriate health plan. The Obamacare provisions do NOT apply to these plans. The government has decided that, at this time, it is too difficult for these types of plans to comply with the law for a variety of practical reasons; for example, it is too challenging to define and enforce preventive care internationally, and it is a logistical challenge to effectively communicate with enrollees living abroad. While the government continues to evaluate the feasibility of these expatriate plans complying with the law, they have granted an exemption until at least December 31, 2015.

It is important to understand the type of expatriate health plan you are covered under. The plan must be an insured group health plan that limits enrollment to primary insureds (and covered dependents) who reside outside of their home country for at least six months of the plan year. Assuming your plan fits the description above, your coverage satisfies Obamacare requirements. It also means that your expatriate health plan won't offer the additional benefits that Obamacare provides (such as free wellness/preventive care, coverage for children up to age 26, no lifetime maximums or guaranteed maternity coverage).

For More Information

If you have any questions about your residency status as a US expat or your US tax filing requirements, contact an expat tax professional who can help you better understand your options. As with many expat tax issues, not fully understanding your US healthcare responsibilities can end up being quite costly!

About the Author

The Greenback team specializes in the preparation of US expat taxes for Americans living abroad. Greenback offers straightforward pricing, a simple, hassle-free process, and CPAs and EAs who have extensive experience in the field of expat tax preparation. For more information about Greenback Expat Tax Services, FATCA, FBARs, or other issues related to US expat taxes, don't be shy! Contact the Greenback Team right away to get started.

Write a Comment about this Article

Sign In to post a comment.

Comments about this Article

Nov 4, 2013 09:38

We moved to Costa Rica June 19 as retirees so will not have been in the country for a year by Jan. 1 and dont have any foreign earned income. Where do those of us in transition fit in to the requirements?

Nov 4, 2013 11:18

David! What an excellent and informative accounting of this important information. Although I am now retired and covered under Medicare, I wanted to acknowledge your well-informed addition to this forum. Kudos! Waltercito

Nov 4, 2013 11:34

What I didn't see you say, is that Obamacare is completely other and separate issue from medicare (referring to retired expats.) AND that once you are receiving social security benefits, you automatically get part A free in medicare. HOWEVER, if you don't elect a part B at the time of beginning your benefits, you, as an expat will have to pay a penalty from the time you began receiving benefits to the time you enroll in Part B. The penalty is as high as 20% for each 12 month period. There are those expats, retired, such as myself, that elected to keep medicare despite living in another country. The reason would be to return to US for necessary procedures. Initially, I declined Part B in July 2013, when I moved to Nicaragua. Now, I have changed my mind and decided it would be wiser to have A and B while living in Nicaragua. I now will be required to pay a stiff penalty for re-enrolling in Part B at this late date.

Nov 4, 2013 11:45

This article is of high interest and importance. You addressed this complex topic in your usual concise and clear manner...thanks for the information!

Nov 4, 2013 12:43

Thanks David McKeegan !! *Lots of great info in your article* Your article clears up the personal impact & concerns I had regarding this new piece of regulation, which *further destroys what was once a valuable humanitarian industry. I believe a LARGE number of expats are expats specifically because of the heavy-hand of the Gov. As an able-bodied, R&D engineer, w many successful designs under his belt, i am ardently opposed to MUCH of the laws & culture in the States. Plainly stated: It is no longer the country our fathers & grandfathers built, fought, & died for. You can call me John Galt flailer

Nov 5, 2013 05:26

I am still confused. As an expat that has lived and TAUGHT in Thailand for nearly 5 years(3 years which) I was paid cash, So I will have no way to verify. 2) If I want to move back to America w/o a job, will I be covered for ongoing medication needs under the basic care until I am able to purchse addt'l coverage?

Nov 5, 2013 14:25

Thank you all for the nice comments, we are so glad you are enjoying the article, and finding it useful! With regards to some of your questions, BearCountry you are definitely one of those caught in transition! You will likely be charged the penalty tax for the months prior to establishing yourself as bona fide resident. You will be charged for 5 months- the tax is is calculated on a monthly basis, but as soon as you are exempt for any reason in a month, you are considered exempt for the whole month (ie, if you had acceptable insurance for one day, you are considered covered for the month). Considering you will be a bona fide resident in June, you should not be taxed in that month. The penalties are assessed on your next tax return (which you would file in 2015) and at that time you'll be able to provide evidence of being a bona fide resident which will exempt you from further penalties. I do encourage you to keep up with the latest information from the US on this, as they continue to evaluate how taxpayers outside the US are to be impacted by Obamacare going forward. Toper3, from the sounds of it, you should qualify under the residency tests (and thus will not have to purchase additional coverage from the US). However once you move back to the US you will have to purchase coverage, or face the penalty tax. If anyone has additional questions, please feel free to email directly. Thanks!! The Greenback Team

Dec 31, 2013 14:21

I am a teacher in Egypt and plan to return next summer to visit my children. I thought I could spend 50 days without penalty. Is this a wrong assumption. Also, I am 66, and could apply for Medicare (but will not yet). Thank you. Patricia

Jan 2, 2014 12:15

Hi Patricia, As long as you can qualify as a Bona Fide Resident, then it does not matter that you will be in the US for 50 days. If you are a Bona Fide Resident, you are excluded from needing Obamacare coverage. We hope this helps! The Greenback Team

Jan 3, 2014 04:57

I am already enroled in Obama Care and am stil in the states.Can i keep my coverage,or must i drop it and enroll in an ex pat insurance program prior to moving to Ireland

Jan 5, 2014 21:57

Hello IrelandBound, With regards to your message, I would recommend keeping the Obamacare coverage you have until you can qualify as a resident in Ireland. Once you are considered a resident (or have sufficient coverage in Ireland), then you no longer need your Obamacare plan. We hope this helps! The Greenback Team

Jan 9, 2014 15:05

Do I have to live in the USA to qualify for social security disability payments? I currently live in the US. I will soon have to stop working due to medical issues. When I can no longer work, I plan on moving to Ecuador.

Jan 10, 2014 10:32

Hi! With regards to your question about receiving Social Security after you move abroad, unlike Medicare, your US Social Security benefits will be available to you in most countries as long as you continue to be eligible for benefits. Please see this article for more details: I hope this helps! David McKeegan

Jan 18, 2014 19:26

Dear Mr. McKeegan, Thanks very much for your detailed and insightful article. I have a follow-up question that I have been unable to answer following exhaustive (and exhausting) online research; namely, are American expatriates living 100% of the time outside of the US still eligible to purchase healthcare insurance on the federal marketplace? I have a preexisting heart condition that made me uninsurable (outside of a corporate umbrella plan, that is) before Obamacare, and I now live in Latin America and seldom return to the US. However, it is likely that I will need to have a follow-up heart surgery at some point in the coming years and, as I am uninsurable in LatAm due to my preexisting condition, I would like to purchase healthcare on the US marketplace so that I can travel home before the surgery and have it in NC, where I maintain an address (though would probably not qualify as a NC state resident). I am keen to buy US insurance because I am uninsurable elsewhere in the world and the cost of my upcoming surgery will be financially catastrophic if I have the surgery without insurance coverage. Do you know if I am eligible for Obamacare coverage under these circumstances? Do you have a suggestion for me? Many thanks in advance. Cory

Jan 18, 2014 19:32

Dear David, I live outside the US for more than 335 days/year and only maintain a mailing address at my parents' home in North Carolina. I have a preexisting condition that makes foreign healthcare coverage unaffordable, so I would like to purchase coverage on the US federal marketplace to be insured in North Carolina so that I can travel home for healthcare for my preexisting condition if I need it. Am I eligible to purchase Obamacare even though I do not live in the US more than 10 or so days/year? Thanks, Cory

Jan 21, 2014 10:56

Hello Expatgringo, Thanks for your comment! With regards to your question, you actually can’t purchase insurance through the Marketplace if you live abroad. There may be a possibility of getting insurance through a private insurance plan that will cover pre-existing conditions (except for the few that are grandfathered in), but at this point our accountants believe this question is better posed to an insurance agent who can clarify. You may want to ask the agent whether or not purchasing or renting a property in the US will allow you to purchase an insurance plan in the state of the property through the Marketplace—or if you need to have that residence as your primary in order to qualify for insurance in that state. If this option made you eligible it might cost less over the years than paying for heart surgery outright! You may also want to look at US expatriate health plans (there are a couple providers we recommend on our website) to see if you’re eligible and if you’d be covered under their plan. Hope this helps! The Greenback Team

Jan 28, 2014 12:01

We have been in Mexico for a year. We recently renewed our rental housing for another year and our residency cards for another three years. My wife is 62 and we would like to avoid the AHC (Obamacare) tax. We are living on Social Security only. We have rental receipts, utility and phone receipts. We will not be in the US over 30 days in 2014. Should we file with our Mexican PO address and form f2555?

Jan 28, 2014 13:38

Hello jbbarker1947, Thanks for getting in touch! With regards to your message, from the sounds of it you will not have to worry about purchasing coverage under the ACA. As you and your wife are considered expats (will be abroad for more than 330 days of the year), you are not required to purchase coverage. However, you will have to file using your foreign address so that they know you are indeed an expat. I hope this helps! The Greenback Team

Feb 5, 2014 14:49

Hi thanks for info. If you please: Can a Bona-Fide non-resident ex-pat ( out of country for a year) later build a house in the U.S. and snowbird for under 6 months a year and STILL retain non-residnet status and not need to buy Obamacare? Or does owning a house and living there a few months trigger "domiciled" status ? Thanks in advance !

Feb 9, 2014 03:33

David, I have insurance currently for my family, but it only covers medical expenses incurred in Thailand. My children are now heading off for University, in the US, and I am trying to find out information on how the ACA affects me and my family, and what can be done to ensure my children have proper health care cover while studying in the US. I am an american citizen, and my children are also, but I no longer have any State residency as I have been living in Thailand more than 25 years now. I cannot even apply for Health care cover, under the ACA web-site, without a state of residence. ACA also states my children, two of which are Type 1 diabetics, should be entitled to health care cover, including the pre-existing condition, without prejudice, and without increased premiums. How do I go about getting this cover for them? Individually, as international students studying in the statues, or as a family health care package?

Feb 10, 2014 17:40

Hi, Unfortunately, with regards to getting ACA coverage for your children, that is beyond the scope of our Obamacare knowledge. I feel your specific situation would best be discussed by an ACA representative at Hope this helps! The Greenback Team

Feb 14, 2014 03:21

Thanks for the helpful explanation. My wife is American and moved here to Australia two years ago. Now she is planning a visit back home to the US, if she get's sick or injured while she's there will Obamacare cover her or will she need travel insurance?

Feb 16, 2014 00:47

For federal tax purposes, we are American citizens and bona fide residents of Taiwan. However we return to New York State every summer to visit our family. We maintain a NY State address. We would like to purchase health insurance for the two months we are in the States. At our income level, we would be eligible for a subsidy if we lived in the US. In the past, we found that purchasing a two month policy was far to expensive. Is there now a way that we could purchase health insurance and still receive the subsidy?

Feb 17, 2014 15:51

For questions relating to what would be covered under temporary trips to the US, you would best be served by speaking directly to an Obamacare/ACA representative. We deal only with the tax side of things, and finding a healthcare solution that works best for you, is something that will have to be discussed with your health insurance provider.

Mar 19, 2014 22:30

we are moving to Spain for 9 months so will not meet the residency test but will have work visas that give us access to Spain's national health care system and we may also buy private coverage from a European insurer. Is this sufficient to avoid the penalty?

Mar 20, 2014 10:49

Hello Bonnie, From the sounds of it, you would have sufficient coverage under the ACA. However, I would strongly advise speaking with an ACA representative to ensure that there is nothing in your situation that would alter that.

Mar 21, 2014 11:35

I am a US Citizen living and working in the BAhamas. I have a job that requires me to attend vendor meetings in the USA from time to time. It is a requirement of the work and I am directed by my employer to attend on behalf of the company. However, doing that puts me in the USA sometimes for more than 30 days in a calendar year. Is there any way around the fact that these trips are a requirement of employment?

Mar 21, 2014 11:52

Hello Debib, Unfortunately work requirements are not an exception to the 330 day rule. However, you may qualify as a Bona Fide Resident ( depending on your specific circumstances. Hope this helps! The Greenback Team

Mar 28, 2014 23:13

I am 47 and have been living outside the U.S. for several years as a Bona Fide Resident, but I will move back to the U.S. permanently around June of 2014. I do not have any American health insurance, and I understand that after I move back, I must get health insurance. However, I am unclear about the following: 1) After I officially move back to the U.S., is there a deadline by which I must buy insurance in order to avoid the tax penalty for 2014 taxes? If so, what is that deadline -- is 30 days after I move back, or 60 days, or what? 2) I understand that the next enrollment period for the Obamacare marketplace-based insurance plans will be around November 2014. During the gap between June and whenever the next enrollment-period insurance begins coverage, what am I expected to do? Do I have to shop on my own for insurance that begins immediately without use of the website, or do I have other options? 3) Perhaps this question is the same as the previous one: even after Obamacare starts, can I buy health insurance on my own at any time of the year, or can I only buy health insurance during the enrollment periods? Hope these questions are not too stupid. Thanks a lot.

Apr 1, 2014 13:07

Hello! Thanks for your question. With regards to your message, you should be able to purchase coverage as soon as you return through any qualified insurance provider (not necessarily one through the ACA website though). I hope this helps! The Greenback Team

Apr 1, 2014 14:48

My son, US Citizen, 27 years old, living abroad in Scandanavia, for past 18 months - not school - not military - - just because. I don't care about the fee if he has to pay a penalty if and when he makes enough money to file taxes. My question is: If I do buy him a catastrophic plan under the Affordable Health Care Act, (Obamacare) and he incurs a major injury or is diagnosed with a major disease/condition while living abroad, etc. will he be covered by the healthcare plan under Obamacare? I'm sure if either of these unfortunate circumstances occurred, he'd be moving back to U.S. Thank you.

Apr 1, 2014 22:14

To the Parent With the Son in Scandanavia, As I have a preexisting condition and live permanently outside the US, I too was very interested to know whether I could purchase insurance in the marketplace of the state in which I was last resident so that I could obtain coverage in the event of a catastrophic health issue (which my foreign health insurance provider will not cover) and return to the US for, e.g., surgery, if need be. After researching this issue at length, calling both insurers and state marketplace representatives, my conclusion is that, in order to be eligible to purchase insurance in a state marketplace, one must reside in the US at least 30 days in a given calendar year. That is, unless one can show US residency, one isn't eligible. Of course, one can still purchase insurance on any state marketplace, but that requires making a representation as to one's residency status, which under these circumstances would be fraudulent. The risk is that one pays months/years of healthcare premiums and, in the event of a catastrophic health issue, coverage is denied. This would seem a gamble on the odds of the insurer confirming dates of residency through the US State Department border exit/entry databases. Perhaps this is unlikely, though if one were medevac'd back to the US, it might raise issues or even be obvious under the circumstances that the return was for a covered surgery. Most disappointing to fall through the cracks in Obamacare, especially for those of with preexisting conditions which were uninsurable before the law passed and now uninsurable due our expatriate status. There's the rub. Cheers

Apr 2, 2014 12:16

Also to the Parent With the Son in Scandinavia, I am afraid ExpatGringo is right. It really depends on the health plan you purchase, and I fear that many would not be willing to insure someone living abroad full time. Perhaps it would help to speak with your insurer to see what their policy on the matter is. Sincerely, The Greenback Team

Nov 22, 2014 18:11

Dear Sirs, If an American living abroad arranges to spend enough time in the US each year to qualify as a "resident" for US tax purposes under the IRS residency test, is that person then eligible to purchase insurance through the marketplace? To wit: the site's page regarding marketplace eligibility states that, "U.S. citizens living in a foreign country for at least 330 days of a 12-month period are not required to get health insurance coverage for that 12-month period." The page goes on in the section "How is living in the US defined" to state that "If you’re considered a “resident” of the United States for tax purposes, you’re eligible to use the Marketplace." Does this mean that an American living abroad -- but who satisfies the IRS residency requirement -- are eligible to purchase coverage on the marketplace? For example, if I purposefully fail the IRS' Physical Presence Test by not arranging to be physically out of the US for more 330 days out of a 365 day period (or, stated in the positive, I arrange to be in the US for more than 35 days each year), am I then eligible (or, indeed, required) to puchase insurance on the marketplace? I have a preexisting heart condition that makes obtaining insurance anywhere in the world impossible, except under Obamacare, hence the urgency of my question. Thanks so much in advance for your time. Kind regards, Colby

Nov 24, 2014 15:42

Hello ExpatGringo, Unfortunately you will have to speak to an ACA marketplace representative directly to see if there is a plan that will work for you. You can review your healthcare options at Good luck! The Greenback Team

Mar 23, 2015 06:50

Hi there! I moved to the UK for my postgraduate studies in February 2014. I've just finished my studies and am planning to return to the US next month. As a long-term student, I was covered by the UK's National Health Service for the last year. Therefore, I had no health insurance in the US. As a recent unemployed graduate, what are my options? Legally speaking, do I have to prove that I have insurance if I am unemployed?

Mar 23, 2015 15:35

Hello Kaela, For the 2014 tax year it sounds as if you will have sufficient coverage under ACA as you were covered by the UK system. For the 2015 year when you move back to the US, you will have to find additional coverage that satisfies ACA requirements. I hope this helps!

Apr 1, 2015 16:02

Hi David, Thanks for offering all the advice above! I have been living in Ireland for the last 8 years, first for PhD studies and then teaching. I will be moving back to the US in late August and have a few concerns about obtaining healthcare and what my options are. I called the helpline the other week and they said I wouldn't have to pay a penalty and that I could potentially claim for the remaining months of 2015 when I arrive (but I have to wait until I actually move). The thing is that I will be moving pregnant and rather worried about arranging healthcare asap and what levels of coverage would be available or how much it would cost. So any suggestions or pointers in a good direction would be much appreciated!

Apr 2, 2015 15:52

Hello Gwen22, In your situation, if you would like to have coverage as soon as your move back to the US, I would recommend pre-purchasing a plan and having it begin as soon as you decide to move back to the US. Even though you won't get dinged with the penalty once moving back to the US, if you want coverage right away, it is best to have it purchased in advance. You can shop around for a good fitting plan at I hope this helps! Tabitha Paddock Greenback Expat Tax Services

May 17, 2015 11:43

I want to be considered a BONAFIDE RESIDENT. I live in the Philippines but like to visit the U.S. annually for around 2 months a year. My income is all from the U.S. stock market and mutual funds. I file my taxes in US but will not file state of Maryland taxes. I never signed anything stating I am NOT a resident of the Phils nor that I would NOT pay Phil taxes. What I read is that the IRS determines on a case by case basis if you qualify as a BONAFIDE RESIDENT. What do you think ? The penalty for a SINGLE PERSON is $325 annually and you then pro rate it for every month you are in the US ? Or is it $325 per person per month ? Can I use the PHYSICAL PRESENCE TEST to get part of my penalty alleviated ? *** FYI as a BONAFIDE resident you can still visit the U.S. during that year you are establishing your residence. You would just have to legitimately just be visiting. You can stay more than the 35 days a year under the physical presence test. So again if you establish a foreign residence say September 12, 2014 and you will be considered a BONAFIDE RESIDENT, then you you could visit the U.S. for more than the 35 days but you don't want it to look like that you are really living in the US and your foreign residence is just a vacation home.

May 18, 2015 17:47

bang4dabuck- If you would like even more information, you can see additional articles on our website. I think this one in particular will help answer your question: With regards to your message, if you qualify as an expat, you do not need to purchase insurance under the ACA. Even though you can not qualify under the Physical Presence Test (as you are in the US for more than 35 days), you could still qualify under the Bona Fide Residency test (granted you meet that criteria). If you qualify as the Bona Fide Resident, then there is no need to purchase any expat insurance. We would have to have more detail from you (in order to tell if you will qualify), but in general if you have no intention of living in the US and have very strong ties to a country abroad, you can qualify. Feel free to contact us at (dot)com if you would like to discuss further with one of our accountants. I hope this helps!

Jul 22, 2015 02:22

I signed up for Obamacare as mandated in December 2013. At this time, my only income was via my Etsy shop (less than $4000/year ) so I was living with my parents in California. In January 2014 I moved to Germany and married a German. I found a part-time job and pay into a German health insurance program. Six months after I left California, my parents started receiving forms from Medi-Cal with enrollment information for me that apparently assigned me a provider HMO. My questions are these:1) Since I file and pay self-employment taxes for my small US-based Etsy shop does that mean I have Medi-Cal benefits when in the US? 2) If living abroad disqualifies me do I have to 'unsubscribe' from Medi-Cal? 4) How do I do that? 2) I now have a baby. If I come to the US to visit family I wouldn't mind having Medi-Cal in case of an emergency, so shouldn't I just keep it? 5) Is there a penalty if I don't unsubscribe?

Jul 22, 2015 12:14

Ingridhn- Even though as an expat you are not required to have an Obamacare plan, I don't think there should be any issue with you keeping the plan as a safety for when you are in the US. You should however double check with the ACA to ensure that no penalty will arise. You can reach them at I hope this helps! The Greenback Team

Aug 31, 2015 14:20

Hello, We are a US couple looking to move to (probably) Panama in the next year. Do you know if there are any International Health Insurance plans that will satisfy the Obamacare mandate so that we are covered in both places/wont have to pay the penalty? We are not sure just yet that we will be in Panama enough days/year to not need Insurance in the US. Thank you! kellsv

Aug 31, 2015 16:56

Kellsv- Thanks for your question! Although we do not deal specifically in health insurance plans, in the past we have recommend Expat Global Medical. You could contact them directly and see if perhaps they have an ACA qualifying plan. Best of luck with the move! Sincerely, The Greenback Team

Sep 4, 2015 19:54

I was hoping to spend my retirement (I am 59) dividing my time roughly equally between the UK and the USA. Now with Obamacare I fear that the most time I will be able to spend in the US is 35 days - without having to either buy Obamacare or be fined for not doing so. Am I right? I have dual nationality. Please can you help.

Sep 4, 2015 20:00

Dear Mr Keegan, I was hoping to divide my retirement between the UK and the US but now fear that with Obamacare that I may be limited to just 35 days or less in the USA without being hit with a hefty fine or having to buy US Health Insurance (which I never use anyway as I go to my doctor in the UK if I'm ill). I am a dual national. Please can you help?

Sep 7, 2015 12:21

Marcella, thanks for your question! With regards to your message, it seems that your only chance of avoiding the ACA fine would be if your UK health insurance plan qualified as acceptable coverage. You would have to contact the ACA administration directly and ask them if your UK coverage would exempt you from having to purchase a plan. Another option would be to move all ties to the UK, and qualify yourself as a Bona Fide resident of the UK. Those who qualify for the FEIE via the Bona Fide residence test do not have to purchase ACA coverage. I hope this helps and good luck! Cheers, The Greenback Team

Dec 14, 2015 10:54

Our family is moving to Thailand from the U.S. sometime in the first half of 2016. My wife has a pre-existing medical condition that will probably prevent her from obtaining health insurance in Thailand, plus some of her medications she needs are not available in Thailand, and she wants to be able to return to U.S. to see specialists. So we want to keep her U.S. health insurance, but our insurance company Florida Blue tells me that once we move out of the country we are no longer a resident of Florida and do not qualify for keeping our insurance. Is this true? Is there a work-around for this without having to lie about our residency by using an address of a friend in Florida as our fake residence?

Jan 28, 2016 17:56

I was a full-time student in the UK for all of 2015, covered by National Health Service (NHS) there. Now I'm doing my US taxes and wondering if NHS qualifies as a qualified insurer under ACA. In other words, do I have to pay the penalty for not having US insurance even though I was not living at the US and was covered int eh UK where I was living?

Feb 2, 2016 14:25

SRG2016- As long as you were outside the USA for more than 330 days during 2015, then you would qualify as an expat and be exempt from needing ACA coverage. I hope this helps, The Greenback Team

Feb 3, 2016 15:21

We are moving to Thailand from US and actually need to keep our ObummerCare insurance for my wife, because she has a pre-existing condition which would more than likely be rejected by most other insurances. Her insurance is needed so she can continue getting her RX at low costs. Using the 330 Day rule in reverse, am I to assume that as long as we do not spend MORE than 330 days out of the US each year, she will still be considered a resident of the US and can continue to keep her insurance?

Feb 4, 2016 14:09

Thanks, David, for your reply. Unfortunately I did come back to the US for more than 20 days to do my research work (I bought travel insurance for that time). Does this mean I was covered or do I have to pay a penalty? Thanks a million for your help!

Feb 5, 2016 15:53

SRG2016- With the FEIE, you can have up to 35 days within the USA and still qualify. I hope this helps!

Feb 5, 2016 15:56

naxiang- Yes, if you plan on spending less than 35 days abroad in Thailand, you have not really "moved" there, and should be ok to keep your US coverage. You should of course confirm your intentions to be abroad with your current healthcare provider to make sure they can still help.

Feb 9, 2016 11:11

Thanks David for the reply. We are actually planning to live in Thailand slightly less than 330 days. That way we will not be considered a resident of Thailand for insurance-purposes if we live there less than 330 days. Losing our U.S. health insurance would be detrimental to my wife. From what I have been told, if we live abroad for 330 or more days in a year, we can no longer be considered a resident of the U.S. and would not qualify for our insurance. For instance, if we lived in Thailand for 350 days, the state of Florida would no longer recognize us as a Florida resident, and we could not keep our Florida health insurance. Does that make sense?

Feb 9, 2016 19:20

Hi again (SRG2016 here), Just to recap...I was a full-time student in the UK with National Health Insurance there for all of 2015. I was in the US over the course of several trips (totalling more than the 35 day limit as defined for overseas residents). I did purchase travel insurance for my trips to the US. My question is, do I have to pay the penalty for not having ACA insurance in the US given my situation?

Feb 9, 2016 20:31

naxiang- Unfortunately you are in a very grey area, and in the end it comes down to your insurance provider, and what they are comfortable with. You will need to speak to them directly to determine when they will no longer cover you. Each company has their own rules and regulations which are outside the tax spectrum. Good luck!

Feb 12, 2016 17:22

SRG2016- I do not believe you will be faced with the tax penalty, however one of our accountants can confirm once they are working on your tax returns. -The Greenback Team

First Published: Nov 01, 2013

Cigna Expat Health InsuranceExpatriate Health Insurance

Get a quote for expat health insurance from our partner, Cigna Global Health.
Get a Quote

Living-in-MexicoCost of Living in Mexico

The cost of living in Mexico is one of the first topics considered by expats exploring the idea of moving there. Here's an idea of what your expenses will be if you choose to one of the expat hotspots in Mexico.

The cost of living in Mexico is one of the first topics considered by expats exploring the idea of moving there. Here's an idea of what your expenses will be if you choose to one of the expat hotspot...

Immigration-MexicoMexico Visa & Residency

If you plan to move to Mexico, you'll need to understand the process involved and the order in which requirements need to satisfied. Here is an excellent primer on what you'll need to do regardless of the amount of time you plan to spend in Mexico.

If you plan to move to Mexico, you'll need to understand the process involved and the order in which requirements need to satisfied. Here is an excellent primer on what you'll need to do regardless o...

Costa-RicaLiving in Costa Rica Guide

Our Living in Costa Rica Guide is a primer on everything about living in Costa Rica: best places to live, cost of living, pros and cons, healthcare and insurance, and more.

Our Living in Costa Rica Guide is a primer on everything about living in Costa Rica: best places to live, cost of living, pros and cons, healthcare and insurance, and more....

Retirement-In-CuencaAn Expat Shares What it's Like Retiring in Cuenca, Ecuador

A retired couple who landed in Cuenca, Ecuador with plans to rent a while and move from place to place is very happy with the decision to move to Ecuador. They appreciate the low cost of living in Cuenca, access to quality healthcare, clubs and activities. The one challenge has been the ever changing residency rules.

A retired couple who landed in Cuenca, Ecuador with plans to rent a while and move from place to place is very happy with the decision to move to Ecuador. They appreciate the low cost of living in Cu...

Moving-To-PortoAn Expat Talks about Moving to Porto, Portugal

An expat talks about moving to Porto, Portugal - moving costs, renting a condo, the lower cost of living in Porto and more.

An expat talks about moving to Porto, Portugal - moving costs, renting a condo, the lower cost of living in Porto and more....

Copyright 1997-2021 Burlingame Interactive, Inc.

Privacy Policy Legal