# Moving to America with older kids



## Deaso (Apr 19, 2010)

I am married to an American for the past 13years, and have three children aged 12, 9 & 7. We are looking at moving to Texas (possibly Lubbock) or Maryland in 3years time (Hubby is on a work contract until then).

My kids will be older when we are looking at moving 15, 12, 10 and I am looking for any advise on moving kids this age overseas. 

Hubby may move with his company, or if not will have to find a job as will I. I have to go through the whole visa process but my kids and hubby are all citizens so no dramas there.

My youngest has high function autisim and epilepsy so that worries me to with medical stuff.

Any advise for moving kids this age would be great, negative and positive.


Jyslana


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## twostep (Apr 3, 2008)

I have done work for a client in Lubbock over the last six months so I have some contacts I can ask specific questions about town.
Lubbock is growing up and being considered one of the best places to live in the US. Cost of living is still reasonable. Texas has no state income tax but real estate tax is in the 2-3 % range. You will find ample medical facilities. 
Maryland - it really depends on the specific location.


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## Deaso (Apr 19, 2010)

Thanks two step, we most likely will go to Lubbock, but the company he is working for now in another country may want him to work for them in the usa, and thats based in a Bethesda, in Mary Lands, and also Fort Worth Texas, so Fort Worth may be on the cards too.

I loved Lubbock and housing seems very reasonable as i get real estate emails all the time.

I would love to know

Best area to live in
areas to avoid
best schools for the ages of my kids

Not sure what i would do for work yet


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## sharbuck (Dec 10, 2013)

I can give you a little info on moving kids overseas. I was a military brat, moving overseas was something we did on a regular basis. There were 4 of us and my parents made the moves seem like holidays. Mom and Dad were incredible, they made it seem easy .

Each child will Handle it differently. Start preparing them well ahead of time. One of the biggest stressors will be the difference in the academics. Your children may be ahead or behind academically depending where you move to. Focus on adapting to the school system rather than the grades for the first 6 months

The biggest problem and perhaps the hardest will be bullying. You will get those who will disagree with me and it may not happen but you must be prepared for it. There was an article about a beautiful Irish girl who killed herself because the other girls were jealous of her. I guess it happens where you are from but there seems to be no fear of punishment. Often the staff stands by and refuses to intervene. Get them involved in sports and activities and church youth groups. 

Lastly remember kids are resilient and will probably handle relocation better than you. Best of luck !


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## twostep (Apr 3, 2008)

There is no way to say today what area will be built up, which schools are the ones to enroll kids in in three years:>)
Ft. Worth will be a different ball game. Metro and booming to say the least, housing is currently a sellers' market, cost of living has gone up about 10% this year so far. Considerable school and medical facility options. Insane commutes but plenty of jobs available.
With three school aged children and their extra curricular activities it will not be easy for you to work. What line of work are you in?


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## Loosehead (Nov 18, 2013)

Given that your child has a chronic medical condition, the one piece of advice that I can give is to make sure that you bring evidence that their condition was covered by your insurer in your home country.


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## twostep (Apr 3, 2008)

Loosehead said:


> Given that your child has a chronic medical condition, the one piece of advice that I can give is to make sure that you bring evidence that their condition was covered by your insurer in your home country.


Can you please elaborate why medical coverage in AUS should have an impact on coverage in USA? BTW OP and her children as US citizens.
It makes sense when it comes to car insurance.


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## Loosehead (Nov 18, 2013)

twostep said:


> Can you please elaborate why medical coverage in AUS should have an impact on coverage in USA? BTW OP and her children as US citizens.
> It makes sense when it comes to car insurance.


Certainly.

Their new medical insurer in the US, when faced with a claim from a Doctor on their behalf for a chronic condition that predates the start of the insurance cover will wish to see evidence that their previous insurer covered it, and that there has been less than 63 days break in coverage. The consequences of not being able to do this are that they will decline cover.

On receiving a claim from the Doctor, the new insurer will write to the policy holder asking for Certificate of Creditable Coverage, which under normal circumstances would be issued by the previous insurer. Of course, when moving from another country (and in my case, from the UK) it may be difficult to provide this certificate, so be prepared to provide evidence of cover which must include a start date and an end date showing that there has been no gap greater than 63 days.

It is not particularly relevant in this case, but this can be tricky to do when moving from the UK, but I managed to do it by sending a scan of my GP registration card and of my E111 showing an expiry date in 2015.

My advice to the OP, therefore, is prepare for this in advance by obtaining some kind of certification from their medical insurer in advance of moving. It will save hassle.

Oh, and citizenship isn't relevant.


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## twostep (Apr 3, 2008)

Loosehead said:


> Certainly.
> 
> Their new medical insurer in the US, when faced with a claim from a Doctor on their behalf for a chronic condition that predates the start of the insurance cover will wish to see evidence that their previous insurer covered it, and that there has been less than 63 days break in coverage. The consequences of not being able to do this are that they will decline cover.
> 
> ...


??? As US citizen OP, her children and her spouse on Green Card status can be covered by "Obamacare.


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## Loosehead (Nov 18, 2013)

twostep said:


> ??? As US citizen OP, her children and her spouse on Green Card status can be covered by "Obamacare.


Fair enough. If Obamacare offers decent medical cover, then that might be the answer.

Indeed, it does raise a point. The OP should perhaps closely examine what health insurance options there are and their various levels of coverage.


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## BBCWatcher (Dec 28, 2012)

Yes, Loosehead, you're a bit out of date. I agree with Twostep. The U.S. Patient Protection and Affordable Care Act ("Obamacare") came into full force this year (2014). Medical insurance companies now must follow guaranteed issue rules. That is, preexisting conditions are not disqualifying, nor are higher premiums allowed if you have a preexisting condition.

To combat the obvious moral hazard problems, the PPACA introduced a tax penalty if you do not have PPACA-compliant medical insurance (or you do not have a justifiable exception). The IRS collects this tax penalty. The penalty will start to be collected in 2014 tax returns (due next year), and the penalty will increase over time. In the first couple years the PPACA insulates medical insurance companies from some (but not all) of the potential risks involved in this transition to the tax penalty system as previously uninsured individuals and families join the ranks of the insured.

Group coverage through employers, especially large employers, has never been a particular problem. Those insurers have been covering preexisting conditions if you qualify for insurance through your employer. That continues.

The PPACA also introduced mandatory coverage for young adults under the age of 26 who wish to avail themselves of coverage through a parent's policy. Again, preexisting existing conditions are not disqualifying.

Relocating to the United States (or to another state) is a "qualifying event" per the PPACA. That is, once you relocate to the U.S. you have a limited period of time -- at least 30 days, but it could be longer -- to sign up for PPACA-compliant medical insurance for you and for your family. If that's through your U.S. employer, fine, no problem. If that's through the PPACA health insurance exchange at HealthCare.gov (which also directs you to a state-run exchange if applicable), that's great, too. As long as you get your qualifying health insurance within a short period of time after your qualifying event, and as long as you maintain coverage (pay your premiums, if any -- you may qualify for government subsidies to help pay for insurance), no problem, you avoid the tax penalty. And all with no preexisting condition limitations.

All PPACA-compliant policies -- and that includes all policies available through HealthCare.gov as well as most employer-provided policies (and more over time) -- must meet at least minimum standards for coverage, including a cap on out-of-pocket costs for covered services (all medically necessary acute care, really) and no annual or lifetime caps. All must provide at least a basic package of free preventive services. All must cover medically necessary prescription drugs, at least after your annual deductible. All must provide some coverage for mental health and rehabilitative care. And so on. Occasionally this means a higher premium than in the past -- occasionally -- but in the past you were most probably buying substandard insurance (or "insurance") that didn't actually provide adequate catastrophic medical coverage. Many PPACA policies provide coverage for emergency medical care when traveling outside the United States, though that's something to check in the coverage statements as you shop for insurance if that's of interest.

All residents of the United States (50 states plus District of Columbia) are affected by the PPACA, regardless of citizenship or even (actually) immigration status.

Hope that helps.


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## twostep (Apr 3, 2008)

"All residents of the United States (50 states plus District of Columbia) are affected by the PPACA, regardless of citizenship or even (actually) immigration status."

Can you elaborate please and give specific links? Which visa allows access to for ease of communication "Obamacare"? Thank you.


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## BBCWatcher (Dec 28, 2012)

I didn't write that phrase as precisely as I would have liked, so I'd be happy to elaborate.

I recommend consulting the Congressional Research Service's report entitled "Treatment of Noncitizens Under the Patient Protection and Affordable Care Act," published March 22, 2011, since it's quite clear and helpful in explaining how that part of the law works. I'll quote the key sentence in the Summary section of that CRS report: "Aliens who are 'lawfully present in the United States' are subject to the heath insurance mandate and are eligible, if otherwise qualified, to participate in the high-risk pools and the exchanges, and they are eligible for premium credits and cost-sharing subsidies."

Yes, a lot of people are surprised by that fact. But it's a fact. You don't need to be a U.S. citizen to benefit from the PPACA. You can be an older individual ineligible for Medicare, for example. (It's possible to be a U.S. citizen who is ineligible for Medicare, by the way, but when it happens it's more common among non-citizens.) You can have any preexisting condition(s). You can be a diversity lottery winner, a refugee, a foreign student attending a U.S. university on a student visa.... None of that matters. You still have the same rights, responsibilities, and privileges under the PPACA as a U.S. citizen living in Boston who can trace her ancestry back to the Mayflower. The PPACA is "universal" -- or at least very nearly so -- in its design.

OK, that's the summary headline. Of course it's a _little_ more complicated, but only a little:

1. "Subject to the PPACA" doesn't necessarily mean you need to do anything or do anything different. If you get your healthcare via Medicare or Medicaid, as examples, you've got nothing more to do with respect to the PPACA.

2. The PPACA doesn't require you to instantly obtain qualified medical insurance. There's a grace period after a "qualifying life event," and if you're without coverage for a maximum of 3 months you're not subject to the tax penalty. Among other things, that grace period exempts short-term foreign tourists -- and if they're long-term tourists they then probably are not lawfully present anyway. (Those tourists might need to clear visa requirements, some of which may be health-related.)

3. No, the PPACA doesn't require foreign diplomats to sign up for medical insurance at HealthCare.gov or anywhere else. There are a few other categories similar to that.

Anyway, the PPACA doesn't itself really distinguish between visa types, but the provisions in the law and their impacts (if any) vary depending on what visa you have and how that visa operates. According to the CRS, for B, ESTA/VWP, J, O, and P visas you're short-term, so it's either very unlikely or impossible to be subject to the PPACA. (If you overstay with any of those visas you're also probably not lawfully present, so also not subject to the PPACA.) You're also probably going to be able to avoid the tax penalties if you're able to truthfully file with the IRS as a non-resident alien. At least some F, J, M, and Q visa holders are NRAs from the IRS point of view, and it's the IRS that administers the tax penalties (to enforce the individual mandate). Other NRAs include foreign government and some NGO employees (who are mostly diplomats), regular cross-border Canada/Mexico commuters, aliens with medical condition leaves in the U.S. (ironically), foreign vessel crew members, and athletes participating in charity events, to pick several examples.

As I read the report, and for some of the individuals I just described, the PPACA may require you to have compliant health insurance, but there's no penalty if you don't because the penalty provision doesn't cover you. There are some other penalty waivers in the law, but that's one.

The PPACA provides some special rules for calculating credits/subsidies for households containing both lawfully present and non-lawfully present members. These are referred to as "mixed status families."

Some of the penalty terms are still _slightly_ unknown because the IRS hasn't finished writing the form instructions for tax year 2014. But there's nothing unusual in that whenever there's a new law that impacts tax collections. For example, green card holders (i.e. U.S. permanent residents) and U.S. citizens living overseas won't have to pay the non-coverage penalty if they qualify for the Foreign Earned Income Exclusion (FEIE), whether they opt to take the FEIE or not. But until the IRS writes out all the instructions I suppose we won't know exactly how that works.

OK, I'll stop there, but there you go. Hope that helps.


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## Loosehead (Nov 18, 2013)

Apologies for muddying the waters. I was going by experience from last year.


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## twostep (Apr 3, 2008)

BBCWatcher said:


> I didn't write that phrase as precisely as I would have liked, so I'd be happy to elaborate.
> 
> I recommend consulting the Congressional Research Service's report entitled "Treatment of Noncitizens Under the Patient Protection and Affordable Care Act," published March 22, 2011, since it's quite clear and helpful in explaining how that part of the law works. I'll quote the key sentence in the Summary section of that CRS report: "Aliens who are 'lawfully present in the United States' are subject to the heath insurance mandate and are eligible, if otherwise qualified, to participate in the high-risk pools and the exchanges, and they are eligible for premium credits and cost-sharing subsidies."
> 
> ...


Basically it comes down to "it depends". Sorry but my family's medical coverage is too important to leave it hanging out to dry.


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## BBCWatcher (Dec 28, 2012)

What on earth do you mean? I agree that medical insurance is important! Have I said otherwise? That's _irrespective_ of your immigration status or location.

Now, if you're in the U.S., the PPACA may require you to be sensible, to protect yourself and your family by obtaining at least PPACA-compliant minimum coverage. Through your employer, through a government program, or through Healthcare.gov. Otherwise, you might have to pay a tax penalty.

You may qualify for premium subsidies/credits for policies purchased at Healthcare.gov.

Almost everyone legally present in the U.S. (as detailed above) is subject to the PPACA. But whether you are or not, healthcare is important.

You asked a question, and I answered it. You did not ask me for my view on the merits and sensibility of carrying medical insurance, and now you know. I hope that helps.


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## jaqjaqbird (May 3, 2014)

My kids are around the same age as your kids. If I had to pick between the two cities, I would pick Bethseda Maryland over Lubbock if you want to instill academic excellence in your children. Bethseda is great, has the one of the best schools (montgomery) in the USA and it's free. However, there is a lot of pressure to succeed. You definitely feel you need to keep up with the Jone's when it comes to your kid's education, career, house, living, etc. Plus it's probably 5-10 times higher in cost than Lubbock, so keep that in mind. I am not very crazy about living in Texas considering I am not from Texas, but many Texans love it there-probably because they grew up there. I don't care for the scenery, weather or culture down in Texas, but it is family friendly, cost of living is reasonable and it is convenient.


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