Medicaid is a public program. It is a joint state and Federal program. Every state’s Medicaid program is different. Eligibility is generally based on income, although it can be difficult to qualify for Medicaid coverage if the state has not expanded under the Affordable Care Act. If your state has expanded you are eligible for Medicaid coverage if your family income is less than 133% of the Federal Poverty level.
The plans sold on the health insurance exchanges are private insurance plans. You can be eligible for a subsidy to defray the costs of that coverage if your income is between 100% and 400% of the Federal Poverty level. You are not eligible for a subsidy on the exchange if you are eligible for Medicaid
The Affordable Care Act will not affect your eligibility for your husband’s employer sponsored insurance. So, no, you will not be dropped from his insurance because of Obamacare. Independently of the health reform law, employers make decisions on what to do with dependent coverage. There is nothing in the Affordable Care Act that requires your husband’s employer to cover you.
Mathew from FL asks: “What is the least expensive insurance for a student out of work and can't afford much?”
Here are your options Mathew: If you are under 26 and your parents have coverage you can enroll in their plan.
If you are under 30 you can purchase “catastrophic coverage”. That coverage has relatively low premiums with high deductibles but will provide coverage for serious illnesses or accidents. You can see what plans are available in your area on Healthcare.gov. and click on “See Plans Now” There is no delay, you just have to state whether you are seeking individual or family coverage, health or dental coverage and for which state and county you want information.
If your state has expanded Medicaid you may be eligible for that coverage. If your state has not expanded and you would have been eligible for Medicaid if it had, you are eligible to purchase catastrophic coverage even if you are over 30.
You are eligible for a subsidy for coverage purchased in your state’s health insurance exchange if your income is greater than the Federal poverty level ($11, 490) and below 4 times that amount ($45, 960). If you are eligible for a subsidy you can not use it to purchase a catastrophic plan, but you may find that a more generous plan is actually less expensive after the subsidy is applied
John: If you are eligible for Medicaid you are not eligible for a tax subsidy in the exchange.
Judy, I’m sympathetic because I know the healthcare.gov website has been very frustrating. The good news is that it is getting better, but it is still not where it needs to be. You can go to an agent to find out about the different policies, but in order to qualify for a subsidy, you must purchase coverage through your state’s marketplace/exchange. You can also use a Navigator in your area to help you go through your options. They can also help you enroll in a plan. You can find a Navigator in your area by going to this website (https://localhelp.healthcare.gov/).
Sandra, Your husband is exempt from the penalty for not purchasing coverage for all the reasons you stated.
No, beginning in 2015 employers will have to offer health insurance to their employees and their employees’ dependents (defined as children, not spouses).
Janet from IN asks: “If I am self-employed do I use my schedule C for my gross income?”
Your eligibility for a subsidy in the marketplace is based on your Modified Adjusted Gross Income. (MAGI) For most people MAGI is simply their Adjusted Gross Income (AGI): line 37 on Form 1040 (line 21 on form 1040A or line 4 on 1049EZ).
To be exact MAGI equals AGI plus non-taxable Social Security income (line 20a minus 20b on form 1040) plus tax exempt interest (line 8b) plus foreign earned income for Americans living abroad (form 2555)
Most people will use 2013 income to estimate their 2014 income in determining their eligibility for a subsidy.
You would need to contact your state’s exchange/marketplace and let them know that you have a life event.
It is your expected 2014 income, but you can use your 2013 income to help you estimate it.
It is unlikely you will be able to find a separate plan for prescription drugs that is better for you than the plans you have researched. There are options available to you with lower prescription copays, but as you have found you may have to pay a higher premium.
You should check with the New York exchange (http://healthbenefitexchange.ny.gov/). Even if you don’t qualify for federal assistance to pay your premium, you can shop for and enroll in a plan offered through the exchange. The exchange is designed to make shopping for insurance easier by letting you compare among all the available plans in your area.
Hi jks, yes, divorce is considered a life event.
If you overestimated your income in determining your eligibility for a subsidy, but your actual income turns out to be less, but it is still above poverty, that means you got less of a subsidy than you were actually due. In that case you will receive the difference owed to you when you file your income taxes. Alternatively if you see that your income is going to be less than you estimated during the year you can inform the exchange of that and receive a higher subsidy.
But be careful. If your income falls below poverty and you live in a state that has not expanded Medicaid you lose eligibility for any subsidy.
If I understand your question correctly, your coverage is likely being terminated at the end of the year, but you are being asked to make a decision on a new plan by Nov. 1. You don’t have to accept the new plan. You can shop for alternatives through healthcare.gov or contact a Navigator in your area to discuss your options. If your income is low enough, you may also qualify for federal assistance to pay your premium. You can find a Navigator in your area by going to (https://localhelp.healthcare.gov/). The marketplace/exchange plans begin coverage on Jan. 1st.