Advice Urgently Needed on Long Term Disability

[rousemark]

Have a young friend (40s) that is drawing long term disability from his job.. Does not have SS disability yet. He has several types pf autoimmune disorders.. a couple quite rare. He has been notified that his health insurance will be cancelled in July. He will be eligible for Cobra but the premium will be more than he draws. Without insurance he will not be able to pay for his medications and treatments which run into the thousands each month. Does he have any options other than cobra? Can he sign up for an ACA plan and possibly get a subsidy due to his income? Naturally he and his wife are terrified of the prospect of no insurance 6 weeks from now and need to get something in place. He talked to TennCare (Medicaid) and they said he could not qualify for coverage becasue he has coverage.

 

[Yagents]

Have a young friend (40s) that is drawing long term disability from his job.. Does not have SS disability yet. He has several types pf autoimmune disorders.. a couple quite rare. He has been notified that his health insurance will be cancelled in July. He will be eligible for Cobra but the premium will be more than he draws. Without insurance he will not be able to pay for his medications and treatments which run into the thousands each month. Does he have any options other than cobra? Can he sign up for an ACA plan and possibly get a subsidy due to his income? Naturally he and his wife are terrified of the prospect of no insurance 6 weeks from now and need to get something in place. He talked to TennCare (Medicaid) and they said he could not qualify for coverage becasue he has coverage.

I'm not licensed in TN, but once the group plan ends, he has "no coverage" any longer:

Options:

1. Cobra - Check under the new ARPA stimulus package, there is a clause that pays 100% of his Cobra premiums (if laid off with an involuntary leave), through end of Sept 2021. Can't beat FREE Cobra. See if they qualify.

FAQs: American Rescue Plan Act of 2021 COBRA | JD Supra

2. Medicaid - I don't think TN expanded Medicaid under ACA, but if yes, if joint income is below $24,000 for a family of 2, they would qualify for free Medicaid in TN. Or, qualify with some other reason once group plan ends like really low income and bad health?

Tennessee and the ACA’s Medicaid expansion | healthinsurance.org

3. ACA - If joint income is above $18,000 or so, in non Medicaid expansion state, they can get a very cheap ACA silver plan with low OOP. If lower then 18k, they may have to pay full price for ACA, which would be as much as Cobra full price. Premiums will go higher as income goes higher under ACA.

 

[DonP]

Ya agent question for you since your knowledgeable. A woman I know who’s been doing this since inception told me this .If somebody estimated they would make $18 k and made $8 k and is under the minimum for ACA.. She said she’s never seen Aca ask for any credits back or cancel anyone’s coverage if they made less than what they said . She said she’s got many people on Aca for yrs where they’ve never said a word . What’s your experience on this ?

 

[Yagents]

Never seen a poor person get a tax credit clawback. But, At some point, you cross the level of it being fraud. Its difficult for many to project income for future years.

Its against forum rules to say I'm knowledgeable

 

[rousemark]

Never seen a poor person get a tax credit clawback. But, At some point, you cross the level of it being fraud. Its difficult for many to project income for future years.

Its against forum rules to say I'm knowledgeable

Well, how about you know your stuff?

 

[Yagents]

IRS posts guidance for temporary COBRA premium subsidy program | BenefitsPRO