Benefits Ran Out. So Does Coverage?

[Bob_The_Insurance_Guy]

Met a lady today who received a Subsidized Plan for 2014, because she had unemployment, which has just ran out. For 2015, she will have NO income.

As I understand it, she will not be eligible for an ACA Plan on Market, because she has no income.

Right or wrong.

This is for the State of Georgia (we did not expand Medicaid)

 

[dgoldenz]

Correct if state did not expand Medicaid.

 

[FLM2]

Bob, if she thinks she will be working next year you can state the income above the FPL and get a subsidized plan-if it doesn't happen there is no penalty per an US Treasury document that has been posted previously on this forum (I don't have time to search for it).

 

[G.Gordon]

Right, she can "estimate" that she is going back to work.

I refrain from making such suggestions, but if they open the conversation that they are looking for work I go along with the fact that they are estimating 2015 income.

 

[FLM2]

Right, she can "estimate" that she is going back to work.

I refrain from making such suggestions, but if they open the conversation that they are looking for work I go along with the fact that they are estimating 2015 income.

I understand your position but this is a ridiculous situation-making someone pay $400+ a month because they don't have a job (even though they have a work history) makes no sense.

I don't deal with very many in this income range but, when I do, I would say to a client that, if they get a job for even minimum wage and earn $12000 they will get a bonus of about $5000 with almost free health insurance and it usually gets the point across.

 

[dgoldenz]

I understand your position but this is a ridiculous situation-making someone pay $400+ a month because they don't have a job (even though they have a work history) makes no sense.

I don't deal with very many in this income range but, when I do, I would say to a client that, if they get a job for even minimum wage and earn $12000 they will get a bonus of about $5000 with almost free health insurance and it usually gets the point across.

It's a great system isn't it?

 

[RayNY]

Did I miss something that makes those with an income=$0 ineligible for medicaid?

https://dch.georgia.gov/eligibility-criteria-chart GA's eligibility chart says "low income medicaid" is available, and $0 is certainly under the limits they give. It's certainly under 100% FPL. Healthcare.gov says they're medicaid eligible.

 

[FLM2]

It's a great system isn't it?

No, it isn't but it's the only one we have, right?

 

[Bob_The_Insurance_Guy]

Did I miss something that makes those with an income=$0 ineligible for medicaid?

https://dch.georgia.gov/eligibility-criteria-chart GA's eligibility chart says "low income medicaid" is available, and $0 is certainly under the limits they give. It's certainly under 100% FPL. Healthcare.gov says they're medicaid eligible.

So, what you are saying is, if she puts down an income of $0, she will get 100% subsidy?

 

[AllenChicago]

So, what you are saying is, if she puts down an income of $0, she will get 100% subsidy?

You're making it too complicated Bob. Re-read FLM2's first post in this thread. Follow that guidance and your client will love you.
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