WiscBroker
Expert
- 92
Seasoned brokers- Here is the scenario- need some advice:
1. Application on the exchange for 2018
2. One child, current age is 18, but will be turning 19 on November 29 this year.
3. Household income is approx. $40,000.
4. When applying on healthcare.gov, the marketplace is sending the currently 18 year old to CHiP/Medicaid because of the household income.
5. However, the child will actually turn 19 later this month and will be 19 for the 2018 plan year and my understanding of the rules will mean that 19 is too old to qualify for CHiP. In fact, if I put the child in as 19 years old, he stays on the Marketplace plan with a full tax credit for all family members and no one is sent to CHiP/Medicaid.
6. Question: Am I correct to assume the Marketplace is calculating ChiP/Medicaid eligibility based on the current date of application age of the child instead of the age of the client as of the effective date of 1/1/2018? Should I wait to submit this application until after the child turns 19 on Nov 29 and then will it keep the child on the Marketplace application instead of sending to ChiP/Medicaid? If this is in fact how it is handled, this could be a problem for those scenarios where an 18 year old turns 19 from Dec 16-Dec 31 because you would have to apply during OEP and therefore they would be sent to ChiP only to be found ineligible due to being 19.
Am I right on this? Does this make any sense?
1. Application on the exchange for 2018
2. One child, current age is 18, but will be turning 19 on November 29 this year.
3. Household income is approx. $40,000.
4. When applying on healthcare.gov, the marketplace is sending the currently 18 year old to CHiP/Medicaid because of the household income.
5. However, the child will actually turn 19 later this month and will be 19 for the 2018 plan year and my understanding of the rules will mean that 19 is too old to qualify for CHiP. In fact, if I put the child in as 19 years old, he stays on the Marketplace plan with a full tax credit for all family members and no one is sent to CHiP/Medicaid.
6. Question: Am I correct to assume the Marketplace is calculating ChiP/Medicaid eligibility based on the current date of application age of the child instead of the age of the client as of the effective date of 1/1/2018? Should I wait to submit this application until after the child turns 19 on Nov 29 and then will it keep the child on the Marketplace application instead of sending to ChiP/Medicaid? If this is in fact how it is handled, this could be a problem for those scenarios where an 18 year old turns 19 from Dec 16-Dec 31 because you would have to apply during OEP and therefore they would be sent to ChiP only to be found ineligible due to being 19.
Am I right on this? Does this make any sense?
