Insurance For Those Who Don T Qualify For Medicaid


I Need Health Insurance But I Have No Income

What Is Medicaid? | Medicaid Made Clear

In case youre jobless and have no income you might have the option to get a reasonable medical coverage plan through the Marketplace, with investment funds from your savings account and family unit size. You may likewise fit the bill for nothing or ease inclusion through Medicaid or the Childrens Health Insurance Program .

Medicaid Enrollees Experience Income Changes That Lead To Coverage Disruption

Medicaid eligibility is based on a familys current monthly income. Once they enroll, most enrollees have 12 months before they must renew their coverage, but during the 12 months they must report any changes that affect their eligibility. If they report a change that makes them ineligible, they lose coverage. In addition to the requirement that enrollees report changes, many states regularly check data sources such as quarterly wage reports and, if they find information suggesting enrollees may be ineligible, they require that enrollees provide information showing they remain eligible. If enrollees dont respond to the request for information within a short period of time or are unable to show they remain eligible, they lose coverage.

People often dont receive a request for information or dont respond to it in time, or they may have worked overtime or picked up an extra shift that temporarily put them over the eligibility threshold. Many enrollees reenroll in Medicaid within months of losing coverage, a process known as churn. Others arent aware they are still eligible or are unable to successfully reapply, and they remain uninsured.

What Would Happen If All States Expanded Medicaid

If states that are currently not expanding their programs adopt the Medicaid expansion, all of the nearly 2.2 million adults in the coverage gap would gain Medicaid eligibility. In addition, 1.8 million uninsured adults with incomes between 100 and 138% of poverty6 would also gain Medicaid eligibility . Though most of these adults are eligible for substantial tax credits to purchase Marketplace coverage,7 Medicaid coverage would likely provide more comprehensive benefits and lower premiums or cost-sharing than they would face under Marketplace coverage. For example, research from early implementation of the ACA showed that coverage of behavioral health services, prescription drugs, rehabilitative and habilitative services, and long-term services and supports may be more limited in the Marketplace compared to Medicaid.8,9 In addition, research examining the population with incomes between 100-138% FPL in expansion and non-expansion states finds that Medicaid expansion coverage produced far greater reductions than subsidized Marketplace coverage in average total out-of-pocket spending, average out-of-pocket premium spending, and average cost-sharing spending.

Figure 3: Nonelderly Uninsured Adults in Non-Expansion States Who Would Be Eligible for Medicaid if Their States Expanded, 2019

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Trends In Uninsured Rates By Race/ethnicity 2010

Prior to the ACA, people of color were more likely to be uninsured compared to their White counterparts. In 2010, when the ACA was enacted, 46.5 million people or 17.8% of the total nonelderly population were uninsured. People of color were at much higher risk of being uninsured compared to White people, with Hispanic and AIAN people at the highest risk of lacking coverage . The higher uninsured rates among people of color reflected more limited access to affordable health coverage options. Although, the majority of individuals have at least one full-time worker in the family across racial and ethnic groups, people of color are more likely to live in low-income families that do not have coverage offered by an employer or to have difficulty affording private coverage when it is available. While Medicaid helped fill some of this gap in private coverage, prior to the ACA, Medicaid eligibility for parents was limited to those with very low incomes , and adults without dependent childrenregardless of how poorwere ineligible under federal rules.

Figure 1: Uninsured Rates for the Nonelderly Population by Race and Ethnicity, 2010-2019

How To Get A Free Car Seat If Medicaid Does Not Approve Your Application

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Medicaid is a government organization but there are many private and state funded organizations too where you can apply for a free car seat. Below is a list of 36 states with links to the responsible websites. You can check if it works for your state.

If your child weighs anywhere between 5 and 65 lbs then you can receive a free car seat or a booster seat and if you have twins then you are entitled to receive two seats.

Parents can receive a free car seat after a child receives all required immunizations.

Free car seats are made available to low income parents and legal guardians of children until the child is ready to ride safely.

Free car seats are not available but you can get it at a reduced price of $10.

A limited number of car seats might be available to families with low incomes

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Unemployed Applicants Should Use State Or Federal Marketplace

An unemployed person can apply for health insurance on the federal or state exchanges. They may find affordable low-premium options based on family income. Should they not find an affordable option, they may qualify for an exemption, Medicaid, or the CHIP.

Many states offer assistance to low-income families to help them qualify for affordable health insurance including payment assistance. If income is below the minimum needed for Obamacare, then applicants can seek coverage under the applicable state Medicaid program or CHIP for minors.

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Income Fluctuation Is Common Among Medicaid Enrollees

Even before the COVID-19 pandemic, income volatility was rising due to labor market changes including increased self-employment, seasonal work, unpredictable work schedules, and growth in contracting and temporary work arrangements. Hourly employees with variable work hours and those with more than one part-time job are particularly likely to experience income fluctuations that may raise their incomes above the Medicaid threshold for short periods of time. Three-quarters of early-career hourly workers experience fluctuations in their work hours, varying by an average of more than eight hours per week. And 70 to 80 percent of parents with young children working in hourly jobs have hours that fluctuate substantially. Many participants in the gig economy also experience considerable variability in hours based on the availability of work.

For example, a family that earns $2,100 in the month it applies for Medicaid might have income thats 25 percent higher for two or three months during their eligibility period. For most adults, that exceeds the Medicaid eligibility threshold and the adults in the family would be at risk of losing coverage. However, that same household could also experience two to three months in that same year where their income was about $1,580 per month, which is below the poverty line.

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How To Apply For Medicaid

Qualifying for Medicaid varies from state to state. The two basic ways to apply for Medicaid or CHIP coverage is to contact a state Medicaid agency to apply through them or to fill out an application through the Health Insurance Marketplace and wait for a Medicaid or CHIP representative to contact them.

The qualification process covers things like establishing Medicaid eligibility, discussing coverage and services, discussing liens and third-party liability coverage, discussing provider enrollment rules and Medicaid claims, how to report a lost Medicaid card and request a replacement, finding a Medicaid or CHIP provider, and checking the status of a Medicaid or CHIP application.

Appealing Medicaid Denials

If Medicaid denies an application for the program, they must send the applicant a denial notice. That notice would come in the mail within 90 days if the applicant applied for Medicaid for a disability and 45 days if the applicant applied for the program on another basis. The specifics on making a formal appeal will also be written on the notice, so applicants must read the rejection carefully if they receive one.

Legislation Aims To Make Medicare More Affordable For Lower

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The Improving Medicare Coverage Act, introduced in the U.S. House in September by Washington Representative Pramila Jayapal, would do away with cost-sharing and premiums for Medicare beneficiaries with income up to 200% of the poverty level .

This bill, or something like it, would eliminate the current sticker shock that can go along with the transition from expanded Medicaid to Medicare. If you have an opinion on the legislation, you can reach out to your elected officials to speak with them about it.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health marketplace updates are regularly cited by media who cover health reform and by other health insurance experts.

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Closing Medicaid Coverage Gap Would Help Diverse Group And Narrow Racial Disparities

The 2.2 million uninsured adults with incomes below the poverty line who were caught in the Medicaid coverage gap in 2019 are a varied group theyre essential workers, parents caring for children, older and younger adults, and diverse in terms of race and ethnicity but they all have something in common. They live in states that have failed to adopt the Affordable Care Acts Medicaid expansion, even with significant federal financial incentives, leaving this group with no pathway to affordable coverage.

States that havent implemented expansion should do so, and to account for states that wont, Congress should act on calls from Senators Warnock and Ossoff and over 60 civil rights and other organizations to close the coverage gap by creating a federal fallback.

Extending health insurance to people in the coverage gap squarely benefits people with incomes below the poverty line who are uninsured and lack any access to affordable coverage.Extending health insurance to people in the coverage gap squarely benefits people with incomes below the poverty line who are uninsured and lack any access to affordable coverage. Some 60 percent of people in the gap in 2019 were people of color, reflecting long-standing racial and ethnic disparities in health care access that coverage extensions would do much to address.

Special Enrollment Periods For Unemployed Persons

Losing coverage because of losing a job is a life event under the Affordable Care Act that creates a special enrollment period. Those who lose employment-based coverage can get new coverage with a special enrollment period of sixty days. This life event exception applies to those that lose coverage as a dependent too.

They can get a special enrollment period to buy new insurance coverage. The items below are among the life events that can help the unemployed get a special enrollment period.

  • Losing employer-sponsored health insurance as an employee
  • Losing employer-sponsored health insurance as a dependent
  • Losing employer-sponsored coverage on the 26th birthday
  • Losing employer-sponsored coverage by divorce

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Gaps In Health Coverage

The pandemic and economic crisis have exposed major gaps in health coverage. Individuals who lose their jobs and employer coverage could fall through four cracks:

  • In states that did not expand Medicaid, families could fall into the coverage gap. In these states, income eligibility for Medicaid typically ends below 50 percent of the federal poverty level, but income eligibility for ACA subsidies does not begin until 100 percent of the federal poverty level. The Kaiser Family Foundation estimates that 9 million people will fall into the coverage gap by January 2021.
  • Families could have incomes above 400 percent of the federal poverty level in 2020, making them ineligible for ACA subsidies. Because income eligibility is determined on a calendar-year basis and unemployment insurance benefits count as income, unemployed individuals could have incomes above 400 percent of the poverty level even if they have no current wages. The Kaiser Family Foundation estimates that 7 million people will be ineligible for subsidies due to the way income is counted.
  • Families could be eligible for Medicaid or ACA subsidies but not know of their eligibility, or the process of enrollment could pose a barrier. Before the pandemic, millions of people were eligible for subsidies but not enrolled in coverage. The lack of seamless enrollment will be an acute problem during the current crisis.
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    How Advanced Planning Helps

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    When you change the ownership of assets, you make it easier to qualify for Medicaid in the future. Typically, the state will go back over 60 months or five years of your financial activity. If you want to qualify quickly when you apply, you typically need to have made any major transfers at least five years before applying. Otherwise, there may be a penalty.

    You can also change the ownership of your house to a trust to protect it from estate recovery efforts after your death. The right planning will give you access to financial support during retirement without putting your legacy at risk.

    Learning more about Medicaid qualifications and other estate planning concerns will help you manage your finances and medical needs in your golden years.

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    Medicaid Expansion Improves Coverage And Access To Care

    States that expanded Medicaid have seen significantly greater reductions in uninsured rates than states that failed to expand. In 2019 the uninsured rate among low-income, non-elderly adults had fallen to roughly half of the pre-ACA rate in expansion states, from 35 percent in 2013 to 17 percent in 2019. Non-expansion states experienced a much smaller reduction in the uninsured rate among this group, falling from 43 percent in 2013 to 34 percent in 2019. The Kaiser Family Foundation estimates that if the 12 remaining non-expansion states expand Medicaid, 4 million uninsured adults would become eligible for Medicaid coverage, equivalent to 36 percent of the uninsured non-elderly adult population in these states.

    The State Limits Your Assets And Income

    The size of your household determines how much income you can have annually while still qualifying for Florida Medicaid. Retired adults living on a fixed income can often structure their budgets to qualify.

    They will also have to think ahead about changing how they hold some of their property. Assets in your own name can prevent you from qualifying for Medicaid. There are very strict limits on personal property, with the exception of real estate. You can qualify for Medicaid with hundreds of thousands of dollars in equity in your primary residence. However, the state might make a claim against your estate after you die and expect your loved ones to sell your house to pay for your medical care.

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    Many People Remain Uninsured

    Many individuals who lose Medicaid coverage believe they are ineligible and dont reapply. Since other insurance options are likely unaffordable, they go without coverage. Other individuals may recognize that they remain eligible, but may be unable to navigate the application process to regain coverage. This group that remains uninsured is not often covered in measures of churn, which are based only on those who reapply after a gap in coverage.

    A study of individuals who lost CalFresh benefits found that, based on quarterly wage data, 55 percent to 75 percent of those who left the program appeared to have income below the eligibility threshold during the month they left. Yet only 15 percent returned to the program within 90 days. This suggests that many people who lose benefits remain eligible but dont find their way back to the program.

    Low- and moderate-income people with incomes above the Medicaid eligibility threshold are eligible for subsidized coverage through the marketplace, but the process of transitioning to marketplace coverage is cumbersome and difficult to navigate. People may not understand notices from the Medicaid agency, not be aware they are eligible, believe marketplace coverage is too expensive, or think they have to wait for open enrollment.

    Emergency Health Coverage For The Unemployed And Uninsured In Response To The Pandemic And Economic Crisis

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    To guarantee immediate coverage for all of the unemployed, Congress should pass legislation to rapidly enroll them in Medicaid.

    Nearly 38 million Americans have filed claims for unemployment insurance, and many more live in households in which someone has lost a job. As a result, nearly 27 million people could lose their employer coverage and become uninsured. Among this group, about half could be eligible for Medicaid, and several million more would be eligible for subsidies under the Affordable Care Act . However, major gaps in coverage and affordability would remain. If the unemployment rate reaches 20 percent, Oliver Wyman estimates that the number of uninsured will increase by about 9 million people.

    To respond to this crisis and help as many people as quickly as possible, this column proposes emergency health coverage for the unemployed and uninsured. This emergency health coverage would build on one of the most popular parts of the ACAits Medicaid expansionby automatically enrolling the unemployed into Medicaid. In doing so, it would guarantee immediate coverage for all of the unemployed.

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    How Mepd Services Are Provided

    If you’re an adult with a disability and qualify for MEPD, these services are typically provided by STAR+PLUS. You will choose a STAR+PLUS health plan from the ones available in your service area.

    If you have a child with a disability who qualifies for MEPD, these services are typically provided by STAR Kids. You will choose a STAR Kids health plan from the ones available in your service area.

    You might also be enrolled into traditional Medicaid. Traditional Medicaid just means the state pays your doctors, nurses and other caregivers directly.


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