Assets too high for Medicaid, income too low for subsidy

[Mr. Paul]

Well for crying out loud

We are 59 and our plan has been to live off savings, spending about 60K per year, until being eligible for SS at 62. We had virtually no income in 2012 and expect the same for 2013.

Our Anthem individual health care premium is going from $1374/mo to $1696/mo next year (Anthem rep said "looks like your premium is going up a bit for next year" )

Our assets make us ineligible for Medicare. Our lack of income makes us ineligible for a subsidy.

However if we take $22,000 from our IRA next year, that apparently will put us just above the poverty level and qualify us for a 95% subsidy on an ACA plan. That is working the system ... but the alternative is spending nearly $55 PER DAY next year on a 5K deductible health care policy.

 

[donheff]

Odd that the House has not proposed a simple fix allowing gap individuals in non-medicaid expansion states to get some of their contributions returned by authorizing supplements to people like you. I would think the Senate would go along with that.

 

[Lsbcal]

...
Our assets make us ineligible for Medicare. Our lack of income makes us ineligible for a subsidy.
....

At 59 yes, but at 65 you'll be eligible. Probably you already know this but just thought I'd mention it. Link: Medicare.gov - Medicare Eligibility Tool (General Enrollment)

One of the benefits of old age I guess.

 

[Mr. Paul]

At 59 yes, but at 65 you'll be eligible. Probably you already know this but just thought I'd mention it. Link: Medicare.gov - Medicare Eligibility Tool (General Enrollment)

One of the benefits of old age I guess.

Thanks. I meant to say we weren't eligible for Medicaid due to assets.

I know I didn't originally really post a question ... just kind of a commentary on how nuts this whole healthcare thing has become.

Thanks

 

[Fermion]

Where is the 60K coming from? If that is "money under the mattress" (or already taxed money in low paying bonds) then I understand why you would have little income.

If you do have that 60K around, why not do a conversion from the IRA to a Roth for $25,000 or so. This will give you $25K of income and you will get a subsidy, plus you keep your money earning tax free.

The system can be gamed so hard right now....fun times for us on this board!

 

[MichaelB]

Thanks. I meant to say we weren't eligible for Medicaid due to assets.

I know I didn't originally really post a question ... just kind of a commentary on how nuts this whole healthcare thing has become.

Thanks

Changed the title to minimize confusion. What state do you live in? Many have expanded Medicaid and are no longer subject to asset tests.

 

[Lsbcal]

It wasn't planned this way but a side benefit for us was that in doing the Roth conversions we had income that later on helped us qualify for the best terms in a refi. Strange but true.

We're now using the Roth's to manage our income streams for taxes, prior to RMD's.

Yep, there are games you can (maybe must) play. It's fun too.

 

[Mr. Paul]

Changed the title to minimize confusion. What state do you live in? Many have expanded Medicaid and are no longer subject to asset tests.

Avoid Confusion? Heck most of us wouldn't be comfortable if we weren't confused

Colorado has expanded Medicaid but the asset rules are still in place. It was designed for folks that really really need it and it that sense it is working.

 

[Mr. Paul]

Where is the 60K coming from? If that is "money under the mattress" (or already taxed money in low paying bonds) then I understand why you would have little income.

If you do have that 60K around, why not do a conversion from the IRA to a Roth for $25,000 or so. This will give you $25K of income and you will get a subsidy, plus you keep your money earning tax free.

The system can be gamed so hard right now....fun times for us on this board!

Even though I didn't ask a question this is one hell of an answer. Thank You Fermion.

 

[MichaelB]

Avoid Confusion? Heck most of us wouldn't be comfortable if we weren't confused

Colorado has expanded Medicaid but the asset rules are still in place. It was designed for folks that really really need it and it that sense it is working.

This is news I hadn't heard elsewhere. My understanding was the expanded Medicaid used a single methodology to determine eligibility that is based solely on MAGI. Can you give me a link to this?

 

[rbmrtn]

This is news I hadn't heard elsewhere. My understanding was the expanded Medicaid used a single methodology to determine eligibility than is based solely on MAGI. Can you give me a link to this?

Yes, that doesn't sound correct. If medicaid is expanded then the new rules are in place.

Here's a link to CO medicaid FAQ

https://connectforhealthco.custhelp...pbWUvMTM4Mzk2MjIwOS9zaWQvdlZucG5URWw=/c/32,33

https://connectforhealthco.custhelp.com/app/answers/detail/a_id/220

 

[daylatedollarshort]

This article states that federal law bars assets tests for Medicaid, though Colorado Republicans want the test back -

Colorado Republicans want asset test for Medicaid - The Denver Post

 

[Mr. Paul]

This is news I hadn't heard elsewhere. My understanding was the expanded Medicaid used a single methodology to determine eligibility than is based solely on MAGI. Can you give me a link to this?

I have found it quite impossible to find anything in writing regarding eligibility and asset level. Everything I've found so far has been through phone conversations with support folks provided by the state.

Looking at all the links suggested, I can't find anything specific to this particular issue of asset levels and Medicaid.

Thanks

 

[kevink]

I've looked into this extensively and found NO means testing for Medicaid under ACA. Please do let us know if you find out differently, but I would go ahead and apply for Medicaid based on your income if it suits you. Otherwise, as others have pointed out, you'll have to "generate" income to get you up to the subsidy levels.

I see you're from Westcliffe and I used to live nearby, in Cañon City, which despite being a retirement haven has historically had very few doctors who take Medicare, let alone Medicaid. So it would behoove you if you're contemplating going the Medicaid route to know what that means in terms of actual access. It might not amount to much more than grudging admittance to the ER at St. Thomas Moore.

I'd skip any more phone calls to the State and rely on KFF and the federal program guidelines. Let us know how you make out.

 

[pb4uski]

I have found it quite impossible to find anything in writing regarding eligibility and asset level. Everything I've found so far has been through phone conversations with support folks provided by the state.

Looking at all the links suggested, I can't find anything specific to this particular issue of asset levels and Medicaid.

Thanks

I would be very hesitant to rely on phone conversations with state support people. Some of them a very knowledgeable but most are quite clueless once you get beyond the basics in my experience. Besides, if you have an issue later, it is hard to defend a flawed position by claiming that "so and so told me this on x date at y time" since there is no record of what they told you. If they do tell you something, ask for the reference so you can look at it yourself.

 

[Mr. Paul]

I've looked into this extensively and found NO means testing for Medicaid under ACA. Please do let us know if you find out differently, but I would go ahead and apply for Medicaid based on your income if it suits you. Otherwise, as others have pointed out, you'll have to "generate" income to get you up to the subsidy levels.

I see you're from Westcliffe and I used to live nearby, in Cañon City, which despite being a retirement haven has historically had very few doctors who take Medicare, let alone Medicaid. So it would behoove you if you're contemplating going the Medicaid route to know what that means in terms of actual access. It might not amount to much more than grudging admittance to the ER at St. Thomas Moore.

I'd skip any more phone calls to the State and rely on KFF and the federal program guidelines. Let us know how you make out.

What is KFF ?

I've already applied for and been denied for Medicaid. Perhaps an appeal is in order. That would at least get the reasons for denial in writing.

The county here has a great local clinic now. And grudging admittance to the ER is still admittance

 

[rbmrtn]

Kaiser Family Foundation, very good resource for health care info Medicaid | The Henry J. Kaiser Family Foundation

It almost sounds like you applied and were denied for CURRENT medicaid. The medicaid expansion coverage doesn't start until Jan 01 2014. How did you apply for it ?

 

[MichaelB]

Kaiser Family Foundation, very good resource for health care info Medicaid | The Henry J. Kaiser Family Foundation

It almost sounds like you applied and were denied for CURRENT medicaid. The medicaid expansion coverage doesn't start until Jan 01 2014. How did you apply for it ?

+1 on both KFF and the Medicaid application.

 

[kevink]

Seconding what rbmrth and MichaelB say and if I were you I'd just be applying via Healthcare.gov online or using their 800 number if the site is still screwy. As with any other communication with the government I suggest giving them just the information they ask for and volunteering nothing else. The income you've reported on your annual tax filings qualifies you for Medicaid from what you've said and you don't expect that number to move much. The fact that you have assets and are living off them is your business, not theirs - until you turn 65, at which time normal Medicaid means testing kicks in. That'll be moot for you anyway since you're planning on doing Medicare, but why not save some bucks for your supplemental premiums in the intervening few years?

 

[Mr. Paul]

Thanks for the great information. I applied for 2014 Medicaid on the Colorado web site in the first week of October, right after it was opened. Got a letter in the middle of October saying I was denied but that they were trying to expand availability and my app would be reviewed at a later time and that I might be determined to be eligible. Got a final denial last week.

Thanks to the helpful folks here I now understand that this does not sound right and I've got some follow up work to do.

Many thanks.

 

[Mr. Paul]

As suggested here, I have found that I am indeed eligible for Medicaid starting Jan 1. Nobody can tell me why I received the email saying I was denied.

Thanks for your help. Much appreciated.

 

[audreyh1]

Great news for you!

 

[golfnut]

I applied for ACA and got the Medicaid letter. What is the minimum income needed to avoid Medicaid. We live in Illinois and am looking to get aca coverage for my wife, son and myself. Most of our "income" is coming from taxable investments. We are also, of course, including my wife's and son's salaries from their pt jobs.

Thanks,
Golfnut

 

[pb4uski]

We're not your research department. You should be able to figure it out in about 5 minutes using google or your state's subsidy calculator.

 

[golfnut]

We're not your research department. You should be able to figure it out in about 5 minutes using google or your state's subsidy calculator.

Tried that before posting. Maybe others can help.