Medicaid and ER

[SoutheastSam]

Can a family get medicad if you quit work and decided to retire early?

I mean the parents. I think a kid can get on it I know if the income is low enough.


only reason I ask is a 'friend of a friend' retired around 45. they did well with their careers but my friend said that the parents have the kid on medicad. and they took out a catastrophic type policy on themselves.

why can't the parents get the medicad also? (providing they meet the income levels) wouldn't that make ER easier for many?

just wondering. never dealt with govt stuff much so when my friend mentioned this I started wondering.

 

[travelover]

Medicaid eligibility varies by state. I filled out an application for Medicaid for my FIL when it became necessary for him to go to a nursing home. In Michigan you have to list all your assets, not just income, so if you had a healthy IRA, 401(k) or taxable account, you would be expected to deplete that first, within limits to protect the spouse.

 

[ziggy29]

I don't know how exactly how PPACA will change this next year, but many states have asset limits to qualify for Medicaid. And those limits are generally very low, so you can't withdraw $50K per year from a $2M portfolio and show "no income" to receive Medicaid.

I don't believe there are any such asset tests under PPACA for the subsidies for incomes between 133% and 400% of FPL, and I'm not sure how it changes the rules for Medicaid eligibility, but *right* now I'm pretty sure someone with no income but considerable assets needs to check their state laws.

I **believe** (definitely NOT sure) that states which opt into expanded Medicaid eligibility next year can't use asset tests to determine eligibility (anything under 133% of FPL would qualify), but states that do NOT opt into it can keep their existing rules. Again, I am far from certain on this point. The original intent of PPACA was to require Medicaid expansion for everyone, but the Supreme Court ruled that states could opt into it but not be forced.

 

[MichaelB]

I don't know how exactly how PPACA will change this next year, but many states have asset limits to qualify for Medicaid. And those limits are generally very low, so you can't withdraw $50K per year from a $2M portfolio and show "no income" to receive Medicaid.

I don't believe there are any such asset tests under PPACA for the subsidies for incomes between 133% and 400% of FPL, and I'm not sure how it changes the rules for Medicaid eligibility, but *right* now I'm pretty sure someone with no income but considerable assets needs to check their state laws.

I **believe** (definitely NOT sure) that states which opt into expanded Medicaid eligibility next year can't use asset tests to determine eligibility (anything under 133% of FPL would qualify), but states that do NOT opt into it can keep their existing rules. Again, I am far from certain on this point. The original intent of PPACA was to require Medicaid expansion for everyone, but the Supreme Court ruled that states could opt into it but not be forced.

That's pretty much it. The PPACA Medicaid reform determines eligibility only on income and includes everyone. Here's a map showing which status by state. So far, 18 states have committed to the expansion. http://www.cbpp.org/files/status-of-the-ACA-medicaid-expansion-after-supreme-court-ruling.pdf

 

[heeyy_joe]

I hope we can all aim just a little higher than Medicaid.

 

[ziggy29]

I hope we can all aim just a little higher than Medicaid.

+1

I mean, I can see "aiming" for getting below 400% of FPL for PPACA's subsidies if you have a relatively simple lifestyle. You can live comfortably on that in most of the country if you are debt-free and have simple tastes.

But even if I could engineer my situation in a way that allowed me to be on Medicaid even with substantial assets, I wouldn't choose to take it and have significant limitations on the providers who will take it and other factors. I think I'd rather pay a bit and have more choices with my providers and possibly more "available" care. That said, I only speak to the legalities.

 

[Bikerdude]

I don't know, maybe its just me, but asking my friends and neighbors to pay my medical expense so I can retire early just doesn't seem fair.

 

[ERhoosier]

I don't know, maybe its just me, but asking my friends and neighbors to pay my medical expense so I can retire early just doesn't seem fair.

+1

And IMHO ACA provisions lowering the Medicaid eligibility to EXclude net worth will have to be changed when the full cost of this expanded coverage is realized.

 

[ziggy29]

I don't know, maybe its just me, but asking my friends and neighbors to pay my medical expense so I can retire early just doesn't seem fair.

It may seem unfair, but we have to ask what our goal is: saving money or enforcing what "feels" just (and they are not always the same thing). Some states eliminated their assets tests on Medicaid -- and their costs DROPPED because the cost of enforcing the limits was greater than the costs of "wealthy leeches" abusing the system. (This was Oklahoma's experience for at least one example).

How many multi-millionaires want to use only Medicaid doctors and facilities? Think about it. Maybe a few of the type of [-]tightwads[/-] frugal people that are heavily represented on this board would be willing to do that, but we are outliers -- as has often been said. We are not the 90% of the people who don't try to live significantly below their means.

I am not advocating for the elimination of assets tests, so PLEASE, people, don't go on that ideological red herring. I'm just saying if it's about saving taxpayer money, the correct policy is not obvious and *might* be counter-intuitive. What you assume to be true may not be.

 

[razztazz]

This seems like as good a thread as any to ask this. I haven't found a definitive answer anywhere in my readings of PPACA. Say a person has NO income. An outta work guy. He makes no money. BUT, he was conscientious and prudent and carried an individual policy from an insurance company which is currently in-force. In 2014 will he be eligible for a subsidy to continue to purchase this policy or will he be forced to ditch the policy and go to Medicaid?

 

[M Paquette]

I don't know, maybe its just me, but asking my friends and neighbors to pay my medical expense so I can retire early just doesn't seem fair.

Good news! Most of us Early Retirement folks have decided to retire at effective income levels above 135% of the poverty line, so we won't be asking our neighbors for medical support OR stealing their cat's Fancy Feast.

I plan on not using Medicaid or PPACA subsidies for any or my medical coverage, and have sufficient funds to cover myself until the Generational Justice folks cart me off to Generational Challenge Camp. (Tip o' the hat to Frank Luntz for more great phrases!)

 

[SoutheastSam]

great replies on this thread. I am learning alot about it all.

 

[MichaelB]

This seems like as good a thread as any to ask this. I haven't found a definitive answer anywhere in my readings of PPACA. Say a person has NO income. An outta work guy. He makes no money. BUT, he was conscientious and prudent and carried an individual policy from an insurance company which is currently in-force. In 2014 will he be eligible for a subsidy to continue to purchase this policy or will he be forced to ditch the policy and go to Medicaid?

All policy access on the exchange will be driven by eligibility, so individuals will most likely only be able to apply for those policies for which they meet the specific eligibility. In this case, Medicaid. States may have different medicaid eligibility rules, so this will differ around the country.

 

[Bikerdude]

Good news! Most of us Early Retirement folks have decided to retire at effective income levels above 135% of the poverty line, so we won't be asking our neighbors for medical support OR stealing their cat's Fancy Feast.

I plan on not using Medicaid or PPACA subsidies for any or my medical coverage, and have sufficient funds to cover myself until the Generational Justice folks cart me off to Generational Challenge Camp. (Tip o' the hat to Frank Luntz for more great phrases!)

My Cat thanks you.