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Old 10-06-2013, 10:19 AM   #21
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Originally Posted by donheff View Post
Many could get caught below the "gap" in regular Medicaid territory but with too much in assets to get Medicaid.
I believe qualifying for Medicaid under PPACA is strictly based on MAGI now and no longer includes assets.
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Old 10-06-2013, 10:28 AM   #22
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Originally Posted by tinlizzy View Post
I believe qualifying for Medicaid under PPACA is strictly based on MAGI now and no longer includes assets.
Only if your state expands medicaid. If they don't the old rules are in place.
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Old 10-06-2013, 04:17 PM   #23
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This strategy may differ depending on whether your FPL is above or below 250%. If lower than 250%, you can recovery the subsidy on an exchange purchased policy, but AFAIK you will not retroactively get copay and out of pocket assistance. This does not seem to be recoverable at year end should your medical expenses go that high even if your income was lower. This can be a difference lost of up to about $10k annually.

So at 250 or lower, it may be worth documenting as needed to get the 73% AV version of the health plan. Then it becomes even more worthwhile at 200% or lower levels on the exchange in order to get the 87% - 94% AV versions going down to near zero deductibles and $1k out of pocket.
Hi, I've been lurking but this thread got me to register at last. I *thought* I was pretty up on ACA stuff, through here and other sources, but this is the first time I've heard about the copay and out of pocket assistance under 250% of FPL. I am planning to pull the plug at work in December, based on being able to get insurance on the exchange. Hubby and I both have pre-existing conditions, and have been waiting for this moment.

We are planning to control MAGI through Roth conversions, and want to get it just above 138% FPL to stay out of Medicaid (expanded in WA state.) I was ready sign up for the Bronze plan, but this means I need to take a second look. Can anyone explain how this assistance works? I can't find anything on the exchange website. I can start a new thread on it if appropriate... Thanks for all the help given here!
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Old 10-06-2013, 04:26 PM   #24
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Originally Posted by NW-Reader View Post
Hi, I've been lurking but this thread got me to register at last. I *thought* I was pretty up on ACA stuff, through here and other sources, but this is the first time I've heard about the copay and out of pocket assistance under 250% of FPL. I am planning to pull the plug at work in December, based on being able to get insurance on the exchange. Hubby and I both have pre-existing conditions, and have been waiting for this moment.

We are planning to control MAGI through Roth conversions, and want to get it just above 138% FPL to stay out of Medicaid (expanded in WA state.) I was ready sign up for the Bronze plan, but this means I need to take a second look. Can anyone explain how this assistance works? I can't find anything on the exchange website. I can start a new thread on it if appropriate... Thanks for all the help given here!
+1 New concept to me as well. This is all academic to me but I have friends to whom it may matter. The Federal Health Benefits Program also hides opportunities and pitfalls that can be very hard to analyze. It would be so much easier if you knew exactly what health resources you would use in the coming year.

Oh -- and welcome to the forum NW-Reader.
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Old 10-06-2013, 04:40 PM   #25
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We are planning to control MAGI through Roth conversions, and want to get it just above 138% FPL to stay out of Medicaid (expanded in WA state.) I was ready sign up for the Bronze plan, but this means I need to take a second look. Can anyone explain how this assistance works? I can't find anything on the exchange website. I can start a new thread on it if appropriate... Thanks for all the help given here!
Look at this link, pages 13 & 14 http://www.healthreformgps.org/wp-co...redit-7-18.pdf . It details cost sharing subsidies, why and how they work.

The idea behind cost sharing is simple. People below 250% of the FPL can't afford a policy, even which subsidies, because the deductible and copays are too high for their level of income. To make it affordable, in addition to premium assistance the copays and deductible need to be reduced. This is what cost share does. To simplify the process, one silver level policy on the exchange is designed for that purpose.
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Old 10-06-2013, 04:56 PM   #26
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Thanks, that helps. Looks like I have some more homework to do. I think I will end up having to work with a navigator, since everything will be based on projected (and quite different) income for next year, with nothing to verify it. I too ran into trouble online since I am still employed, with HI, and wasn't sure how to answer those questions. Still confident I can get it all worked out, and looking forward to ER!
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Old 10-06-2013, 05:24 PM   #27
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Also note in regards to the 250% copay/deductible subsidy is that it is available only if you choose a silver plan.
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