Medicaid Expansion For The Unemployed
Under the Affordable Care Act, states have the option to expand Medicaid to families with incomes up to 138 percent of the federal poverty level. To rapidly absorb the unemployed into affordable coverage, states should have the option to further expand Medicaid to two categories of enrollees: 1) individuals who are receiving unemployment insurance benefits or who were receiving unemployment insurance benefits that expired during the public health emergency and 2) families with incomes up to 200 percent of the federal poverty level. As under the current Medicaid program, eligible individuals who are enrolled in ACA coverage or employer coverage would be able to switch to Medicaid.
For the first eligibility category, states would automatically enroll in Medicaid all individuals who receive unemployment insurance benefits or food stampsunder the Supplemental Nutrition Assistance Program regardless of their income. This auto-enrollment would be similar to the current Express Lane Eligibility option, in which several states enroll children in Medicaid or the Childrens Health Insurance Program based on their SNAP eligibility.
States would guarantee continuous eligibility for these enrollees until the end of the public health emergency, at which point their eligibility would be redetermined. If they are no longer receiving unemployment insurance benefits, they would qualify for Medicaid under the second eligibility category.
What Information Will I Need To Have Ready To Apply
You will need to provide information such as name, date of birth, and gender for all members of the household. You will need to provide information about all sources of income received by household members and whether individuals have other insurance. For more on what counts as income, read this blog by Tricia Brooks. You will also need to provide Social Security numbers for anyone applying for coverage.
More From This Series Insuring Your Health
When you apply for health insurance on your states marketplace, youll be asked about your income. If youre collecting a typical unemployment check of about $300 a week and you live in the District of Columbia or one of the 25 states expanding Medicaid to adults with incomes up to 138 percent of the federal poverty level , youll probably qualify for coverage under that program and wont have to buy a plan on the exchange.
If the amount you received in tax credits is higher than it should have been based on your annual income, youll have to pay back the difference. But under the law your liability is limited if your income is less than 400 percent of the federal poverty level. Someone like you with income between 300 and 400 percent of poverty would be liable to repay no more than $1,250.
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Additional Federal Income Extended Through 2020 Included In Eligibility
If the additional federal compensation was extended from the current 16 weeks through to the end of 2020 and still included in the income eligibility calculations, the population of workers eligible for subsidies would be lower than if policymakers did not make any changes at all. Eligibility would drop for both expansion and nonexpansion states. However, the decline would be sharper for expansion states.
Expansion states would have no workers that would be eligible for both ACA marketplace premium tax credits and cost-sharing reductions. Instead, its populations would be divided nearly into thirds, with 35 percent eligible for Medicaid, 29 percent eligible for ACA marketplace premium tax credits, and 36 percent not eligible for any assistance.
Nearly half of all nonexpansion state vulnerable workers , on the other hand, would be eligible for ACA premium tax credits. Meanwhile, a third would have no assistance available.
Q How Will I Receive My Medical Care
A. In Delaware, Medicaid benefits are provided mainly through a managed care organization, or MCO, under contract with the state. Managed care is an organized way to ensure that people receive the quality medical care they need in the most cost-effective manner. Some Medicaid recipients in Delaware those who also receive Medicare and those in Long Term Care Medicaid programs such as the Nursing Facility program do not receive their medical care through a managed care organization.
DMMA provides a choice of managed care organizations so you can select the MCO plan that is best for you and your family. Delaware contracts with two managed care plans AmeriHealth Caritas and Highmark Health Options.
The Medicaid MCO provides almost all of the care for Medicaid members who join their plan. Prescription and non-emergency medical transportation services are covered directly by Medicaid, not through the MCO. Medicaid recipients need to show their Medicaid card to pharmacies and transportation providers when receiving these services.
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Who Can Get Medicaid
- No matter your state, you may qualify for Medicaid based on your income, household size, disability, family status, and other factors. But if your state has expanded Medicaid coverage, you can qualify based on your income alone.
- Enter your household size and state. We’ll tell you who is eligible for Medicaid, if your state expanded and if you qualify for Medicaid based only on your income.
- If you think you have Medicaid eligibility, you can create an account and fill out a Marketplace application. If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll send your information to your state agency. They’ll contact you about enrollment. You can apply any time of year.
- If you don’t qualify for Medicaid, we’ll tell you if you qualify for financial help to buy a Marketplace health plan instead.
What To Do If You Dont Qualify For Medicaid
If you dont qualify for Medicaid, you can possibly get subsidized health care through the Obamacare marketplaces during a special enrollment or open enrollment period. Americans who make between 100% and 400% of the FPL qualify for a premium tax credit that can significantly lower the cost of a plan.
Federal open enrollment for 2019 health care plans ended on Dec. 15, 2018, though some state exchanges are open longer and Nevada sells health insurance all year round. Learn 2020 open enrollments dates by state. Healthcare.gov, the federal exchange, usually opens from November 1 to December 15 each year.
If you cant find affordable health care on your marketplace during open enrollment, you have a few back-up options.
Short-term health insurance: Originally designed to prevent short-term health insurance gaps, these plans are cheaper, but much less comprehensive than traditional coverage. They dont have to cover Obamacares ten essential benefits or pre-existing conditions. Following changes by the Trump administration, short-term health plans can last from three months to potentially three years.
Limited benefit plans: These plans cover a very small portion of the costs associated with certain medical events, like a doctors visit or ambulance ride. Both the number of events and dollar amounts covered are capped.
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Which Medicaid Plan Is Best In Florida
Each Medicaid plan in Florida comes with the same core benefits which are listed here. You can also compare the performance data for the various plans in your area by using what is known as the Medicaid Health Plan Report Card. You will also have to consider things like the types of services that might be needed along with how many doctor visits that will be necessary, the plan that is accepted by your doctors, the types of doctors you will need, and what extra benefits will meet your needs.
What Does Medicaid Cover In Virginia
Medicaid in Virginia has three levels of benefits.
Full coverage provides members with the complete range of benefits. This includes pharmacy, hospital, and doctor services for qualified individuals.
Time-limited coverage is for people who meet the spend-down or women who get 24 months of services regarding family planning once the Medicaid coverage they had expires at the end of their pregnancy.
Medicare-related coverage is where Medicaid will pay for Medicare premiums. This might also include payments for Medicare coinsurance and deductible.
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What If I Earn Too Much To Qualify For Medicaid Or Chip But Cant Afford Private Health Insurance
Many individuals are eligible for financial assistance in purchasing a private health plan through the Affordable Care Act health insurance Marketplaces. Typically, consumers can only enroll in Marketplace coverage during the annual open enrollment period, unless they experience a life change such as losing health insurance, getting married, or moving. Many of the millions of people who have recently lost their jobs also lost their job-based insurance these individuals will have a 60-day window in which to sign up for Marketplace coverage. However, many who lost their jobs may not have coverage through their employer . Absent another life change, these individuals would not automatically qualify for a special enrollment opportunity. Twelve of the 13 states that operate their own Marketplaces are allowing the uninsured to sign up for Marketplace plans through a special enrollment period.
Visit the Georgetown University Center on Health Insurance Reforms Navigator Guide for answers to your questions about Marketplace plans.
What Options Does Medi
When you apply for Medi-Cal, your countys social services office will determine the eligibility of every family member. Depending on your circumstances, some household members might qualify, while others need to get a Covered California plan. Some Medi-Cal services aim to keep families and children healthy. Children, adults and their families may qualify for the following special services:
- Medi-Cal Access Program : Low-cost coverage for pregnant women based on income
- Childrens Health Insurance Program : Assistance for low-income children who dont qualify for Medicaid coverage
- Coverage for former foster youth: Free Medi-Cal until age 26 for people in foster care on their 18th birthday or later
Your letter of determination and local county social service office can help you discover more services that help your family get the most out of Medi-Cal.
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How To Apply For Medicaid
If youâre eligible for Medicaid, you can apply all year round through your states Medicaid website or HealthCare.gov, the federal health insurance marketplace. If you apply for Medicaid through Healthcare.gov and it looks like you qualify, the federal government will notify your state agency, which will contact you about enrollment. States also generally let you print out paper applications you can mail, fax or return directly to your local government office.
To complete your Medicaid application, you will likely need to provide documentation that you meet your states requirements. This documentation may include:
Your birth certificate or drivers license to serve as proof of age and citizenship
Recent pay stubs or tax returns to serve as proof of income
Copies of bank statements
Proof of address, which could include a lease, utility bill statements or a copy of your mortgage
Medical records to serve as proof of disability
States have 45 days to process your Medicaid application. They have 90 days if eligibility is tied to a disability . If you dont qualify for Medicaid, you might be able to get subsidized health insurance through Healthcare.gov. However, only certain life events allow you to apply for a marketplace health care plan outside of open enrollment, which takes place from Nov. 1 to Dec. 15 each year.
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What If Im Turned Down By Medicaid
- You may be able to buy a private health plan through the Marketplace instead for the 2018 plan year in the fall. You may qualify for savings based on your income through a premium tax credit and savings on out-of-pocket costs.
- If you don’t qualify for either Marketplace or Medicaid savings, you still have options. Learn more here.
I Lost My Job During The Pandemic My Only Income Is From Unemployment Insurance Benefits Is There Affordable Coverage For Me
There are new affordable coverage options for you under the American Rescue Plan, depending on where you live:
Medicaid: In most states, you may be able qualify for no-cost/low-cost public health plan coverage under Medicaid. Eligibility is based on current household income. If your income is no more than 138% FPL you can qualify. The federal supplemental UI benefit of $300 per week is NOT counted in determining eligibility for Medicaid or CHIP. To be eligible for Medicaid, you also must be a US citizen or lawfully-present immigrant who meets other requirements.
In 2021, people receiving UI benefits can qualify for specially enhanced subsidies for marketplace plans. Eligibility for marketplace subsidies is based on your annual income. However, during 2021 only, if you will receive UI benefits for even one week during the year, the marketplace will disregard your household income above 133% FPL That means you will qualify for a zero premium benchmark silver plan, after accounting for your premium tax credit. In addition, you will qualify for cost sharing reductions that substantially reduce the silver plan deductible .
COBRA: The American Rescue Plan also temporarily provides up to 6 months of full COBRA premium subsidies in 2021 for people who lost group plan coverage following loss of employment. See these FAQs for more information.
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Howand Whyto Apply For Texas Medicaid After Losing Your Job
Did you lose your joband your health insurancesince the start of the COVID-19 pandemic?
If so, you are not alone.
Many Texas businesses have reduced their hours or closed, either temporarily or forever, since the economic downturn began earlier this year.
That means more than 1.6 million Texans could lose the health coverage they received through their employers, according to KFF.org.
As you search for a new job, you may also be looking for health insurance. One option to consider is Medicaid.
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Q Where Do I Go To Apply For Medicaid
A. There are several ways to apply for Medicaid and other medical assistance programs:
- On the internet, you can use ASSIST to check your eligibility for several different assistance programs by completing a self-screening questionnaire. ASSIST then allows you to apply online.
- You may also print an Application for Health Insurance/Medicaid. The application form is also available in Spanish/en EspaÃ±ol.
- By phone, you can contact Medicaid Customer Relations at 1-800-372-2022 or 255-9500 to be directed to the Division of Social Services office closest to where you live. DSS staff members will help you find out more about eligibility for Medicaid and other assistance programs. Then the appropriate information and application forms will be mailed to you. Complete, sign and date the application form in ink and mail it to the address provided.
- For Long Term Care applications, please call the Long Term Care Medicaid Unit listed for the county where you live.
Insurance Coverage Options If Youre Not Eligible For Medicare
If you are not yet 65, you are probably not eligible for Medicare, unless you meet the disability or illness qualifications listed above. Still, you might have other health insurance options if youre unemployed or retire early. To bridge the period between ages 60 and 65, you may want to explore options such as:
- You may want to check to see if your former employer offers group insurance coverage to retirees. If it does, ask if you qualify for coverage until you are eligible for Medicare.
- If your spouse is working and has health insurance from an employer, union, or government agency, check to see if you can be added to the plan as a dependent. Your spouse may have to pay a higher monthly premium for dependent coverage.
- You may want to buy a health insurance policy until you are eligible for Medicare. There may be several different types of health insurance available at different costs. Read more on this below.
- If your income is low, you might look into one of these options until you are eligible for Medicare:
- The federal or state health-care marketplaces for health insurance coverage with potential tax subsidies
- Medicaid check with your state Medicaid agency to learn more about eligibility requirements for Medicaid.
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Are You Eligible For Medicare
To be eligible for Medicare coverage, generally you must meet the following requirements:
- You are age 65 or older
- You are a U.S. citizen or a permanent legal resident who has lived in the United States for at least five years
Whether youre eligible for Medicare doesnt typically depend on whether youre employed or unemployed. However, when you become eligible for Medicare, your employment history might affect how much you pay for Medicare Part A . You typically dont have to pay a Part A premium if youve worked at least 10 years while paying Medicare taxes.
Do I Qualify For Medicaid
Medicaid provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels. Medicaid qualifications depend partly on whether your state has expanded its program.
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Neither State Nor Federal Income Included In Eligibility
If, however, neither state nor federal compensation could be counted in the income eligibility determination, then expansion states would have more workers eligible for federal- or state-funded assistance.
In this case, the Medicaid expansion states would see 83 percent of their workers be eligible for some form of assistance, with 67 percent of their vulnerable populations being eligible for Medicaid. This would leave 17 percent unable to rely on any assistance.
In comparison, nearly half of vulnerable workers in nonexpansion states would not be eligible for any assistance. Those who were eligible would mainly be able to access both ACA marketplace premium tax credits and cost-sharing reductions or ACA marketplace premium tax credits . Only 13 percent would be eligible for Medicaid.
The KFF researchers clarified that while extending federal unemployment compensation to the end of the year would reduce eligibility in both expansion and nonexpansion states, it would not hurt workers and workers families. Having additional cash on hand and access to large marketplace subsidies and cost-sharing reductions could be very useful to unemployed workers in nonexpansion states.
Extending eligibility for financial assistance above 400 percent FPL would allow workers to both receive extra cash to meet needs like housing and food while also having healthcare coverage security, the researchers added.