Question about the ACA, in case anyone happens to know . . .

[pnwmom]

We have a college student living with us who's estranged from her family. We've been paying for her health insurance and plan to continue doing so. She works part-time, and -- according to the online calculator -- her income is low enough to qualify her for Medicaid. But we don't want her to be the only one in the family on Medicaid, so we'd rather help her buy a policy from the exchange. Is that even possible? Or is it Medicaid or nothing?

The policy offered by her college sucks.

[enlightenment]

1. Why don't you want her to be on Medicaid?

Is there something wrong with it? Too embarrassing? Not good enough?

To answer your question, I suspect you should talk to one of the "navigators" for the exchanges - they can tell you if she can go on a subsidized plan.

[pnwmom]

2. We're living as a family, as much as we can, and I don't want to single her out if I don't have to.

She's had enough sadness in her life already.

[enlightenment]

3. I understand that,

but she has a different insurance now, through the uni, right? And she'll have a different insurance if you help her buy coverage from the exchange.

Medicaid may prove the best option for her needs, and if you sit down with her and work through the options together, I don't think she'll feel singled out at all.

[pnwmom]

4. No, I didn't get her insurance through the university because it cost 2/3 as much

as a policy like ours, while offering much worse benefits and very low annual and lifetime limits. We get our own through my husband's work, so that wasn't an option; but I got her a private policy along the same lines. I was hoping to get her something similar through the exchange, so she could go to the same doctors we do.

[enlightenment]

5. Ah,

I misunderstood your comment in the OP about the college insurance (which I agree, is usually pretty awful - and expensive).

Really, I'd check with the navigator folks who are supposed to be helping people sign-up. I suspect it isn't an uncommon question (or won't be, once the exchanges open). Since every state is different, broad information probably won't help too much.

[pnwmom]

6. Thanks!

[Pretzel_Warrior]

7. I never knew how that worked. So because she lives with you

And there is no guardianship or anything because she's an adult, for insurance purposes you can claim her as dependent? How about for tax purposes?

[pnwmom]

8. She filed on her own and we're not claiming her as a dependent anywhere. nt

[Pretzel_Warrior]

9. Never mind. I misread what you said initially

[Nye Bevan]

10. There is absolutely no shame in Medicaid.

There is no more shame in qualifying for Medicaid on the basis of ones income than there is in obtaining a subsidy from buying a policy on the exchange.

The first question is whether you are in a state that has opted to expand Medicaid:



If you are, and she is eligible (income below about $11,500), she should definitely take advantage of it. If not, you can check to see if she is eligible for Medicaid anyway, but in many states this will not be the case.

If you are not in a state that is expanding Medicaid, or if she still does not want to participate in Medicaid, apparently if she estimates her income for next year to be at least the Federal poverty level (about $11,500), she will benefit from the full premium subsidy for an exchange policy, but will not have to pay any of the subsidy back if she ends up earning less than that.

See http://www.webmd.com/health-insurance/20130808/how-poor-might-qualify-for-obamacare-subsidies-in-states-that-dont-expand-medicaid

[pnwmom]

11. Thanks for the link! n/t