General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsLow Income Single Childless Folks Qualify For Medicaid in All States Now Under ACA
Single childless DU members who are low income should check into Medicaid coverage now that the ACA provides this benefit. Even though many States (Red ones) did not expand the income limits many single folks will qualify at the lower FPL in place in these Red States. For a single person the 100% of FPL income is $11,490 and at 133% of FPL it rises to $15,000 or so. I saw a thread earlier tonight with a DU member relaying his experience is shopping for a plan on the Exchange in SC and finding fairly high premiums since his income was not high enough to qualify for a subsidy. The problem is that he should should not be looking to purchase a plan on the Exchange but rather signing up under Medicaid at no cost.
winter is coming
(11,785 posts)Here's the table of what the eligibility limits will be as of January 1, 2014 in each state.
http://medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/Medicaid-and-CHIP-Eligibility-Levels-Table.pdf
Looking at the next-to-last and last columns on the far right of the table, it appears that Wisconsin is the only state not expanding Medicaid where low-income single adults (not on disability) would be eligible for Medicaid.
Using those numbers, the DUer from South Carolina wouldn't be eligible for Medicaid even if he were a parent.
Indykatie
(3,697 posts)Indiana is one of the Red States that did not expand income eligibility but you can get Medicaid coverage now if you are childless unlike before. The Indiana Exchange system directed her to the Medicaid online enrollment after she keyed in her income.
winter is coming
(11,785 posts)it says
I hope she will qualify for Medicaid under those special conditions, but it's not a universal thing.
Barack_America
(28,876 posts)Why do they hate their own citizens so much?
uppityperson
(115,681 posts)of us via this shutdown blackmail thing. They deny their state by not expanding medicaid, or is that by the governor? Musing here. And yet the voters voted for them, enough to get into office. Wonder how many regrets there are.
enough
(13,262 posts)TorchTheWitch
(11,065 posts)States run their own Medicaid how they see fit. If certain states aren't expanding Medicaid due to ACA then there is no money to provide for all these people single or otherwise.
flamingdem
(39,328 posts)For instance I know someone who needs to see an eye doctor. The choice is to go to the emergency room or wait 6 months to 1 year to see a doctor via referral.
It's the very most basic coverage for emergencies though I think for women it covers more for childbirth and gynecological.
pnwmom
(108,995 posts)It's actually more comprehensive than Medicare.
http://www.webmd.com/health-insurance/medicaid-health-care-people-low-incomes
How Much Do Medicaid Programs Cost?
The cost of a Medicaid program depends on the state. Some programs require you to make a small co-payment for medical services in addition to what Medicaid pays.
What Does Medicaid Cover?
In general, Medicaid programs offer more comprehensive medical coverage than Medicare. They usually include hospital stays, visits to doctors, tests, some home medical care, and more. Again, the specifics vary from state to state.
flamingdem
(39,328 posts)that in some states, in this case California, it's not possible to get a visit to a specialist in a reasonable period of time. This program I'm referring to is a transitional program to Medicaid, known as Medical in CA. Maybe they have more restrictions.
Bluenorthwest
(45,319 posts)specialists as needed with not much fuss or muss. And no cost. Medical IS Medicaid, just as the Oregon Health Plan is Medicaid. Not 'transitional to Medicaid, it is Medicaid.
It's pretty much as good as my own insurance only they don't pay for anything and I pay for everything!
duffyduff
(3,251 posts)You MUST sign a statement that in effect your estate is collateral for the government to "recover" all payments made on Medicaid at the time of your death. This includes any monthly premiums paid by the government, even if you never use Medicaid.
It is called "estate recovery." Many poor people have assets, such as a house, that the government can seize when they die or their widowed spouses die.
I don't know the deal with people under 55 is who are not currently under the categories for current Medicaid eligibility, and what repayment they are subjected to, if any.
What you don't understand is that few doctors will see patients on Medicaid, so it is not "all that."
pnwmom
(108,995 posts)It used to be Medicaid was only for single parents and their children, but not single, childless adults; and very poor elderly people. The Medicaid expansion will allow low-income people to receive standard Medicaid benefits even if they have no minor children. And the income maximum to qualify for Medicaid is being raised substantially.
Unlike Medicare, Medicaid also pays for long term nursing care, so some Medicare recipients in the past would give their homes and other assets to their children in order to qualify for Medicaid. The purpose of the documents you mention is to prevent middle class or even upper middle class people from divesting their assets to their children, in order to have their nursing home bills covered by Medicaid. It allows people who have too much equity in a home for Medicaid to receive Medicaid anyway -- as long as their estate paid back the cost at the person's death. This is a benefit to the person because if their health improves, they still have a home to return to. The repayment won't be till after their death.
Ms. Toad
(34,092 posts)My daughter was on Medicaid from age 0 to 5. It was comprehensive coverage from the first penny, without any additional wait time because the "insurer" was Medicaid rather than a commercial carrier. (And partway through that period, they forced everyone from traditional Medicaid into a plan provided by a commercial insurance company (with the premium paid by the state). There was no difference in coverage - except for the normal insurance type limits.)
xmas74
(29,676 posts)Missouri did not expand. There is no Medicaid for adults unless you are poor, blind or pregnant. A family of 2 in Missouri cannot make more than $250 a month to qualify, an amount that hasn't changed since the early 90's.
kestrel91316
(51,666 posts)and they stick you in an HMO. I looked into that today here in CA. Same HMOs as the exchange plans. You don't really get any details, either, just the names of the companies involved.
pnwmom
(108,995 posts)Costs to Consumer: In some states, Medicaid charges consumers small amounts for certain services.
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Cost-Sharing/Cost-Sharing.html
States have the option to charge premiums and to establish out of pocket spending (cost sharing) requirements for Medicaid enrollees. Out of pocket costs may include copayments, coinsurance, deductibles, and other similar charges. Maximum out of pocket costs are limited, but states can impose higher charges for targeted groups of somewhat higher income people. Certain vulnerable groups, such as children and pregnant women, are exempt from most out of pocket costs and copayments and coinsurance cannot be charged for certain services.
Premiums
States can charge limited premiums and enrollment fees on the following groups of Medicaid enrollees:
Pregnant women and infants with family income at or above 150% FPL ($22,065 for a family of 2 in 2011)
Qualified disabled and working individuals with income above 150% FPL ($16, 334 for an individual in 2011)
Disabled working individuals eligible under the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA)
Disabled children eligible under the Family Opportunity Act (FOA)
Medically needy individuals
States have the option to impose higher, alternative premiums on other groups of enrollees, if their family incomes exceed 150% of the federal poverty level. Certain groups, such as institutionalized individuals and most children, are excluded from higher cost sharing.
kestrel91316
(51,666 posts)subsidized plans. I wonder how the poor are going to cope.
Oh, no I don't. They'll all be lined up at the ER and the local community health center by the hundreds as usual. Sigh.
pnwmom
(108,995 posts)Some states don't charge any premiums or other costs at all.
kestrel91316
(51,666 posts)Emit
(11,213 posts)I believe the best thing for each individual to do is talk with a representative from ACA, their Health Insurance Marketplace or at their local Medicaid office. I work in the social services field and while we often give guidance on available benefits and services, we use caution in making assumptions of eligibility for various programs because each program has their own 'hoops' that individuals must jump through to become eligible. For programs such as housing assistance, food stamps and Medicaid, it has been my experience that it is best left to the individual to actually go through the application process to know for sure if they are eligible.
That being said, here are a couple of .gov links that discuss Medicaid eligibility, but I caution readers to examine their own state's Medicaid websites and apply in person:
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Eligibility.html
https://www.healthcare.gov/do-i-qualify-for-medicaid/
Humanist_Activist
(7,670 posts)if you have an income that's too high, you have to "spend down" to the level of someone who would otherwise qualify for medicaid, so, for example, you make 1100 a month in disability(SSI), but medicaid has an absolute income limit of 800 dollars, well, you have to pay them 300 dollars, every month, before it kicks in for that month.
Response to Indykatie (Original post)
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In many states Medicaid is only for the blind, pregnant, or permanently disabled. Poor, childless adults dont get anything.
Welcome to DU.
duffyduff
(3,251 posts)Not really a good deal.
I am weighing options here because I think my income could change from being Medicaid-eligible to not being.
I don't want to sign over whatever estate I may have to pay the government.
bunnies
(15,859 posts)It completely blew me away. Why cant states just HELP people who need it without all these damn strings attached?
bunnies
(15,859 posts)If the state does not expand Medicaid, none of the rules change. Believe me, Im in one of them. I know first hand.
Warpy
(111,352 posts)Mean and stingy Republicans blocked any change in the eligibility requirements that remained the same dollar amount set in the 1960s and was never indexed to inflation.
The only people who qualified were people already on AFDC/TANF and destitute elderly people in nursing homes.
quinnox
(20,600 posts)I did a search when you first posted this in a different thread, and found the facts don't back the OP up.