I recently left my job due to family difficulties and my employer-based health coverage is expiring. I am planning to live on savings until the end of the year. I applied to my state health insurance marketplace (Covered California) and uploaded my last pay statement, showing a year-to-date income that is high enough to qualify me for an ACA plan. However, the state marketplace denied eligibility because, since I left my job, my expected income for the next 8 months of 2022 is 0, and they referred me to medicaid (medi-cal). The ACA eligibility notice literally says “income too low”. Covered California told me on the phone that I should expect a medi-cal enrollment package from the county in the next few weeks.
I do prefer a marketplace plan. I think that based on the year-to-date income alone I don’t qualify for medicaid.
I have been thinking about some of my options but would welcome any advice.
What is the deciding computation here? It seems that at tax-filing time, the relevant number is the 2022 MAGI number, which is already proven to be above the amount that qualifies for an ACA plan. If that’s the case, an appeal to Covered California should succeed, right? It doesn’t make sense for the state to deny coverage based on expected income of 0 in some future months? By using a per-month cash flow analysis they deviate from the tax-code calculation. I could wait for the medicaid enrollment package to arrive, and then point out to them that I do not qualify due to high income, and then they would send the package back to the marketplace administrator. This is not my preferred option, because it leaves me in insurance limbo starting May 1st. I could alter the marketplace application by splitting the already received income over 12 months, or saying I plan to realize capital gains, or saying I plan to regain employment. However, I don’t want to actually do that and end up with higher income that decreases the financial help.
Thanks.
submitted by /u/lumberjaq
[link] [comments]I recently left my job due to family difficulties and my employer-based health coverage is expiring. I am planning to live on savings until the end of the year. I applied to my state health insurance marketplace (Covered California) and uploaded my last pay statement, showing a year-to-date income that is high enough to qualify me for an ACA plan. However, the state marketplace denied eligibility because, since I left my job, my expected income for the next 8 months of 2022 is 0, and they referred me to medicaid (medi-cal). The ACA eligibility notice literally says “income too low”. Covered California told me on the phone that I should expect a medi-cal enrollment package from the county in the next few weeks. I do prefer a marketplace plan. I think that based on the year-to-date income alone I don’t qualify for medicaid. I have been thinking about some of my options but would welcome any advice. What is the deciding computation here? It seems that at tax-filing time, the relevant number is the 2022 MAGI number, which is already proven to be above the amount that qualifies for an ACA plan. If that’s the case, an appeal to Covered California should succeed, right? It doesn’t make sense for the state to deny coverage based on expected income of 0 in some future months? By using a per-month cash flow analysis they deviate from the tax-code calculation. I could wait for the medicaid enrollment package to arrive, and then point out to them that I do not qualify due to high income, and then they would send the package back to the marketplace administrator. This is not my preferred option, because it leaves me in insurance limbo starting May 1st. I could alter the marketplace application by splitting the already received income over 12 months, or saying I plan to realize capital gains, or saying I plan to regain employment. However, I don’t want to actually do that and end up with higher income that decreases the financial help. Thanks. submitted by /u/lumberjaq [link] [comments]Read Morer/HealthInsurance