MA – MassHealth and Employer Offered Insurance

I live in Massachusetts. I am currently disabled and collect Worker’s Comp. My wife recently left her full-time job and took a part time job working only while our daughter is at school because I have difficulty taking care of her by myself. Her health insurance from her previous employer ran out at the end of October and we have elected COBRA to cover us for November and December since my daughter has an upcoming surgery scheduled and we had already hit our out of pocket max.

She starts her new job on Monday. They offer health insurance to part time employees. She has 15 days from her start date to accept coverage, but coverage will not begin until January 1st. Since the amount the employer contributes is pro-rated for part time employees, the cost of insurance for our family would be over half of her paycheck. I tried researching MassHealth and the state’s Health Connector website, but I am a little confused.

Based on her income, we would all be eligible for MassHealth. It looks like we would fall under the MassHealth Premium Assistance Program since we have access to an Employer-Sponsored Health Insurance. I started filling out the MassHealth application but got stuck on the income portion. Since she has not started working yet, I cannot put in her pay before taxes. I can estimate it based on her hourly rate, expected hours worked and expected health insurance premium. It also says the Income Effective Date is invalid because her start date hasn’t passed yet. Also, the only proof of income I currently have is her offer letter since she will not have a paystub for a couple of weeks.

Should she elect coverage for us through her employer when she starts working? Once she starts, do I continue with the application and estimate her income or wait a couple of weeks until I have a paystub which will not show the health insurance deduction since that would not occur until January?

Another concern I have is that I am awaiting a judge’s decision on Social Security Disability. The hearing took place over the summer. If approved, that would go towards our income and could possibly make it too high to qualify for MassHealth. I am not sure how much my Social Security payment will be since it will be offset by Worker’s Comp. Using my best guess for an amount, I put the potential additional income into the eligibility estimator on the Health Connector website. It came back saying that my wife and I would be eligible for a ConnectorCare Plan with Advance Premium Tax Credit and my daughter eligible for MassHealth. At that point, would we have to give up the Employer offered insurance and get a plan through the Health Connector or could the Advance Premium Tax Credit go towards the employer’s plan’s premium? Also, would the lump sum backpay from Social Security count as income in 2022 since I would most likely receive it in 2022 or does it not count since it should have been paid out previously?

I am so confused by all of this. I have been lucky enough to just need the employer provided health insurance in the past.

submitted by /u/jeffp1818
[link] [comments]I live in Massachusetts. I am currently disabled and collect Worker’s Comp. My wife recently left her full-time job and took a part time job working only while our daughter is at school because I have difficulty taking care of her by myself. Her health insurance from her previous employer ran out at the end of October and we have elected COBRA to cover us for November and December since my daughter has an upcoming surgery scheduled and we had already hit our out of pocket max. She starts her new job on Monday. They offer health insurance to part time employees. She has 15 days from her start date to accept coverage, but coverage will not begin until January 1st. Since the amount the employer contributes is pro-rated for part time employees, the cost of insurance for our family would be over half of her paycheck. I tried researching MassHealth and the state’s Health Connector website, but I am a little confused. Based on her income, we would all be eligible for MassHealth. It looks like we would fall under the MassHealth Premium Assistance Program since we have access to an Employer-Sponsored Health Insurance. I started filling out the MassHealth application but got stuck on the income portion. Since she has not started working yet, I cannot put in her pay before taxes. I can estimate it based on her hourly rate, expected hours worked and expected health insurance premium. It also says the Income Effective Date is invalid because her start date hasn’t passed yet. Also, the only proof of income I currently have is her offer letter since she will not have a paystub for a couple of weeks. Should she elect coverage for us through her employer when she starts working? Once she starts, do I continue with the application and estimate her income or wait a couple of weeks until I have a paystub which will not show the health insurance deduction since that would not occur until January? Another concern I have is that I am awaiting a judge’s decision on Social Security Disability. The hearing took place over the summer. If approved, that would go towards our income and could possibly make it too high to qualify for MassHealth. I am not sure how much my Social Security payment will be since it will be offset by Worker’s Comp. Using my best guess for an amount, I put the potential additional income into the eligibility estimator on the Health Connector website. It came back saying that my wife and I would be eligible for a ConnectorCare Plan with Advance Premium Tax Credit and my daughter eligible for MassHealth. At that point, would we have to give up the Employer offered insurance and get a plan through the Health Connector or could the Advance Premium Tax Credit go towards the employer’s plan’s premium? Also, would the lump sum backpay from Social Security count as income in 2022 since I would most likely receive it in 2022 or does it not count since it should have been paid out previously? I am so confused by all of this. I have been lucky enough to just need the employer provided health insurance in the past. submitted by /u/jeffp1818 [link] [comments]Read Morer/HealthInsurance

Leave a Reply

Your email address will not be published.