This fairly complex, but I’ll try to keep it brief. I submitted it to /r/medicaid as well but some of the general insurance questions may be better answered here.
I guess my main questions are:
Can I count on having coverage through Magellan? Will being on CCC plus instead of Medallion 4.0 will be an issue down the road? How can I even be sure that I’m covered at all? Seems like I shouldn’t have been eligible in the first place. If there was indeed an error, what I happens then? I was 100% honest on my applications so it would be on their side. I’ve heard that they’re not able to kick people off medicaid during a national emergency. Any chance of getting Aetna to pay anything for the May hospital charges even though I’m not on their plan anymore? Healthcare.gov says I have until June 11 to pick a plan. Should I just go ahead and pay for one while I’m figuring this out?
February
I was laid off in February and my health insurance was going to expire on 2/28. My old employer and some others said I should apply for medicaid to see if I got it. I looked at the eligibility and I wouldn’t meet the income test, which I think was about $18k for a single person with no kids. Jan+Feb income=$11k (included a bunch of unused PTO pay), rental income (from renting a room)=$10k, unemployment=$700/wk as long as I had it. Well over $18k.
I applied anyway and I think I put $40k as my expected income for 2021. At the end of the application process it said that I would hear back in 45 days, which was no use if my insurance was expiring in a week, so I went to healthcare.gov and tried to sign up. It said I may be eligible for medicaid in VA and it submitted a separate application for that.
Couldn’t sign up for another plan in the meantime. I knew COBRA was expensive ($750!) but also retroactive, so I figured I’d hold off for March and see what happened.
March
Got letters from VA department of medical assistance asking me to submit other forms to commonhelp.virginia.gov. From memory, it was copies of my driver’s license and proof of citizenship. I didn’t keep any of the forms but realize now I should have. Sent in my forms and was still waiting for a response.
Ended up having to go to the ER in March, so I paid the COBRA.
April
Got a notice from healthcare.gov that my VA medicaid had been denied due to income/family size and that I could enroll in a market plan. Wasn’t surprised but it sucked that I couldn’t have applied for a marketplace plan at the beginning. Put in the application for a marketplace plan.
Got a letter from the VA DMA with my medicaid card telling me to choose a plan. I chose Aetna, got my card (start date was May 1) and thought it was all sorted and I was covered. The commonhelp.gov site says my claim was denied due to duplicate applications but has no details about the accepted claim. When I called, they could only see one application that had been accepted.
Was accepted on the healthcare.gov site and although I could choose a plan, I didn’t because I thought I had medicaid.
Had to go back to the ER on April 30 (same issue) and stayed overnight in the hospital, so the service dates were in both April and May. Showed both my old insurance card and the Aetna card at the hosptial. Paid COBRA for April but it wasn’t clear what the story was with medicaid/Aetna and I was hoping they would cover the May charges.
May
After a bunch of calling around, I worked out that I had been kicked off the Aetna plan (active dates were May 1 – May 1). No explanation as to why. I was put on Magellan, which would start in June. I didn’t want to be stuck with the $5k bill from the May charges in the hospital, so I paid COBRA for May.
Anyway, I didn’t want to be on Magellan and I tried to change my plan. After dozens of calls, it seems that I’m on the CCC plus program, not Medallion. CCC plus is for people over 65 or with disabilities. I’m neither of those so it doesn’t make much sense. One of the people at Medallion said I had been eligible for both but the state had put me in the CCC+ program. I changed the plan through the CCC plus site and the new plan will start in July. Still on Magellan for June.
So now June is 2 days away, I don’t have a Magellan card (they say it’s probably in the mail), I’ve paid COBRA for 3 months when I should have only had to pay for 1, I don’t even know for sure that I’m covered and my May hospital charges are pending on my old insurance’s site.
submitted by /u/ShitFlakes
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This fairly complex, but I’ll try to keep it brief. I submitted it to /r/medicaid as well but some of the general insurance questions may be better answered here. I guess my main questions are:
Can I count on having coverage through Magellan? Will being on CCC plus instead of Medallion 4.0 will be an issue down the road? How can I even be sure that I’m covered at all? Seems like I shouldn’t have been eligible in the first place. If there was indeed an error, what I happens then? I was 100% honest on my applications so it would be on their side. I’ve heard that they’re not able to kick people off medicaid during a national emergency. Any chance of getting Aetna to pay anything for the May hospital charges even though I’m not on their plan anymore? Healthcare.gov says I have until June 11 to pick a plan. Should I just go ahead and pay for one while I’m figuring this out?
February
I was laid off in February and my health insurance was going to expire on 2/28. My old employer and some others said I should apply for medicaid to see if I got it. I looked at the eligibility and I wouldn’t meet the income test, which I think was about $18k for a single person with no kids. Jan+Feb income=$11k (included a bunch of unused PTO pay), rental income (from renting a room)=$10k, unemployment=$700/wk as long as I had it. Well over $18k.
I applied anyway and I think I put $40k as my expected income for 2021. At the end of the application process it said that I would hear back in 45 days, which was no use if my insurance was expiring in a week, so I went to healthcare.gov and tried to sign up. It said I may be eligible for medicaid in VA and it submitted a separate application for that.
Couldn’t sign up for another plan in the meantime. I knew COBRA was expensive ($750!) but also retroactive, so I figured I’d hold off for March and see what happened.
March
Got letters from VA department of medical assistance asking me to submit other forms to commonhelp.virginia.gov. From memory, it was copies of my driver’s license and proof of citizenship. I didn’t keep any of the forms but realize now I should have. Sent in my forms and was still waiting for a response.
Ended up having to go to the ER in March, so I paid the COBRA.
April
Got a notice from healthcare.gov that my VA medicaid had been denied due to income/family size and that I could enroll in a market plan. Wasn’t surprised but it sucked that I couldn’t have applied for a marketplace plan at the beginning. Put in the application for a marketplace plan.
Got a letter from the VA DMA with my medicaid card telling me to choose a plan. I chose Aetna, got my card (start date was May 1) and thought it was all sorted and I was covered. The commonhelp.gov site says my claim was denied due to duplicate applications but has no details about the accepted claim. When I called, they could only see one application that had been accepted.
Was accepted on the healthcare.gov site and although I could choose a plan, I didn’t because I thought I had medicaid.
Had to go back to the ER on April 30 (same issue) and stayed overnight in the hospital, so the service dates were in both April and May. Showed both my old insurance card and the Aetna card at the hosptial. Paid COBRA for April but it wasn’t clear what the story was with medicaid/Aetna and I was hoping they would cover the May charges.
May
After a bunch of calling around, I worked out that I had been kicked off the Aetna plan (active dates were May 1 – May 1). No explanation as to why. I was put on Magellan, which would start in June. I didn’t want to be stuck with the $5k bill from the May charges in the hospital, so I paid COBRA for May.
Anyway, I didn’t want to be on Magellan and I tried to change my plan. After dozens of calls, it seems that I’m on the CCC plus program, not Medallion. CCC plus is for people over 65 or with disabilities. I’m neither of those so it doesn’t make much sense. One of the people at Medallion said I had been eligible for both but the state had put me in the CCC+ program. I changed the plan through the CCC plus site and the new plan will start in July. Still on Magellan for June.
So now June is 2 days away, I don’t have a Magellan card (they say it’s probably in the mail), I’ve paid COBRA for 3 months when I should have only had to pay for 1, I don’t even know for sure that I’m covered and my May hospital charges are pending on my old insurance’s site.
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