So Dweezil turned 26 this year. As such, we cannot cover him under our health insurance after December 31st.
He’s a college student (mild autism meaning this has taken a lot longer than the usual 4 years), and has not worked since returning to college full-time 2 years ago. We have not encouraged him to do so this past year, for COVID-related reasons - he worked at a grocery store until he went back to college full-time, and while I’m sure they would be delighted to have him back, it would pose a risk for the rest of the family.
Anyway - he just applied for Medicaid - our state has Medicaid expansion for adults. It could be 45 days before he hears back re eligibility.
Obamacare’s application deadline is tonight, if I understand it.
Should we have him apply there as well just in case? Any idea on whether he’s likely to be found eligible for Medicaid?
We did deduct him as a dependent in 2019. We could in theory do so for 2020 as well, as we certainly provided over half his support. Dunno if that would mess anything up with eligibilty.
I have no clue how much in the way of subsidies for Obamacare would be for his scenario, either. His total income for 2019 was less than 2,000 and for 2020 basically zero.
I’m certainly not an expert, but since you need to decide quickly, I’ll tell you what I know. You can certainly cancel an Obamacare plan during the year. This would be the normal thing to do if (say) you got a job mid-year that gave you insurance. And part of initiating an Obamacare plan is paying the January premium by January 1st, if you don’t do that the coverage doesn’t even start. So I’m fairly sure that filling out the application for Obamacare does not lock you in.
If you don’t find a more expert answer than mine before this evening, in your position I would tell him to go ahead and enrol for Obamacare, but don’t pay the premium yet. I think that buys you at least the 2 weeks until Jan 1st to research this further, and so far as I can tell it doesn’t cost you anything if you cancel. If he puts in all of his financial information I think it should also give an immediate subsidy figure.
If you let the Obamacare deadline pass today, I think you probably lose this option completely - from what you’ve said I don’t think his circumstances would quality for mid-year special enrolment.
ETA: and make sure he doesn’t start doing it at 11pm. If you are eligible for a subsidy, you have to put in a lot of information. And if the website goes down, who knows if they would extend.
I am not an eligibility worker in your state, plus I’m retired now, so my info is going to be pretty general.
As @Riemann said, Obamacare can be canceled at any time during the year, it just needs to be started by the end of this year. I feel he should apply just to be sure he could get it if needed. I believe his application will be returned telling him to apply for Medicaid, but at least he will know that he has that available if needed.
As to his Medicaid? Each state has their own way of doing things, but the money for the Medicaid comes from the Federal government and all states must follow Federal guidelines.
Medicaid is an income based program. If he has no income (including cash gifts, interest payments, dividend payments, etc.) and he is a US citizen, he is eligible as long as your state has opted in for adult medical care.
While I am fairly sure that you want him to deal with this himself, its possible you might want to consider becoming his Authorized Representative so you can make sure all goes well. Even high functioning neurotypical folks have issues dealing with government bullshit.
I did finally get him to call the Medicaid office - at 3:15 PM. Argh. He did list me as his authorized representative with them. Similarly we had my daughter list me as a representative on her SNAP application last month (she lives in another state).
I started the online application at healthcare.gov - and finally dragged him to the computer at 11:20 to complete it. It turns out the only plans they show him are Medicaid and Medicaid Limited (I think that was the term). I was able to make it display the full-price plans - the cheapest of which was over 300 a month with an 8550 deductible. Ouch.
So I have to go with the assumption that with healthcare.gov saying he’s going with Medicaid, that’s really his only choice. If he got a subsidy for private insurance I’d be tempted there, but it doesn’t seem to be an issue.
I expect we’ll still be out of pocket for some costs for him - he sees a counselor and mostly those don’t work well with insurance of any sort. Luckily he’s quite healthy in general - so if we did have to go with private insurance I’d definitely encourage him to go with a high deductible plan (but the deductible being more than twice the premiums??? Ouch).
As a side question / comment: on the state’s Medicaid website, I tried answering a whole boatload of questions about his situation and they suggest he might be eligible for all sorts of oddball benefits like arts programs. He could in theory apply for a Pell grant - but we’ve got his college covered. Ditto SNAP (“food stamps”) - which might help him buy food for his apartment at school, though I would feel guilty about that since we’ll see to he he’s fed (and he has a low-level meal plan).
Many states have different benefits for differently-abled folks. AZ has a specific Development Services department which helps individually tailor services for clients, so what I know about that here probably wouldn’t apply in your case.
I would suggest he does apply for the Pell grant. Unless you have unlimited funds, its probably not a bad idea to accept help which will also extend the funds you do have and allow you to help your son longer.
All states have their own rules for SNAP but again, the money comes from the feds and they have to follow federal regulations. Full time college students are NOT eligible for SNAP unless they are also working at least 20 hours per week*. The feds don’t like giving regular folks money twice for the same thing and it is assumed that he has received a Pell grant. His meal plan might also disqualify him, but that might be state by state.
It does get somewhat complicated. Best of luck to everyone involved!
*paid at the federal min. wage. If he makes twice the federal min. wage, it would only be 10 hours per week.
Interesting to know, thanks! He does NOT work during the school year (and this past summer we would not have encouraged him to look for a job) - he has enough trouble managing time. I’ll check into the Pell grant - dunno if they’d give him anything, and he’s (hopefully) only got one semester left, so it might or might not arrive in time. On the SNAP, I suppose we could push for a waiver to the work requirement given his disability, but like I said, we don’t think he should take that money from someone else who needs it.
I am trying so hard to use the right words here. I don’t want to offend, but I feel that your understanding of government programs like this isn’t as good as it could be.
He would not be taking money from someone else who needs it. Please stop thinking this way. Its not like he would be taking the last piece of pizza while there are hungry people waiting in line, everyone will get a piece of pizza.
Unless you are in the top 10% of wage earners, you pay around 25-30 cents a year in federal taxes to fund the SNAP program. That money helps ensure that everyone who meets the eligibility requirements can get the help they are entitled to. Some people scam the system, but many other people who are very entitled to help don’t get it because they don’t want to be greedy or selfish.
So many people don’t ask for help until they really need it, when asking for help before things get desperate can often lessen or even stave off desperation totally. This was very frustrating to me when I was working, so please forgive me if it sounds like I’m yelling at you.
Anyhow, in AZ getting a disability waiver for SNAP just means getting a doctor note if the disability isn’t obvious (missing limb, blind, in a wheelchair, etc). I doubt its much harder in your neck of the woods.
Do look into what your state offers as far as other benefits. All of these programs are designed to help those who need help and really cost the taxpayers next to nothing.
Oh, I know there isn’t a fixed pot of money - but the money has to come from somewhere, whether it’s current tax income, or by the government taking on debt, which may be paid off by our great-grandkids.
He needs the health coverage. He “could use” SNAP but doesn’t NEED it. It’s not a lot anyway - benefits keep getting slashed from what I hear.
30 cents a year sounds awfully low. If we have 150 million taxpayers, that’s just 45 million dollars a year (Ignoring the high-income earners just because I have no idea what their contribution would be, that is).
Those were the numbers I was given a few years ago and it stuck with me. You made me think to go back and double check, so I’ve found that my memory was wrong. It was 30 dollars a year then, now its almost 35 a year. Thanks for making me double check my facts! (I also found that almost 24% of each tax dollar we pay goes to defense spending.)
SNAP in AZ is 194.00 max benefit, which isn’t much.
Being on SNAP does often give other benefits, though. Out here, its good for a 25% discount on one’s electric bill, it automatically enrolls school age children in the free lunch program, it helps with child care costs and you get a discount on your MMJ card. There are other benefits that I can’t remember now.
However, the SNAP requirements and restrictions here are such a PITA that I’d really not advise anyone apply if they really don’t need to.
Anyhow, good luck with the medical enrollment. Its a fairly simple process out here because its totally income based, hopefully it will be as easy where you live.