Monday, December 16, 2013

Have Children that are forced out of the Exchange due to not qualifying (or being forced onto Medicaid)? Read this.

If you are like many parents, you want your children to have good health insurance coverage. Yet due to the way the system is designed, ESPECIALLY in Illinois. You as parents can qualify for a subsidy, but healthcare.gov will not allow you to enroll your children in the exchange (due to them qualifying for Medicaid - in Illinois it's called AllKids).

There is also another obvious glitch. I've had multiple people who have had 3+ children all under the age of 18 where only the youngest qualifies for Medicaid and all the rest QUALIFY FOR NOTHING. The letter states that they should go to a local clinic.

IF YOU DO NOT WANT YOUR CHILDREN ON MEDICAID

  1. Remain on your existing plan (if possible). Sometimes this is the best option if the following options would be more expensive overall.
  2. Place the people eligible for a subsidy on a subsidy eligible plan. Next take the non-eligible children and purchase an off-exchange policy directly from the insurance company. Use an agent to help guide you how to do this. If this is cheaper/better coverage, this is a good alternative.
  3. Purchase one family policy off-exchange. It probably won't save you any money other than having the combined deductibles and out of pocket maximums and one bill.
  4. Do an expedited appeal through their secret special website: http://externalappeal.com/. It takes 72 hours (if you qualify to appeal) and may cost around $25. But $25 is better than having your children uninsured.
  5. If you don't want your children on Medicaid, you could estimate your income as higher for 2014. The issue with this is your family subsidy will go down when you boost your income up. The income guidelines are so generous for Illinois' AllKids (medicaid) plans, that you may wipe out the majority of your subsidy by boosting your income. See http://www.allkids.com/income.html. For example, a family of 4 would need to make over $74,892/year not to qualify for AllKids.

IF YOU DON'T MIND HAVING YOUR CHILDREN ON MEDICAID

  1. If your eligibility letter stated that the children's applications have been submitted to your state Medicaid program, then follow up with your state program to make sure they actually made it. If you are unsure, apply directly to your state Medicaid office. Cross your fingers and hope for the best (and expect to hear 1 - 3 months later).
  2. Purchase an off-exchange policy for your children or keep your children on an existing policy until you receive a determination from Medicaid. You may be able to purchase a Short Term Medical plan instead of a full-blown policy. Realize that short term medical plans do not cover any pre-existing conditions, are of limited length
  3. Always consider talking to your state representative and see whether they can help facilitate your application. These politicians work for you and are happy to help you out. If you don't know who your local politician is, go to votesmart.org to find out.

If you find out any other options, please leave a comment or FB, G+, LinkedIn me to let me know what it is.

Thank you,

Robert

1 comment:

  1. Robert, a Blue Cross hotline employee told me in late December that a parent should be able call in and add the child/children who were placed on Medicaid/Allkids on to their Exchange-purchased plan after 1/1/2014. However, so far, none of my clients have been able to get through to Blue Cross customer service to learn if this is accurate. Hope it is! -Allen in Chicagoland

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