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Should I try Medicaid or keep cashing out for private health plan.

Trboatworks

Diamond
Joined
Oct 23, 2010
Location
Maryland- USA
All-

This last two years was a perfect storm for my finances which has bumped me into Medicaid eligibility.

Last year I was going full steam and did a shop expansion plus a higher than normal level of equipment purchases so took a loss for year.
This year a health crisis has wiped out earnings so my taxable income will be very low.
In the two year window I expect I will get sorted and return to normal income levels which would place me at some level of discount in the open market enrollment with ACA.

So right now:

- I am carrying a too expensive group plan for the business with Kaiser I was forced to take as I got plan outside of enrollment. (ai have no employees so I am only member in group)

- I am ineligible for private plans with assistance with ACA due to Medicaid access so price to get coverage is roughly equivalent to plan I have now.

- With Kaiser which I have to say has been excellent in meeting my high health care needs without additional hits from high copays etc.


So:

- Stay with Kaiser (which I can't afford at my current cash flow).

- I can jump to Medicaid till my business income recovers and then stage to some private plan with ACA.

- Pay full ticket with a private plan with ACA.

What say you all?
Does anyone have any experience with Medicaid- Is this something I should avoid at all cost?
Just take the dole and hope for the best?

Maybe I should answer a basic question first- what the heck is Medicaid?

Thoughts?
 
Review the fine print in Medicaid. You may find your assets confiscated.

There are laws on the books that can reverse a sale of property even years after if they (government sponsored health care) want it.

I attended public hearings to stop this and a very few were there from the public. I was the lone voice, a fart in the wind.

If you think you can escape losing your life long accumulations without proper legal estate planning, sorry.
 
One question, you cannot afford Kaiser with your current cash flow, but can you afford not to have Kaiser? Thinking of any ongoing medical costs
Would a plan in normal enrollment make a difference?
 
Gus - very good point.
I am stable but who knows- one trip in and any posturing over a few thousand one way or the other is wiped out.
I carry a ~$500/month at retail medication bill so I need to have at very least something to offset that and pay well enough for ongoings and a crisis should it occur.
 
Crap- I looked into it- I am in an asset trap.
I have no income to speak of so eligible for Medicaid and therefor ineligible for ACA donation.
But... I have assets so am ineligible for Medicaid....

I must be making a mistake with getting integrated into this mess...
 
TR - don't know if this is a fourth possibility, but depending upon your age and/or disability you might be eligible for Medicare rather than Medicaid?
 
Pete- I am 59.
I wouldn't say I am disabled though this event essentially wiped out eight months this year of my ability to work.
Going forward I have reason to believe I will get sorted and return to normal earnings coming through shop.

I did put a call into MD Healthcare.gov and they indicate that there is no threshold number of assets which disallow participation in program.
They state only taxable earnings are used for verification of need.

I certainly qualify as stated above for both last year and this.
I just spoke with my insurance broker and I am not able to keep my current policy and avail myself to any assistance.
I can select Kaiser as the provider under Medicaid with a different policy.

I have one reservation only with Kaiser outside of current cost- they are difficult to work with out of network providers and I wish to keep a neurologist at Hopkins in my care team which is a struggle at best with Kaiser..

I am wary-

There is no free lunch:

Eligibility | Medicaid

I would have much preferred if the program had allowed my purchase in ACA market even if eligible for Medicaid..
 
Gus - very good point.
I am stable but who knows- one trip in and any posturing over a few thousand one way or the other is wiped out.
I carry a ~$500/month at retail medication bill so I need to have at very least something to offset that and pay well enough for ongoings and a crisis should it occur.

Have you shopped that? I take 5 prescribed medications, for BP, and heart problems plus a vial of insulin a month and it now comes out at $125 a month, full cash price, without insurance. I originally was using the local mom & pop pharmacy which had good prices, but they went out of business after using them for 5 years. I wanted to use the new CVS as they were close by but found out they are ridiculously expensive. I ended up going to Walmart 30 miles away, my dislike of them was overcome as they were less than half price of the closest competitor. CVS was the highest at $450 for what Walmart sells for $125 and that is even signing up for their spam bombing discount program.
 
Do always quote propaganda without even thinking about it?

Biden quite literally cannot be a 'carpetbagger' President

try and grow a brain

Can't argue with a cultist. BTW, ever notice who is most likely to bring the first "hit" of politics into a thread? Starts with a "C" and ends with "ultist".

And then they'll bitch about getting pushback...

TR, best of luck. We're in similar "boats" (sorry) regarding healthcare. I'll follow this thread with interest.
 
This question of assets is a tough nut to crack- I want to have insurance to protect assets.
I certainly don't want the state to have powers to simply seize them to settle obligations.

I am fine with the basic math of insurance- you pay the bit to get protection.
Medicaid.... all I am finding is "Estate recovery".

I assume that means I am dead..
 
This question of assets is a tough nut to crack- I want to have insurance to protect assets.
I certainly don't want the state to have powers to simply seize them to settle obligations.

I am fine with the basic math of insurance- you pay the bit to get protection.
Medicaid.... all I am finding is "Estate recovery".

I assume that means I am dead..

Being dead is the best insurance against unexpected expenses...

I wonder what protections are offered by having a shell company or LLC, Inc., etc. that you're working for? Or some similar arrangement to separate you from the tools, property, etc.?

If you have successors you want to leave stuff to, maybe some early transfer mechanism can be legally sound?
 
Medicaid is from what I have heard definitely not very good for getting the best care. It is usually used when all other options have been extinguished.

Keeping your insurance is best. Perhaps the ACA has a pretty good option for you. After these are no longer affordable and the medical bills begin mounting this is what Medicaid does is it is a safety net for those who have no other viable options.
 
Crap- I looked into it- I am in an asset trap.
I have no income to speak of so eligible for Medicaid and therefor ineligible for ACA donation.
But... I have assets so am ineligible for Medicaid....

I must be making a mistake with getting integrated into this mess...

Can you find someone to run the shop for you for a while which you trust and can oversee? It may help bring income into play.
 
Do always quote propaganda without even thinking about it?

Biden quite literally cannot be a 'carpetbagger' President

try and grow a brain

Look it up Carpetbagger. One definition is “ a person perceived as an unscrupulous opportunist.”

"the organization is rife with carpetbaggers"

So there is that. I would add watch your women when they move through and have your six gun loaded and ready as they will even molest the livestock.
 
Medicaid is from what I have heard definitely not very good for getting the best care. It is usually used when all other options have been extinguished.

Keeping your insurance is best. Perhaps the ACA has a pretty good option for you. After these are no longer affordable and the medical bills begin mounting this is what Medicaid does is it is a safety net for those who have no other viable options.

Yeah- I am a babe in the woods here.
I last had health insurance in my twenties with the last real job- I ran without till this year and even the first hit of a big problem was not so bad- 15k and I just wrote them a check.
All that time before this it was a workable program to just pay out of pocket.
At first blush even the cash out was a bargain given the long picture.
Odd thing is what really caused $$$ this year was getting a SAH from the meds which nearly killed me.


I got insurance to defend against follow up care costs and then things went to shit and the next bill was 120k and rolled on from there.

The policy I have works fine it is just eating up about 50% of what is coming in the door just now.
I am looking it all over- I would rather pay something and pick an exposure level than just toss myself on the dole..
 
As i understand it -
$17,500/yr income is the threshold between Medicaid and ACA. If you pay yourself that much in income and pay the taxes on it, you are eligible for ACA with tax credit reduction in premium. I know a business owner personally who pays himself $18K salary, and qualifies for ACA, he has a sweetheart plan that costs $4.97/ month, has near zero copays for meds and a $5 coplay for office visits, etc. (previous years' premiums were higher, this year is practically free. I've seen the documents, this is not BS) Under $17,500 gets into asset problems, as you mentioned. This owner has small corporation, but I think an individual proprietor can do payroll also, they just usually don't for tax reasons. The payroll taxes he pays are more than offset by the cost reduction of his ACA plan.
Look at healthcare.gov again and put in $18K as your income and see what you find.
 








 
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