ACA: Turning 19 Next Week, App Sent to Medicaid, Need Work Around

[yorkriver1]

Maybe just wait until he turns 19 next week, do a new app?

App failed online, phone rep was not too experienced, didn't expect app to say he had to apply for Medicaid. He's losing Medicaid (acutally CHIP) end of the month.
Applying alone, has own job, he will have own tax return for 2014. Parents status will go from H/H of 5 to H/H of 4. 2 other kids still on CHIP. Parents on subsidized coverage.

 

[Tkruger]

Maybe just wait until he turns 19 next week, do a new app?

App failed online, phone rep was not too experienced, didn't expect app to say he had to apply for Medicaid. He's losing Medicaid (acutally CHIP) end of the month.
Applying alone, has own job, he will have own tax return for 2014. Parents status will go from H/H of 5 to H/H of 4. 2 other kids still on CHIP. Parents on subsidized coverage.

This is a loss of coverage QLE. Redo the app with the loss of coverage noted and you should be fine with the 19 yo.

As for the Parents, this too is a QLE for them as well.

Why not keep the 19 yo on the policy with the parents? Was this on or off exchange?

 

[Yagents]

Mmmmm, I didn't know that someone who files their own tax return can get subsidies on their parents' policy. Might want to ask an expert on that one.

 

[Tkruger]

If I File Independent on My Taxes, Can My Parents Still Provide Me with Health Insurance?

In most circumstances, the new federal law requires health insurance providers to provide coverage for any child under the age of 26 provided that a parent attaches him or her to an existing health insurance plan. This is true for group coverage plans as well as independently-purchased single-coverage plans. After 2014, insurance companies will be required to provide coverage under this rule to virtually any young adult who requests it. They will no longer be able to deny coverage to children with pre-existing health conditions.
This new rule is not designed to provide young adults with a "free ride" on their health insurance coverage: These dependent children must pay the full cost of coverage on their parents' plans. If they can't afford to do so, their parents must pick up the cost of coverage.


Law Dictionary: If I File Independent on My Taxes, Can My Parents Still Provide Me with Health Insurance?

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Can I Be a Non-Dependent and Still Remain on My Parents' Health Insurance?

Passed in 2009, the Affordable Care Act has dramatically changed this uneasy arrangement. Insurance companies are no longer permitted to drop independent children from their parents' insurance policies. Instead, providers are required to keep both dependent and independent children on their parents' insurance policies for the first 25 years of their lives. Of course, children can opt out of this coverage requirement after procuring an employer-sponsored coverage plan. Likewise, parents can refuse to insure their own children for personal reasons. However, insurers can no longer refuse to join willing parents and children under the same insurance policy.

Law Dictionary: Can I Be a Non-Dependent and Still Remain on My Parents' Health Insurance?

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https://www.healthcare.gov/can-i-keep-my-child-on-my-insurance-until-age-26/

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If a child under 26 isn't a dependent for the parent’s tax purposes, the child should fill out his or her own application to apply for a tax credit. They can select the same plan, if they choose, but will be on a different policy.

Note: This is true only if anyone on the same application wants to qualify for premium tax credits and lower out-of-pocket costs based on household size and income. The same rules apply for all tax dependents. For example, children who claim their parents as tax dependents on their tax return need to follow these instructions.

 

[unic.consulting]

If I File Independent on My Taxes, Can My Parents Still Provide Me with Health Insurance?

In most circumstances, the new federal law requires health insurance providers to provide coverage for any child under the age of 26 provided that a parent attaches him or her to an existing health insurance plan. This is true for group coverage plans as well as independently-purchased single-coverage plans. After 2014, insurance companies will be required to provide coverage under this rule to virtually any young adult who requests it. They will no longer be able to deny coverage to children with pre-existing health conditions.
This new rule is not designed to provide young adults with a "free ride" on their health insurance coverage: These dependent children must pay the full cost of coverage on their parents' plans. If they can't afford to do so, their parents must pick up the cost of coverage.


Law Dictionary: If I File Independent on My Taxes, Can My Parents Still Provide Me with Health Insurance?

----------

Can I Be a Non-Dependent and Still Remain on My Parents' Health Insurance?

Passed in 2009, the Affordable Care Act has dramatically changed this uneasy arrangement. Insurance companies are no longer permitted to drop independent children from their parents' insurance policies. Instead, providers are required to keep both dependent and independent children on their parents' insurance policies for the first 25 years of their lives. Of course, children can opt out of this coverage requirement after procuring an employer-sponsored coverage plan. Likewise, parents can refuse to insure their own children for personal reasons. However, insurers can no longer refuse to join willing parents and children under the same insurance policy.

Law Dictionary: Can I Be a Non-Dependent and Still Remain on My Parents' Health Insurance?

----------

https://www.healthcare.gov/can-i-keep-my-child-on-my-insurance-until-age-26/

----------

If a child under 26 isn't a dependent for the parent’s tax purposes, the child should fill out his or her own application to apply for a tax credit. They can select the same plan, if they choose, but will be on a different policy.

Note: This is true only if anyone on the same application wants to qualify for premium tax credits and lower out-of-pocket costs based on household size and income. The same rules apply for all tax dependents. For example, children who claim their parents as tax dependents on their tax return need to follow these instructions.

So what you're saying is as long as the independent child isn't trying to get a subsidy, they can be on the same plan as their parents. However, if they want a subsidy, or feel like they are in better health than their parents and want a cheaper plan, they can sign up on their own.

 

[Yagents]

I'm not debating that they can be on the parents plan, I'm debating whether they can get a subsidy while on the parents plan if they file their own taxes.

I'm assuming a 19 yr old has low enough income to qualify for APTC. But thanks for pointing out the obvious

 

[yorkriver1]

Yes, Yagents we are on the same page with subsidy. I figured that out with another client, 24 year old. Better to have own plan, lower cost better cost sharing. Parents can have their own subsidy/cost sharing.
On the app I listed as no others in H/H due to "tax" household of one.

My real question was about how to avoid the goofy referral to Medicaid, since he's on it now until 9/30/14. Loss of CHIP is the reason for the SEP, for heaven's sake. I think maybe if I wait until he's actually 19 next week it won't do that. I did say loss of coverage 9/30/14. Last time I did an LOC app, they told me don't say there's employer/other existing coverage now, it will disqualify for subsidy, even though the coverage ends at the end of the month. Weird glitch.

I am really slammed until next week anyway. Other thoughts are welcome.

 

[AllenChicago]

Yes, Yagents we are on the same page with subsidy. I figured that out with another client, 24 year old. Better to have own plan, lower cost better cost sharing. Parents can have their own subsidy/cost sharing.
On the app I listed as no others in H/H due to "tax" household of one.

My real question was about how to avoid the goofy referral to Medicaid, since he's on it now until 9/30/14. Loss of CHIP is the reason for the SEP, for heaven's sake. I think maybe if I wait until he's actually 19 next week it won't do that. I did say loss of coverage 9/30/14. Last time I did an LOC app, they told me don't say there's employer/other existing coverage now, it will disqualify for subsidy, even though the coverage ends at the end of the month. Weird glitch.

I am really slammed until next week anyway. Other thoughts are welcome.

It's troubling that as we near the next open-enrollment, the Marketplaces are issuing an increasing number of written and verbally-delivered "work-arounds" for getting people covered.

 

[cadylou]

Referrals to Medicaid are an ongoing problem. I am in MO where we didn't expand Medicaid, yet I had people with kids (who already knew the children didn't qualify) have their kids "split off" and sent to Medicaid for "determination". One family I had ended up buying an off exchange plan for their kid - so now they get a subsidy, but their kid has his own deductible, etc. "off exchange". Medicaid never did get back to them with a "status" . . .no word at all. I never figured out how to get the system to stop doing this. If they get split off here or in KS, it goes into a black hole. . . .