Will Qualify for Medicaid, But Wants To Pay Some Cost Share

[cladams]

I have a client who is on a Fed/State subsidized program for self-employeds in Arkansas. He will qualify for Medicaid in 2014, as he will make less that 138% FPL. He mentioned that he would like to still pay something toward his healthcare.

Does anyone know - If an applicant is applying on the Exchange for a subsidized plan, and their income is less than 138 FPL, will they still be able to apply and pay some percentage, or will they have to go through DHS and take Medicaid?

It seems the idea of getting help is welcomed, but I can imagine some will not like the thought of being on Medicaid outright, if they can contribute something.

 

[stuy119]

I don't believe they will have an option, unless they purchase off the exchange.

And if they do, then be sure to get something in writing to CYA.

 

[Yagents]

As Stuy said, If Arkansas is expanding medicaid, then he has 3 options:

1. Take medicaid for free
2. Pay full price for off exchange product
3. Take medicaid and then cut a check to the US Gov't if he "wants to pay something"

 

[Ann H]

If I understand your question, the person really doesn't want Medicaid and is willing to pay some premium for better coverage.

The way the rules work, if the person is ELIGIBLE FOR another government sponsored program, such as Medicaid, SCHIP, VA, Medicare, etc., then they cannot enroll in the exchange, and they cannot get a subsidy. In fact, if they apply for the exchange and subsidy, yet their income makes them Medicaid eligible, they will be auto-enrolled in Medicaid.

Interesting twist... If they estimate that their 2014 income will be higher than 138%, and they get subsidies, then find out when they file their tax returns that their income was less than 138%, then the clawback limit is $600 for a person at that level of income.