How do I get health insurance next month if healthcare.gov keeps trying to send me to Medicaid (which I won't be qualified for)?

[u/Colambler]

Currently unemployed and on Medicaid.

Start a new job on Sept 1st that doesn't provide health insurance. Will make well over the amount that qualifies me for Medicaid. Have also moved to a different state.

Am attempting to use healthcare.gov to get healthcare for September. But because I put '0' for August income, despite that I've put $60000 for total expected annual income, it's telling me I'm being evaluated for Medicaid and won't show me plans available.

It's beyond frustrating. Do I just have to contact an insurer directly to purchase health insurance to ensure I'm covered on the 1st?

Edit: Never mind. I reapplied and told it not to check for savings, so it didn't ask me for income and just showed me plans. Presumably if I do qualify for savings (which is doubtful) I can get it back in my taxes. Leaving this up in case it's helpful for others.

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[u/PolkaD0tMom]

Did you update your new address? What is your new state?

[u/SeriousBrindle]

Wait until you get paid from the job and report it to Medicaid as an income change. Medicaid will send you a letter once you no longer qualify and you can use that as a QLE to go back to the marketplace. Don’t jump the gun. You typically retain Medicaid until the end of the month when you get kicked off.

[u/Beneficial-Lynx-5268 → u/SeriousBrindle]

This is the way.

[u/LizzieMac123]

you can make a million dollars in jan-june, but if in July, you made zero, you qualify for medicaid (if your state has expanded medicaid).

Medicaid goes off of current---

Healthcare.gov however goes off of annual-- but if you qualify for medicaid, then medicaid is where your financial assistance comes from (you can't get a subsidy if you qualify for medicaid).

So, essentially, you either need to say "I'm going to pay full price, I don't want medicaid" and you don't take a subsidy. OR, you wait until medicaid has made a determination- if they say you qualify, you take medicaid. If they say you don't qualify, you can then sign up at healthcare.gov and get a subsidy based on your past income.

If you qualify for medicaid though- again- that's where you financial assistance comes from.

[u/anabanana100 → u/LizzieMac123]

This is a good example of waste in the system due to fragmentation and a poorly designed process. I've been stuck in this doom loop a couple of times and it's extremely frustrating (getting kicked to Medicaid when you know there is 0 chance you qualify). Medicaid is looking at your past income and the state marketplace is expecting you to project forward. Even worse, you're expected to abide by deadlines as the applicant and neither Medicaid offices nor the marketplace will be accountable to any such standard.

[u/Colambler → u/LizzieMac123]

I generally get that - it's how I qualified for Medicaid after being laid off late last year.

It just seems like if I'm applying for coverage that starts in September, it should be based off my expected income for September, not my income for August. I guess that might be overly complicated for most folks.

[u/Old_Draft_5288 → u/Colambler]

The problem is that income hasn’t started, and it can always not materialize. And then you’re stuck. Having it evaluated it in a month two month basis is probably the most efficient option you could get for a government program.

[u/Emotional_Beautiful8]

It’s not literal for those who don’t want/need it to be. Re-Open your application and divide your projected 2025 annual income by 12 and input that amount.

Marketplace goes by annual income, Medicaid by monthly income based on current month.

Note: if they have already referred you to Medicaid, you’ll need to cancel it through the state Medicaid office (found this out the hard way).

[u/someguy984 → u/Emotional_Beautiful8]

If OP cancels that would NOT create a special enrollment period and would have to wait until the end of the year and open enrollment.

[u/Emotional_Beautiful8 → u/someguy984]

Their plan is not already active though. You can update your application it until it’s active. Their SEP still qualifies them.

[u/someguy984]

Medicaid is monthly based, if you put under $1,800 a month it will go to Medicaid. Previous months don't count. If you live in a state with no Medicaid expansion you will never qualify for it.

[u/Mobile_Bell_5030]

Just put in your income for September.

[u/MuddieMaeSuggins]

Presumably if I do qualify for savings (which is doubtful) I can get it back in my taxes

Yes, if you qualify for any premium tax credit you’ll figure that out as part of your regular tax return. 

[u/AwfullyChillyInHere]

Vote.

[u/Old_Draft_5288]

Wait until you start the job and report the income changed to Medicaid, and then they’re going to drop you and that’s a qualifying life event to enroll in the marketplace