I (55) stopped working in May after making around 50k this year. Due to losing a job (it was a gig with an end date) I enrolled in an ACA plan but then almost right away had to leave the country for 4 months to take care of my mother in Europe. So I cancelled ACA and bought travel insurance for that period - ACA wouldn't cover me in Europe anyway. When I came back it turned out that I'm unable to re-enroll because I cancelled the coverage voluntarily. So I'd have to wait until open enrollment. The exchange specialist told me however that since my monthly income (interest + dividends) is less than $1463 I would qualify for Medicaid which is called NJ FamilyCare here. Sure enough I did qualify (waiting for my Horizon card and paperwork). So that's the back story.
Questions about the future. I have no plans of going back to work so I'll live off my savings. That's not income - and they don't care about assets, the application did not ask about that. But I'm not quite sure what qualifies as income when it comes to Medicaid, specifically stocks and bonds. Their application lists interest and dividends as "examples" of income. I reported those and they asked for recent brokerage and bank statements. I supplied those. But what happens if I decide to sell stock? Is that income (I mean the "realized gain")? What about traditional IRA to ROTH conversion? It's taxed as regular income on 1040 but is it income for Medicaid purposes? What about tax return if it exceeds 1500? I don't expect any random gifts or inheritance but I really would like to see some kind of checklist that would allow me to stay compliant and report everything correctly.
Secondly, how do I report those possible infusions of cash? Selling stock or converting tIRA to ROTH are one time events that would take me over the limit in the month they occur but the following month I'm eligible again? So do they wait with kicking me off until they decide that extra income was temporary or it happens automatically, my coverage runs out at which points I report low income again? I read on another forum that you only get kicked off if your monthly income exceeds the monthly limit two calendar months in a row. That would make sense but who knows...
I keep hearing that paying out of pocket for medical services while being on Medicaid is illegal. But only 39% of doctors in NJ accept it. What if I want to go to one that doesn't? What if I want to do something that Medicaid doesn't cover? Specifically Invisalign. That's not something than any Medicaid related dental plan covers.
As to the ethics of being on Medicaid: I did not choose to be on it. I simply followed the rules and that's where I ended up. I'm not sure that I want to stay on Medicaid but I'm also not sure that I want to manipulate my income upwards just to get on an ACA plan. As of right now I have no immediate plans to sell any stock or do ROTH conversion so my income for next year is expected to be below ACA qualifying threshold.
