Author Topic: Post FIRE and Covered Calif stuck me in MEDI-CAL!  (Read 6137 times)

Snoopyflier

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Post FIRE and Covered Calif stuck me in MEDI-CAL!
« on: October 22, 2019, 01:18:58 PM »
Hi all. I am post FIRE, and because my living expenses are low (using my investments), and no actual W-2 income, I wanted to buy health insurance from the marketplace. After filling out the application- They automatically put me in MEDI-CAL! I don't want that.

I have investments, own two properties (here and overseas), and they say what you have in the bank does not matter, it is what your monthly income is!

And now they have stuck me and my family there, and it seems they don't want to let us out of the system to go to the marketplace to get our insurance.
I have googled and read that this happened to a bunch of people in the past and it is a nightmare to get out of.

We don't want MEDI-CAL. We wanted to buy our insurance and get the tax credits. And now they have assigned us a case worker and we are stuck in this system! I proved to them my assets but it seems to be of no use. Covered California Rep says that they cannot remove us from Medi-cal and that Medi-cal has to do it so that we get kicked back over to the marketplace. I have raised my income on the app to a crazy $17k a month, and they still keep me there! Is there anyone who has experienced this? How to get out of it?

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #1 on: October 22, 2019, 01:28:28 PM »
Update: I just want to add that I FIRED on 10/3/19 from my old W-2 job, and have Health insurance through Dec 2019. I was trying to get coverage for 2020 starting in January, and now don't know what to do about the situation.

Omy

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #2 on: October 22, 2019, 02:15:15 PM »
Talk to an accountant or financial planner. There are lots of ways to bump up your income  depending on your situation - get a rental property, Roth conversion, sell stock with gains, or (gasp) get a job.

ysette9

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #3 on: October 22, 2019, 02:44:21 PM »
Why don’t you want MediCal, out of curiosity?

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #4 on: October 22, 2019, 03:37:42 PM »
Hi. Well the main reason was because my spouse is foreign from Europe. Has the ten year permanent resident green card but is in the process of getting the US citizenship, and Trump made it a rule that if they get medical help from the government they can me denied or worse deported! I have money to pay for health insurance and don't want any problems.

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #5 on: October 22, 2019, 03:38:49 PM »
Fixing typo - don't know where edit is.

"They can get denied for citizenship or get deported."

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #6 on: October 22, 2019, 03:41:09 PM »
If that were the case, we would have to sell our home and uproot and move overseas.

ysette9

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #7 on: October 22, 2019, 03:51:48 PM »
Hi. Well the main reason was because my spouse is foreign from Europe. Has the ten year permanent resident green card but is in the process of getting the US citizenship, and Trump made it a rule that if they get medical help from the government they can me denied or worse deported! I have money to pay for health insurance and don't want any problems.
That is a legit reason. Do ACA subsidies not count towards that?

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #8 on: October 22, 2019, 03:59:11 PM »
I don't know. Subsidies are only tax credits. So if your income increased and if the the tax subsidy was based on your income, and they gave you a large subsidy, you just pay back more in taxes for that year at the end of the year when you do your taxes. The subsidies are not free money, it is like a tax deduction until you tally it up all at the end of the year.

Also, I think the courts threw out the legal permanent resident immigrant not being able to get govt help as unconstitutional, but did not want to take any chances. And I did not want to use benefits someone who really needs it might need.

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #9 on: October 22, 2019, 04:00:17 PM »
I think the system is broken...:(

robartsd

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #10 on: October 22, 2019, 04:02:49 PM »
I don't know. Subsidies are only tax credits. So if your income increased and if the the tax subsidy was based on your income, and they gave you a large subsidy, you just pay back more in taxes for that year at the end of the year when you do your taxes. The subsidies are not free money, it is like a tax deduction until you tally it up all at the end of the year.

Also, I think the courts threw out the legal permanent resident immigrant not being able to get govt help as unconstitutional, but did not want to take any chances. And I did not want to use benefits someone who really needs it might need.
In your case, I might have delayed FIRE until citizenship was complete (but it's probably to late for that for you). You could always just buy medical insurance without the ACA subsidies if you don't want to take any chances.

Your benefit eligibility will not affect any other person's eligibility.

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #11 on: October 22, 2019, 04:05:04 PM »
Yes that is an option. I thought we HAD to  by law buy insurance via the Covered California by law if we were without. Will check around for prices.

robartsd

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #12 on: October 22, 2019, 04:59:46 PM »
Yes that is an option. I thought we HAD to  by law buy insurance via the Covered California by law if we were without. Will check around for prices.
Although there are plenty of legal questions around the individual mandate, AFAIK there was never a requirement to purchase insurance through the exchange; however, only plans purchased through the exchange can qualify for subsidies.

nancy33

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #13 on: October 22, 2019, 08:07:59 PM »
Can you can get the insurance for your wife because of the immigration issues thru one of the Christian health sharing plans? That they were accepting as coverage? What a MESS if not for the immigration issue I’d say take the medi cal then pay for direct primary care physician / concierge out of pocket and use medi cal for hospitalization, etc.

seattlecyclone

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #14 on: October 22, 2019, 09:12:31 PM »
What is your source of taxable income at the moment (taxable dividends, capital gains, rental income, Roth conversions, etc.)? If none, the exchange is correct to stick you in Medicaid rather than sell you a policy. It's on you to manufacture enough income to clear the maximum income bar for Medicaid if you don't actually want to take advantage of that program.

In your initial post you mentioned you're living off investments and have rental properties. Us FIREd folks are still a pretty rare breed. Bureaucrats may not always know what to do with us. The people at the exchange may have interpreted your lack of a job to mean that you have no income and therefore should be on Medicaid. Investment income counts just as well as job income for this purpose. Try collecting your records of what your income actually is now, make sure it's actually too high for Medicaid, and show it to whoever it is that your social worker has indicated is empowered to make a decision. If they don't accept it, try escalating to their supervisor. At some point you should hopefully reach someone who is aware that people with high enough investment income should not be on Medicaid.
« Last Edit: October 22, 2019, 09:18:00 PM by seattlecyclone »

Paul der Krake

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #15 on: October 22, 2019, 09:33:08 PM »
Hi. Well the main reason was because my spouse is foreign from Europe. Has the ten year permanent resident green card but is in the process of getting the US citizenship, and Trump made it a rule that if they get medical help from the government they can me denied or worse deported! I have money to pay for health insurance and don't want any problems.
Fellow European immigrant here.

The rule doesn't apply to existing green card holders:
https://www.federalregister.gov/documents/2019/08/14/2019-17142/inadmissibility-on-public-charge-grounds

Quote
Comment: One commenter asks whether the public charge regulation would apply to applicants seeking naturalization.

Response: The laws governing naturalization can be found in Title III of the INA. The public charge ground of inadmissibility does not apply in naturalization proceedings. DHS notes, however, that USCIS assesses as part of the naturalization whether the applicant was properly admitted as a lawful permanent resident and therefore was eligible for adjustment based upon the public charge ground of inadmissibility at the time of the adjustment of status.

By the way, there is an injunction preventing implementation of this rule for now.
« Last Edit: October 22, 2019, 09:41:38 PM by Paul der Krake »

jim555

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #16 on: October 23, 2019, 06:18:05 AM »
The only way you get put in Medicaid is you declare your monthly income (all income, not just w-2) to be below 138% FPL, no one is accidentally put in.  In my state you are in Medicaid until your anniversary date, even if your income has risen.  All changes to income must be reported within 30 days.

Trump's rule seeks to deport anyone who is a public charge, no matter what it is, ACA subsidies or Medicaid.  The courts are reviewing it now.
« Last Edit: October 23, 2019, 06:27:44 AM by jim555 »

Paul der Krake

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #17 on: October 23, 2019, 07:36:13 AM »
Trump's rule seeks to deport anyone who is a public charge, no matter what it is, ACA subsidies or Medicaid.  The courts are reviewing it now.
It's more nuanced than that. From the link I posted above:

Quote
DHS has decided not to consider ACA subsidies or health insurance received through the health insurance marketplace outside of Medicaid as public benefits in the public charge inadmissibility determination, due to the complexity of assessing the value of the benefit and the higher income eligibility thresholds associated with the benefit, as compared to the eligibility thresholds for other benefits. As discussed in section III.R of this preamble, DHS has added a heavily weighted positive factor for private health insurance appropriate to the expected period of admission. This heavily weighted positive factor would not apply in the case of a plan for which the alien receives subsidies in the form of premium tax credits.

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #18 on: October 23, 2019, 12:48:56 PM »
The only way you get put in Medicaid is you declare your monthly income (all income, not just w-2) to be below 138% FPL, no one is accidentally put in.  In my state you are in Medicaid until your anniversary date, even if your income has risen.  All changes to income must be reported within 30 days.

Trump's rule seeks to deport anyone who is a public charge, no matter what it is, ACA subsidies or Medicaid.  The courts are reviewing it now.

What I said in my initial post is that since I am FIRED, my living expenses are quite low. We live off of our investments, and that we have assets here and overseas. Because my MONTHLY income from my investments is low, they AUTOMATICALLY said that we were eligible for MEDI-CAL (not MEDICAID. MEDICAID is for people that are disabled or getting organ transplants that are no longer able to work etc, MEDI-CAL if for people with low or NO income.)

So because of the low monthly income, they won't let me BUY  insurance via the exchange, UNLESS, Medi-CAL takes me out. I can refuse MEDI-CAL but then they said my option is to pay the full price of close to $2,000 per month for Health insurance with no tax subsidies.

We spoke to our Immigration lawyer and he said that as the spouse is already a green card holder and permanent resident it would not effect her. BUT, to be absolutely sure (because the courts are fighting it out right now), to move cautiously until he can further advise.

I have COBRA until Dec 31 2019, but just like buying without the marketplace tax credits, it is very very expensive.

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #19 on: October 23, 2019, 12:50:02 PM »
FIRED meaning retired early, not fired from my job. LOL

jim555

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #20 on: October 23, 2019, 12:52:56 PM »
The only way you get put in Medicaid is you declare your monthly income (all income, not just w-2) to be below 138% FPL, no one is accidentally put in.  In my state you are in Medicaid until your anniversary date, even if your income has risen.  All changes to income must be reported within 30 days.

Trump's rule seeks to deport anyone who is a public charge, no matter what it is, ACA subsidies or Medicaid.  The courts are reviewing it now.

What I said in my initial post is that since I am FIRED, my living expenses are quite low. We live off of our investments, and that we have assets here and overseas. Because my MONTHLY income from my investments is low, they AUTOMATICALLY said that we were eligible for MEDI-CAL (not MEDICAID. MEDICAID is for people that are disabled or getting organ transplants that are no longer able to work etc, MEDI-CAL if for people with low or NO income.)

So because of the low monthly income, they won't let me BUY  insurance via the exchange, UNLESS, Medi-CAL takes me out. I can refuse MEDI-CAL but then they said my option is to pay the full price of close to $2,000 per month for Health insurance with no tax subsidies.

We spoke to our Immigration lawyer and he said that as the spouse is already a green card holder and permanent resident it would not effect her. BUT, to be absolutely sure (because the courts are fighting it out right now), to move cautiously until he can further advise.

I have COBRA until Dec 31 2019, but just like buying without the marketplace tax credits, it is very very expensive.
If you have a Traditional IRA you could do a monthly Roth conversion to create income to get over the 138% line.

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #21 on: October 23, 2019, 12:53:24 PM »
Apparently this has happened to a lot of folks and is a problem. Here is an excerpt from a Sacramento newspaper about others it happened to:

"The interface between Medi-Cal and Covered California continues to be very problematic,” says Dede Kennedy-Simington, vice president of the insurance agency Genesis Financial in Southern California.

“They have to find a way to hand consumers back and forth,” she says. “It’s creating a lot of concern and anger and frustration.”

Michael Connelly, 62, of Granite Bay, near Sacramento, got caught in Medi-Cal when he tried to sign up for Covered California for the first time.

Connelly, who retired Oct. 1, mistakenly reported his income for the last three months of 2016 as zero when he applied for 2017 coverage, thinking it wasn’t pertinent to his application.

In doing so, he immediately got kicked into Medi-Cal, even though he really doesn’t qualify, and it took trips to county offices, an appeal with Covered California, endless hours on the phone and help from Knauss to fix the problem.

“After they have you, they won’t let you go,” Connelly says. “I’m telling them, ‘Do you want to see my bank account? I don’t need Medi-Cal.’ ”

Read more here: https://www.sacbee.com/news/local/health-and-medicine/ask-emily/article129018879.html#storylink=cpy

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #22 on: October 23, 2019, 12:55:21 PM »
The only way you get put in Medicaid is you declare your monthly income (all income, not just w-2) to be below 138% FPL, no one is accidentally put in.  In my state you are in Medicaid until your anniversary date, even if your income has risen.  All changes to income must be reported within 30 days.

Trump's rule seeks to deport anyone who is a public charge, no matter what it is, ACA subsidies or Medicaid.  The courts are reviewing it now.

What I said in my initial post is that since I am FIRED, my living expenses are quite low. We live off of our investments, and that we have assets here and overseas. Because my MONTHLY income from my investments is low, they AUTOMATICALLY said that we were eligible for MEDI-CAL (not MEDICAID. MEDICAID is for people that are disabled or getting organ transplants that are no longer able to work etc, MEDI-CAL if for people with low or NO income.)

So because of the low monthly income, they won't let me BUY  insurance via the exchange, UNLESS, Medi-CAL takes me out. I can refuse MEDI-CAL but then they said my option is to pay the full price of close to $2,000 per month for Health insurance with no tax subsidies.

We spoke to our Immigration lawyer and he said that as the spouse is already a green card holder and permanent resident it would not effect her. BUT, to be absolutely sure (because the courts are fighting it out right now), to move cautiously until he can further advise.

I have COBRA until Dec 31 2019, but just like buying without the marketplace tax credits, it is very very expensive.
If you have a Traditional IRA you could do a monthly Roth conversion to create income to get over the 138% line.

Yes, yesterday I was thinking about that too. I am planning to do the Roth ladder conversion this year. 

This situation could apply to others who will be retiring early too and these ideas will help them also.

dang1

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #23 on: October 23, 2019, 01:28:15 PM »
try calling medi-cal in at 916-636-1980

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #24 on: October 23, 2019, 01:31:15 PM »
try calling medi-cal in at 916-636-1980

I did. They have a person that is assigned to the case, every Medi-Cal person gets a case number and a social worker person (ugh) and she says she has to review it when she gets time. According to her I am eligible regardless what I say. So now I have to wait it out. I upped my income and now waiting for another review. It is a nightmare.

dang1

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #25 on: October 23, 2019, 01:40:46 PM »
try calling medi-cal in at 916-636-1980
I did. They have a person that is assigned to the case, every Medi-Cal person gets a case number and a social worker per..
what county?

Snoopyflier

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #26 on: October 23, 2019, 02:11:04 PM »
Riverside. Inland Empire.

dang1

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #27 on: October 23, 2019, 02:44:44 PM »
as for public charge, it's not in effect currently.

at any point, you can choose to discontinue medi-cal for any reason, make a sworn statement and submit, do that if you haven't yet.

once mc is activated it's good for that month. best is that it'll be discontinued on November 30, since it's almost end of October and doubt that the bureaucracy can discontinue it end of this month.

if you haven't gotten proof that it's discontinuing at end of Nov by like middle of Nov, best to go up chain of command.

https://bakersfieldnow.com/news/local/courts-block-public-charge-rule

https://www.healthaffairs.org/do/10.1377/hblog20191018.747447/full/

http://dpss.co.riverside.ca.us/files/pdf/dpss-org-april-2019.pdf

http://dpss.co.riverside.ca.us/contact

seattlecyclone

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #28 on: October 23, 2019, 03:05:54 PM »
The only way you get put in Medicaid is you declare your monthly income (all income, not just w-2) to be below 138% FPL, no one is accidentally put in.  In my state you are in Medicaid until your anniversary date, even if your income has risen.  All changes to income must be reported within 30 days.

Trump's rule seeks to deport anyone who is a public charge, no matter what it is, ACA subsidies or Medicaid.  The courts are reviewing it now.

What I said in my initial post is that since I am FIRED, my living expenses are quite low. We live off of our investments, and that we have assets here and overseas. Because my MONTHLY income from my investments is low, they AUTOMATICALLY said that we were eligible for MEDI-CAL (not MEDICAID. MEDICAID is for people that are disabled or getting organ transplants that are no longer able to work etc, MEDI-CAL if for people with low or NO income.)

Medicaid is a program run in partnership between the federal and state governments. "Medi-Cal" is just what California calls their implementation of Medicaid. Here in Washington state they call it "Apple Health." Still Medicaid.

Paul der Krake

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #29 on: October 23, 2019, 03:19:05 PM »
I would love to see a polling firm ask a sample of 1,000 Californians and see how many can accurately explain what Medicare/Medicaid/Medi-Cal each do.

Deciding to have Medicare and Medicaid have such similar names was already a pretty fucking stupid idea, but letting individual states do their own branding was borderline criminal. How many tens of thousands of man hours are wasted each year because of confused consumers like OP?

dang1

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #30 on: October 23, 2019, 03:23:20 PM »
rock, paper, scissor might work better

jim555

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #31 on: October 23, 2019, 05:28:49 PM »

Yes, yesterday I was thinking about that too. I am planning to do the Roth ladder conversion this year. 

This situation could apply to others who will be retiring early too and these ideas will help them also.
I would be sure to do the conversion every month, that way there is no possibility for confusion.  If you do it all at once, it only counts in the month done.
ACA is calendar year while Medicaid is monthly based.
« Last Edit: October 23, 2019, 05:33:36 PM by jim555 »

Car Jack

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #32 on: October 24, 2019, 11:43:21 AM »
What happens if you put your income at $100k a month?  I have to believe it'll throw you out. 

jim555

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #33 on: October 24, 2019, 12:17:58 PM »
What happens if you put your income at $100k a month?  I have to believe it'll throw you out.
In NY you get to go to your annual recertification date, even if your income has increased to over the line.

spartana

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #34 on: October 24, 2019, 12:57:31 PM »
OP I was also "accidentally" put on Medicaid (called Medi-Cal here in Calif).

I FIREd pre-ACA and first had COBRA and then a low cost catastrophic plan thru Blue Cross. Once the ACA was enacted and my plan was dropped I went on the Covered Calif website to sign up for a subsidies plan believing my income, although low, was high enough to be out of Medicaid. However, since some of my income was tax free (a $600/month VA disability benefit) they didn't count that so put me on Medicaid instead of an ACA plan. That left me 4 choices. Get a job to increase taxable income (had already did all my tIRAs to Roths). Stay on Medicaid. Cancel Medicaid and pay full cost for unsubsidized health insurance. Or use the VA medical centers for free/low cost care. I chose the VA and just wrote the Medi-Cal person assigned as my case worker a letter requesting the drop me from Medi-cal. Easy peasy.

 I only had it a month and never used it but my understanding is that in Calif it's pretty good. My sister (laid off from her job and transitioning to FIRE) is on it with a Kaiser plan and it seems to work exactly her Kaiser plan did when working. Just no cost to her. So is there a reason you don't want medicaid? Ethical reasons or worry about quality of care?

ETA I just read that your reason for not wanting it was concern for your wife's immigration status. That's understandable. However I believe you can be on it and other family members can have different insurance coverage.
« Last Edit: October 24, 2019, 01:02:17 PM by spartana »

fh2000

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #35 on: January 06, 2020, 08:43:42 PM »
I hope OP by now has found a solution.

I was also put on Medi-cal around November, 2019. I received an email to update my income but I did not do that, so on CoveredCA system my income was too low, and they sent me to my county Medi-cal program by the end of November.

After I uploaded my proof-of-income document and talked to county Medi-cal department, I was able to resume my status back in Covered California.  I renewed the plan that we had in 2019, and was able to get coverage for 2020.

So, if you are persistent calling county office, and CoveredCA service center, they will help you out.

RedwoodDreams

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Re: Post FIRE and Covered Calif stuck me in MEDI-CAL!
« Reply #36 on: January 12, 2020, 11:37:45 PM »
OP, I think you will have to get your income fairly high if your goal is to have everyone in your family on an ACA plan rather than Medi-Cal (which is the CA name for Medicaid; my son is on it so I'm well familiar with the back and forth between our county HHS office and Covered CA. It's a huge pain), because children will be on Medi-Cal up to a fairly high MAGI, as shown by this chart.