Author Topic: HSA Contributions and Medicaid  (Read 9154 times)

ginklord

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HSA Contributions and Medicaid
« on: August 05, 2016, 12:43:45 PM »
Hi everyone,

I qualified for (and am now receiving) Medicaid benefits in New York earlier this year during a three month period of unemployment. This includes health, dental, and vision insurance with no deductible and no copay.

I started a new job and reported my income, but New York won't allow me to stop receiving medicaid benefits for one year. I'm now eligible for a HDHP through my employer, and I'd like to start contributing to my existing HSA again, but it sounds like the contributions won't be deductible because I have other, non-HDHP health insurance. I probably won't be able to contribute until early next year, when (hopefully) medicaid eligibility expires.

I'm not exactly complaining about the "free" health insurance, but it's a little annoying that I can't contribute because of a health insurance plan that I can't cancel.

Does anyone have experience with this? Any helpful thoughts or advice?

Thanks!

Choices

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Re: HSA Contributions and Medicaid
« Reply #1 on: August 05, 2016, 03:04:50 PM »
Just appreciate your 'free' insurance now. Save up now so you can fully fund your HSA next year $3400 single/$6750 family, more if you're 55 yo or older.

Save an emergency fund so you'll be set if you become unemployed again. Good luck with your new job.

zing12

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Re: HSA Contributions and Medicaid
« Reply #2 on: August 05, 2016, 05:16:57 PM »
What'sthe rationale for them making you stuck on Medicaid? Is your new income over 138% FPL? just curious. I thought it was common for people to bounce on and off Medicaid, they call it churn.

redcedar

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Re: HSA Contributions and Medicaid
« Reply #3 on: August 05, 2016, 05:34:56 PM »
What'sthe rationale for them making you stuck on Medicaid? Is your new income over 138% FPL? just curious. I thought it was common for people to bounce on and off Medicaid, they call it churn.

Same thought and question.

forummm

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Re: HSA Contributions and Medicaid
« Reply #4 on: August 05, 2016, 07:17:44 PM »
Some states are trying to minimize churn and are keeping people on for a year so that people have more stable access to healthcare. I imagine that there are also some saved overhead costs for not having people bouncing on and off.

zing12

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Re: HSA Contributions and Medicaid
« Reply #5 on: August 06, 2016, 01:24:57 AM »
It makes sense, but I'm surprised that they are allowed to do it under the Medicaid laws.

teen persuasion

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Re: HSA Contributions and Medicaid
« Reply #6 on: August 06, 2016, 07:35:08 PM »
That is definitely a change from 2 years ago.  DH quit his job, and it was several months before he had a new one and was eligible for health insurance thru the new employer.  We contacted the state exchange when we had other insurance to stop Medicaid.  There was no overlap at that time.  I seem to remember that Medicaid could be restarted if necessary, though.

I will say that we had all kinds of problems trying to use the state website in 2014.  Phone assistance was variable - some helpful, some benign, some just plain wrong.

ginklord

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Re: HSA Contributions and Medicaid
« Reply #7 on: August 06, 2016, 07:52:21 PM »
Yeah, I suspect it has something to do with minimizing churn. The letter says

"You are no longer eligible for
Medicaid.
However, we will continue
Medicaid coverage. This is because
certain individuals who qualified
for Medicaid get coverage
for twelve continuous months
from the date they were last
determined eligible."

jim555

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Re: HSA Contributions and Medicaid
« Reply #8 on: August 09, 2016, 06:19:28 AM »
NY is a great state when it comes to health insurance.
Just enjoy the coverage.  I don't even know why you are complaining.

I am curious if you have children on the plan?
From the https://www.medicaid.gov/medicaid-chip-program-information/by-topics/outreach-and-enrollment/continuous.html

"States have the option to provide children with 12 months of continuous coverage through Medicaid and CHIP, even if the family experiences a change in income during the year. Continuous eligibility is a valuable tool that helps States ensure that children stay enrolled in the health coverage for which they are eligible and have consistent access to needed health care services."
« Last Edit: August 09, 2016, 07:36:38 AM by jim555 »

JackieTreehorn

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Re: HSA Contributions and Medicaid
« Reply #9 on: August 16, 2016, 09:31:22 AM »
I'm also in NYC and was on Medicaid.  Same thing happened to me.  Never seen a program that was so hard to disenroll from.  You'd think they'd make it easier to, you know, stop getting benefits (i.e. free money) from them. 

Anyhow even after I showed documentation that I had new insurance I was still somehow enrolled in "straight-up Medicaid" as the lady on the phone says (but no longer enrolled in my Empire BC health plan that was previously administering my Medicaid benefits) so I asked her to disenroll me completely and she supposedly did so.

Anyhow, it appears I was still enrolled in Medicaid for July and August while I was making HSA contributions in my employer's HDHP.  Anyone know how this will affect me?  How about for future HSA contributions in 2016?

Goddam they make this shit confusing.  I guess I really can't complain considering I had free healthcare for 6 months during my gap year, but still... :-)

seattlecyclone

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Re: HSA Contributions and Medicaid
« Reply #10 on: August 16, 2016, 10:45:15 AM »
Anyhow, it appears I was still enrolled in Medicaid for July and August while I was making HSA contributions in my employer's HDHP.  Anyone know how this will affect me?  How about for future HSA contributions in 2016?

There's a "last month rule" that says if you are eligible for HSA contributions on December 1 and remain that way for the entire next year, you are considered an eligible individual for the whole year. As long as you remain covered by only HDHP insurance through the end of 2017 I think you should be eligible to make a full-year maximum HSA contribution for this year.

JackieTreehorn

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Re: HSA Contributions and Medicaid
« Reply #11 on: August 16, 2016, 12:25:47 PM »
Thanks SeattleCyclone.  I don't quite understand the timing though...Won't the deductibility of those contributions be determined when I file my 2016 taxes when it won't be known to either me or the IRS whether I will continue to participate in an HDHP until the end of 2017?

Reading the rule on the IRS website was less than illuminating...

seattlecyclone

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Re: HSA Contributions and Medicaid
« Reply #12 on: August 16, 2016, 12:35:33 PM »
Thanks SeattleCyclone.  I don't quite understand the timing though...Won't the deductibility of those contributions be determined when I file my 2016 taxes when it won't be known to either me or the IRS whether I will continue to participate in an HDHP until the end of 2017?

Reading the rule on the IRS website was less than illuminating...

What you do is make a full contribution now and file your 2016 taxes with the assumption that you will be eligible throughout 2017. If plans change and you end up with non-HDHP coverage sometime during 2017, you'll need to pay some penalties or pull the disallowed contributions out or something.

JackieTreehorn

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Re: HSA Contributions and Medicaid
« Reply #13 on: August 16, 2016, 12:44:43 PM »
Cool thanks...I guess that makes sense I mean they are being taken out of my paycheck automatically on a pre-tax basis now so unless they tell me I owe a penalty I will assume I'm good.

Thanks for your help.

Erica

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Re: HSA Contributions and Medicaid
« Reply #14 on: August 16, 2016, 09:56:55 PM »
Yeah, I suspect it has something to do with minimizing churn. The letter says

"You are no longer eligible for
Medicaid.
However, we will continue
Medicaid coverage. This is because
certain individuals who qualified
for Medicaid get coverage
for twelve continuous months
from the date they were last
determined eligible."

You have some possible options but only you know your circumstance to know which ones are viable.

Maybe consider asking Medicaid if they can pay for your families HDHP premiums. Apparently it is possible in New York
https://www.health.ny.gov/health_care/medicaid/#cancel

One obvious reasons you want your HDHP+HSA thru your employer is Taxes.  No matter who contributes to your HSA, you, your employer or the County (via Medicaid) it is YOU who takes the tax write off (per HSA's for Dummies Book 2007 edition). If the County paid your families premiums, you'd likely save on what you pay in taxes. Not a valid resource so verify this statement first. Per this website, http://obamacarefacts.com/health-insurance/health-savings-account-hsa/   contributions lowers your magi so your family may still qualify for Medicaid..
If Medicaid still refuses to cancel you, a fair hearing can be requested. Phone number-->.https://www.health.ny.gov/health_care/medicaid/#hearing  Just the fair hearing request itself, via your telephone call, might get you out of medicaid when/if they call you back.

I would request a form that, states you are inelligble for medicaid. Especially if you are NOT making more than 138% of the federal poverty level for your family size. There is something that they are using to keep you enrolled, and I suspect, it is your income. They are adding it up so for the year and assuming you are less than whatever the monthly 138% of the federal poverty level x 12 months. There is a yearly income cut off and you might just make that cut. That might be the problem. Always be polite and give the benefit of the doubt, but firm. If you chose to be in a managed care plan versus "straight medical' the cost of those plans are much higher. I would always suggest to stay on Straight medicaid so if anything ever came back to haunt you, the bill would cost less.

I believe you can get on your employers HDHP yourself, and your family can remain on medicaid. That is probably the most financially feasible but I do not know your income or family size or tax bracket. And you could present it as a form of compromise, possibly to the medicaid office. Good luck!


« Last Edit: August 16, 2016, 11:25:48 PM by Erica »

Axecleaver

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Re: HSA Contributions and Medicaid
« Reply #15 on: August 17, 2016, 03:13:46 PM »
What is meant by "straight medicaid" is fee for service. The other option, which is much more common, is managed care. With managed care the state pays a provider a per member per month fee, even if they never make use of their services. That's why they switch you to FFS. If you're not using it, it doesn't cost anything.

I work around/with NY Medicaid, and I wasn't aware that they were extending eligibility though the annual determination date. Thanks for making me aware of that! The eligibility system in NY is extremely aged, and has survived many attempts to modernize it. I suspect the decision to extend enrollments through redetermination date was at least partly due to technical system restrictions.