Well what I'm saying is, at least for New York State's application process, they let you use your "average monthly income" as if it were spread throughout the year (I earned roughly $40k before quitting -- so it would average out to over $3.3k monthly), OR alternatively use your "current income" instead if it differs from that. But they define "current income" as your previous month earnings. So last month, May, I ended employment and earned just over the $1,482 limit and I'm afraid they'd deny me based on that month.
Based on that "current income" referring to the previous month, I'd have to wait until the beginning of July and claim that I had no employment income for the month of June to qualify. Does that make sense? Please correct me if my logic is wrong here!
It is current month income, not last month income. That is the legal definition.
Yeah, that's what it seems it should be, which frustrates me. I even contacted customer service and they were quite rude, they said "Well what is the question asking? It says previous month". So I don't know, I'd be lying if I said my previous calendar month employment income was $0.
Yeah, I've been having lots of fun trying to apply, too. DH's last "day" is in early July (not a worked day, a school holiday pay day), and first told him we'd have medical coverage thru July. Then a union rep said HR had it wrong, if he didn't actually work in July, coverage only went thru June. So a scramble to apply before June 15.
First they ask what income we each expect this year. I respond with our taxable (AGI) numbers, not gross numbers (we have lots going to pre-tax retirement accounts and HSA), because that's what eligibility is based on. The website averages that to monthly, and asks if it matches our monthly income. NO! Plus, we have a 22 yo son, who will not be our tax dependent this year, but as he is under 26 he SHOULD be able to stay on our health insurance, and thus his income should be included in household income. He started a job mid April, so his annual income doesn't match weekly * 52, either.
Put our numbers in, and first they break up the household of 4 to a household of 1 (DS4) on ACA, and household of 3 not sure(eventually on Medicaid). By my calculations, we should be on Essential plan for household of 4 with combined income. It's all preliminary, until we prove numbers with uploaded documents, even for teen with no income. I tried calling. Got cut off once. Second attempt - they want a month's pay stubs from workers, and we need a letter of termination from DH's employer with estimated income. Also need a letter of termination from health insurance company. Call health insurance company - can't send a letter of termination, because employer hasn't sent them notice, yet. So request employer craft letters for NYSofHealth and health insurance company. Of course, employer letter of termination has gross income, but labels it taxable (way off), and now says health coverage goes thru July. (Also as per phone call, for teen, upload parents' documents again, as family income).
Upload pay stubs and letter of termination. Now website doesn't like son's pay stubs - need more current ones. Everyday I get a new email about something urgently needed.
Had annual eye exam today. Booking next year's appointment, I asked about changes in health insurance. They can't do Medicaid; can do Medicare, not Medicaid. Gave me the name of the one doctor who can do Medicaid, because I'd have to switch. Apparently only one doctor in an area can be the Medicaid doctor (at least for eyes); Dr So-and-So wanted to also accept Medicaid patients, but was refused, because Dr First was the designated Medicaid Dr here. Really! So was trying to reschedule our sons' appointments from August 2 to within July. Got younger son in (because going to Medicaid) but older will likely have own insurance on ACA, so COULD be covered if he picks the right affiliates (Eyemed, Davis - good; lots of others - not affiliated). Or, as an established patient, could pay OOP, $95 (but was unclear if additional fees for etc.).
This is just the eye doc. No idea about pediatrician, DH's doctor, specialists, dentist...
Still have to pick plans. Waiting until it all shakes out - I expect them to look at our gross income numbers and change everything. And, of course, if DS4 picks an HSA plan he could drop his AGI down. The Essential plan really messes with the Silver CSR - under 200% FPL, you have to do Essential plan, no ACA subsidy for you. From 200-250% FPL you get ACA subsidies, but those aren't enough to get a silver plan for free or cheap, and CSR are not as good. DS4 would need to pay ~$150/mo for silver. A bronze could be free, but no CSR and high deductibles/OOP max. So it's a catch-22: he could pick an HSA plan, fund an HSA, drop his AGI - and now be below 200% FPL and in Essential plan range - and not eligible for an HSA! Round and round we go.
Topic: What comes after the ACA? (Read 2029278 times)
