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A friend left his job this past summer, and had no health insurance. A couple of months later, he was found to have a serious illness, currently is receiving medical care, and will need to do so going forward. He receives just rental income by renting out half of the house that he lives in. The rental income about is below the NJ Familycare maximum threshold for income, plus has expenses the rental income gets used for to pay in his house. He received Medicaid through years' end, and will need to move over to an HMO based Medicaid/NJ Familycare beginning in January. Household/family-size is 1.
He never applied for either Federal disability (SSDI) or Temporary Disability through New Jersey so far, due to not feeling well enough. Would either of these disability incomes disqualify him from receiving HMO based NJ Familycare health insurance? From what I've been able to research, it seems that if he receives temporary disability from NJ and the amount is over the income threshold, it can be disqualify him from the health insurance? But I've also read that SSDI/Federal Disability comes with Medicaid? He (and I) are confused.
Could someone please assist and advise? Much thanks...
Medicaid is based on an income threshold, some states on income and assets. We've had a number of posters state their SSDI/disability income disqualifies them from Medicaid. Some are fortunate enough to have health insurance through their spouses. Others buy insurance through the ACA. For those Medicare-eligible, their other insurance recourse is either an Advantage plan or Medicare supplement if they do not qualify as dual eligibles - i.e., Medicare/Medicaid.
It is more than likely additional income could put him over the threshold and he could lose Medicaid should that income continue for too long. He may be allowed to go over the threshold for a short period but, again, that is a state-by-state issue.
He needs to talk to NJ on its Medicaid requirements.
Much appreciated. As he does not have a spouse or anyone else to be part of their policy, this is a difficult situation. If he gets disability, the price for an individual policy that has excellent coverage is over $1,000 a month, and his current health situation may have co-pays, deductibles, etc. absorb so much of whatever disability he might be due.
If he gets SSDI, he could earn too much to qualify for the NJ Familycare. However, he might still qualify. He can go to the Healthcare marketplace and get subsidized insurance for the first two years. After that time, he will be enrolled in Medicare and won't be able to use the marketplace. Medicare is better anyway, and probably costs less. I earn too much SSDI to qualify for Medicaid, but some do qualify.
So Medicare would be available to him that soon, even though he's only 52 now?
Quote:
Originally Posted by ihatetodust
I believe they are implying that if he was on SSDI after a period he would be eligible for Medicare.
Yes, people under age 65 can apply for Medicare after being on SSDI for 24 months.
See page 12 of https://www.ssa.gov/pubs/EN-05-10029.pdf where it says:
"When do I get Medicare?
You’ll get Medicare coverage automatically after you’ve received disability benefits for two years."
He's not received disability. His insurance has changed in the new year to NJ Familycare/Horizon NJ Health vs straight/emergency Medicaid.
If he ever began receiving SNAP, or assistance for electric/gas/heating/etc. through LIHEAP (Low Income Home Energy Assistance Program) and USF (New Jersey Universal Service Fund), would any of those be considered part of gross income counted by NJ Familycare?
Thank you...
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