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I'm wondering what happens if someone is on Medicaid, and their Medicare eligibility kicks in. This person I know is poor and on SSDI but not "poor enough" for Medicaid, but was eligible until the SSDI was approved. Then Covid hit and the public health emergency was declared. She really is struggling (inflation is eating up her already low income) and I would like to see her have Medicaid as long as she can.
There is too much of an expense gap between Medicaid (free and simple) and Medicare and all it's moving parts (expensive to get full coverage and confusing), when a person is low income, to expect them to afford all the extras- advantage plans, part D, medigap, etc. along with what is taken from their SS checks. There should be a middle ground somewhere for these low income people.
I thought Medicaid was for people in NEED - NOT for people that have since started working and have an insurance plan available to them?
I think this discussion is a bit distorted because there is the traditional standard Medicaid rules (that you assumed correctly) and you now have the revised temporary exemptions/exclusions/revisions enacted during the pandemic. Violations pre-Covid may not be a violation today but could again become a violation later on. Unfortunately, many of these emergency pandemic measures were designed to help people who truly needed the relief, but since the policy and programs were so poorly written, it relived many people of personal responsibility, created a haven for fraudsters and ushered in a new class of entitled welfare cheats.
I think this discussion is a bit distorted because there is the traditional standard Medicaid rules (that you assumed correctly) and you now have the revised temporary exemptions/exclusions/revisions enacted during the pandemic. Violations pre-Covid may not be a violation today but could again become a violation later on. Unfortunately, many of these emergency pandemic measures were designed to help people who truly needed the relief, but since the policy and programs were so poorly written, it relived many people of personal responsibility, created a haven for fraudsters and ushered in a new class of entitled welfare cheats.
One could say the same about the relief checks distributed to Americans (some people didn't need them) but it isn't cheating or fraud to work within the rules. Some regulations were relaxed to prevent greater damage as we go through this pandemic. A lot of people will be without any insurance when the public health emergency ends because their situations have changed and Bidinflation is making them poorer.
I thought Medicaid was for people in NEED - NOT for people that have since started working and have an insurance plan available to them?
If the insurance meets the minimum value standard than, yes, they are supposed to take that insurance. If it doesn't and they are eligible for Medicaid, they can take the Medicaid.
MVS means the insurance covers at least 60% of the total allowed cost of benefits AND the lowest-cost self-only plan offered by the employer is 9.5% or less than the household income.
One could say the same about the relief checks distributed to Americans (some people didn't need them) but it isn't cheating or fraud to work within the rules. Some regulations were relaxed to prevent greater damage as we go through this pandemic. A lot of people will be without any insurance when the public health emergency ends because their situations have changed and Bidinflation is making them poorer.
The eligibility standards for subsidized insurance like Medicaid have NOT changed. Only major change was the American Rescue Plan changing the threshold ceiling for tax credit eligibility (it used to be 200% FPL).
And your last sentence is EXACTLY why ACA is still necessary, and no one should be calling for it to be rescinded. I started working for NYSOH before COVID, and NYSOH has not only provided a source of insurance for people who wouldn't have access to it, but we've made it possible for them to KEEP their insurance through doing auto-extensions (rather than renewals) not just for Medicaid in light of the federal legislation, but also other low-cost programs like Essential Plan and Child Health Plus.
I thought Medicaid was for people in NEED - NOT for people that have since started working and have an insurance plan available to them?
It really depends on each states rules to qualify for Medicaid. Some states expanded Medicaid coverage years ago. There are people who work and have primary insurance that may still qualify for Medicaid coverage as a secondary payer.
For instance, if someone is in a low wage job has multiple kids, their kids may have supplemental Medicaid coverage in addition to their employer sponsored coverage. Medicaid is a payer of last resort (secondary payer).
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