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Old 12-30-2013, 11:31 AM
 
33,016 posts, read 27,469,142 times
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Are the calculations and determinations made annually or monthly?

Let's say a childless adult makes $1,500 a month. That works out to $18,000 a year, so like a good boy he obeys the individual mandate and purchases (subsiidized) insurance.

In August. he gets fired, receives his last paycheck on Aug 31, and never receives a dime of income the rest of the year. He has earned $12,000 for the year, which would at some point make him Medicaid-eligible in a state that did not opt out, also he would be required to file a federal tax return for that year. He was covered for only 8 months of the year, as he lived paycheck to paycheck and had no savings with which to pay for insurance after August. Because his income abruptly ended, he earned less than initially expected and his taxes were overwithheld, so he will file for a tax refund.

Questions:

If he lives in a Medicaid-expansion state. at what point, if any, can he enroll in Medicaid?

If he lives in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months and therefore will he receive a reduced refund?

If he does not live in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months?
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Old 12-30-2013, 11:54 AM
 
4,130 posts, read 4,462,376 times
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You do know that taxes are paid the year after, right? You don't pay what you estimate you will be taxed in the same year.

If you under, or over, estimate for the last year then you owe or get get money back based on your income and deductions. You can file for whatever health insurance you can apply for based on your need when the event occurs (quit or get fired) and get coverage based on your current situation, just like regular health insurance coverage.

Just a question I need to ask, did something happen to your job flipping burgers? It's easier to tailor advice to specific situations instead of beating around the bush and pretending like it's some one else.
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Old 12-30-2013, 12:03 PM
 
Location: texas
9,127 posts, read 7,946,204 times
Reputation: 2385
Quote:
Originally Posted by freemkt View Post
Are the calculations and determinations made annually or monthly?

Let's say a childless adult makes $1,500 a month. That works out to $18,000 a year, so like a good boy he obeys the individual mandate and purchases (subsiidized) insurance.

In August. he gets fired, receives his last paycheck on Aug 31, and never receives a dime of income the rest of the year. He has earned $12,000 for the year, which would at some point make him Medicaid-eligible in a state that did not opt out, also he would be required to file a federal tax return for that year. He was covered for only 8 months of the year, as he lived paycheck to paycheck and had no savings with which to pay for insurance after August. Because his income abruptly ended, he earned less than initially expected and his taxes were overwithheld, so he will file for a tax refund.

Questions:

If he lives in a Medicaid-expansion state. at what point, if any, can he enroll in Medicaid?

If he lives in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months and therefore will he receive a reduced refund?

If he does not live in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months?
There is a difference in the Medicaid system and indigent health care system. Figure out if your hypothetical person qualifies for Medicaid in the state which he hypothetically lives first.
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Old 12-30-2013, 12:08 PM
 
Location: South Bay
1,404 posts, read 1,032,350 times
Reputation: 525
Quote:
Originally Posted by EmeraldCityWanderer View Post
You do know that taxes are paid the year after, right? You don't pay what you estimate you will be taxed in the same year.

If you under, or over, estimate for the last year then you owe or get get money back based on your income and deductions. You can file for whatever health insurance you can apply for based on your need when the event occurs (quit or get fired) and get coverage based on your current situation, just like regular health insurance coverage.

Just a question I need to ask, did something happen to your job flipping burgers? It's easier to tailor advice to specific situations instead of beating around the bush and pretending like it's some one else.
Just a question I need to ask; why did you decide he flipped burgers? How do you know he didn't work a high paying part time gig? I'm on contract with two companies doing their IT and work about 15-18 hours per week which gives me an income of about $15k per year. If I didn't do work for other companies I could ask the same question if I were fired.

Even if freemkt was in the third person and working full time, it would mean he was being paid about $9hr. There are many jobs, other than food joints, paying $9hr.

I agree with Jones.

The level of income (based on the poverty line) dictates eligibility for Medicaid. Here in Cali I believe it's about $15.5k for a single adult, and $19.5k for a married couple. It may be raised to 1.25% of poverty line.
http://sdhcc.org/health-reforms-init...income-adults/

Last edited by surfman; 12-30-2013 at 12:17 PM..
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Old 12-30-2013, 12:29 PM
 
17,440 posts, read 9,273,672 times
Reputation: 11907
Quote:
Originally Posted by freemkt View Post
Are the calculations and determinations made annually or monthly?

Let's say a childless adult makes $1,500 a month. That works out to $18,000 a year, so like a good boy he obeys the individual mandate and purchases (subsiidized) insurance.

In August. he gets fired, receives his last paycheck on Aug 31, and never receives a dime of income the rest of the year. He has earned $12,000 for the year, which would at some point make him Medicaid-eligible in a state that did not opt out, also he would be required to file a federal tax return for that year. He was covered for only 8 months of the year, as he lived paycheck to paycheck and had no savings with which to pay for insurance after August. Because his income abruptly ended, he earned less than initially expected and his taxes were overwithheld, so he will file for a tax refund.

Questions:

If he lives in a Medicaid-expansion state. at what point, if any, can he enroll in Medicaid?

If he lives in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months and therefore will he receive a reduced refund?

If he does not live in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months?
Calculations are done both monthly an annually, depending on the circumstances. You have to show that you had insurance for every month, you have a choice about whether you take the subsidy on a monthly basis to pay premiums or on an annual basis when you do your tax return.

The important thing that probably very few people are aware of ...... is that you must inform the Government of any "life change" that would effect your insurance or payments. The examples given were 'job change', 'move to another area', 'divorce'. I believe it is the IRS that will be tracking this information, but if Medicaid is involved - you should probably talk to the Social Security office.

It doesn't matter if you are in a Medicaid expansion State or not - all individuals are subject to the penalty under the law and must show proof of insurance for all months. Of course that could be 'waived, delayed or tossed on the scrap pile by Obama at any given minute ...... which is why everyone needs to be on top of their own situation.

Both Politico and The Hill seem to be on top of all the "new" rules as they come out. I read a report early this morning about the IRS and reports of 'life change' on Politico.
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Old 12-30-2013, 12:30 PM
 
4,130 posts, read 4,462,376 times
Reputation: 3041
Quote:
Originally Posted by surfman View Post
Just a question I need to ask; why did you decide he flipped burgers? How do you know he didn't work a high paying part time gig? I'm on contract with two companies doing their IT and work about 15-18 hours per week which gives me an income of about $15k per year. If I didn't do work for other companies I could ask the same question if I were fired.

Even if freemkt was in the third person and working full time, it would mean he was being paid about $9hr. There are many jobs, other than food joints, paying $9hr.

I agree with Jones.

The level of income (based on the poverty line) dictates eligibility for Medicaid. Here in Cali I believe it's about $15.5k for a single adult, and $19.5k for a married couple. It may be raised to 1.25% of poverty line.
Medi-Cal Eligibility for Low Income Adults | San Diegans for Healthcare Coverage
Well, I have spoken with him before and that what he said his employment was. Not being mean, it is actually impressive on how he can pinch a penny, but situations are easier to address than vauge generalities without stating all of the information. Certainly less mistakes that need to be corrected or cause problems later.

When people live very close to the edge, beating around the bush can cause more problems than simply feeling bad your issues are out in the open. I knew some one who was vauge about his housing situation, something that could have been cleared up with help, but he was ignorant of what was happening and too ashamed to talk about it. He ended up losing his home over the issue, his down payment (which was most of his savings), and was living in a Honda Element till he finally told us and we took him in to get back on his feet.
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Old 12-30-2013, 01:17 PM
 
47,525 posts, read 69,716,559 times
Reputation: 22474
The penalty for not buying obamacare is so low, why not just take the penalty? It won't matter if you have a pre-existing condition, you can wait until you need health care and then buy it.
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Old 12-30-2013, 02:02 PM
 
17,440 posts, read 9,273,672 times
Reputation: 11907
Quote:
Originally Posted by malamute View Post
The penalty for not buying obamacare is so low, why not just take the penalty? It won't matter if you have a pre-existing condition, you can wait until you need health care and then buy it.
A lot of people will do that and they can probably get by with it for a year or so -- but my experience with Government enforcement is that it will probably end up being one of those things they can always tack on to another charge ..... only it will be a Federal charge. Personally - I wouldn't want to mess with a possible Federal charge of any sort -- that's why I always pay my taxes and pay them on time.

That "low penalty" won't stay low , it's going to jump right up there after the first year or so. You could call the $95 penalty rate an "introductory rate".
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Old 12-30-2013, 02:52 PM
 
16,212 posts, read 10,828,810 times
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As was mentioned by a previous poster, the person applying for coverage makes the determination whether or not he/she will receive an annual or monthly subsidy.

Also, if the person loses a job that is considered a "life change." As such, the person will notify the healthcare.gov folks and if they qualify for Medicaid at that time, then they would be able to receive it, but would have to apply through their respective state.

Contrary to what someone else mentioned, Medicaid is not handled by the Social Security Administration. You have to visit or contact your localities Medicaid office in your state, usually this is the Department of Family and Children's Services or your state's Health Department.
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Old 12-30-2013, 05:58 PM
 
8,483 posts, read 6,935,208 times
Reputation: 1119
Quote:
Originally Posted by freemkt View Post
Are the calculations and determinations made annually or monthly?

Let's say a childless adult makes $1,500 a month. That works out to $18,000 a year, so like a good boy he obeys the individual mandate and purchases (subsiidized) insurance.

In August. he gets fired, receives his last paycheck on Aug 31, and never receives a dime of income the rest of the year. He has earned $12,000 for the year, which would at some point make him Medicaid-eligible in a state that did not opt out, also he would be required to file a federal tax return for that year. He was covered for only 8 months of the year, as he lived paycheck to paycheck and had no savings with which to pay for insurance after August. Because his income abruptly ended, he earned less than initially expected and his taxes were overwithheld, so he will file for a tax refund.

Questions:

If he lives in a Medicaid-expansion state. at what point, if any, can he enroll in Medicaid?

If he lives in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months and therefore will he receive a reduced refund?

If he does not live in a Medicaid-expansion state, is he subject to the tax/penalty for not being insured at least 9 months?
The healthcare site has an exemption section. I would go read that.
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