<p>We discussed earlier in the thread that Washington State is trying to change the recovery requirements for the newly eligible Medicaid recipients, and they intend to make this change before Jan. 1. Any news from other states?</p>
<p>The vast majority of newly eligible people will be unaffected, because they are have no assets to recover and/or are under 55.</p>
<p>[Understanding</a> Obamacare: How will asset limits for Medicaid change? | syracuse.com](<a href=“http://www.syracuse.com/news/index.ssf/2013/08/understanding_obamacare_how_will_asset_limits_for_medicaid_change.html]Understanding”>Understanding Obamacare: How will asset limits for Medicaid change? - syracuse.com)</p>
<p>Some of this may be more complicated, more layered, than is apparent in the media.</p>
<p>"Beginning July 1, 2013, the asset test will be eliminated for certain groups, and a modified adjusted gross income (MAGI) standard will be the basis for determining income eligibility. These new rules will apply to Medicaid, the Children’s Health Insurance Program (CHIP), and eligibility for subsidies in the health insurance exchanges. This standardized approach to determining income eligibility will eliminate wide discrepancies in how income is now counted across states and will be consistent with income counting rules for determining eligibility for subsidies in the new health insurance exchanges. MAGI is defined as an individual’s (or couple’s) gross income (for federal tax purposes), with some adjustments that add back in foreign income and tax-exempt interest.</p>
<p>The elimination of the asset test and the application of MAGI will apply to most children, parents, and childless adults who qualify under existing eligibility rules as well as those who are newly eligible. The following Medicaid eligibility groups will continue to employ asset rules and income disregards [specific types of excluded income] , and are exempt from using MAGI to determine income eligibility: Older adults (age 65 and older,) Foster children, Low-income Medicare Savings Program beneficiaries, Persons receiving supplemental security income, Medically needy persons, Persons seeking Medicare prescription drug low-income subsidies, Persons seeking Medicaid long-term care services."</p>
<p><a href=“http://assets.aarp.org/rgcenter/ppi/health-care/fs185-health-reform.pdf[/url]”>http://assets.aarp.org/rgcenter/ppi/health-care/fs185-health-reform.pdf</a></p>
<p>It seems pretty simple. Some people are being added to the Medicaid rolls, and nobody is being removed. People under 65 with very low income can get Medicaid (in expansion states), no matter what their assets. In addition, people who don’t qualify by being under 65 and having a very low income can get Medicaid under the old eligibility criteria, but they will continue to be subject to the old rules including asset tests.</p>
<p>So, for example, a medically needy person who is also under 65 and has a low income qualifies for Medicaid with no asset test, just like any other person who is under 65 with a low income. A medically needy person who doesn’t have a low income will nevertheless qualify for Medicaid if they already qualified under the old rules.</p>
<p>So we have a simple flowchart for qualification: Do you qualify under the new rules? You’re in, no asset test for you. If not, do you qualify under the old rules? You’re in. Everybody else? Out.</p>
<p>This is interesting, re: recovery, but note it dates back a few years. The tables are interesting. [Medicaid</a> Estate Recovery Collections](<a href=“http://aspe.hhs.gov/daltcp/reports/estreccol.htm]Medicaid”>Medicaid Estate Recovery Collections | ASPE)</p>
<p>Also somewhere I came across note that states may determine the cost-effectiveness of pursuing recovery. Not that that assures us, moving forward.</p>
<p>CF, they do say some will find themselves no longer eligible for Medicaid under the new rules and eligible instead for subsidies. I dunno, this topic is expanding geometrically.</p>
<p>I got three bills today in the mail from BCBS (which is strange because I asked for ebills and have always gotten ebills before this one but whatever). One for next month for my old plan, one for next month for my new plan (medical), and one for my new plan (dental). </p>
<p>I called them today to figure out how I could cancel the old policy and get the new policy on the account that I already had with BCBS (so I wouldn’t have to make a new account and whatnot). Sometimes, that’s not possible and I get that, but the lady on the phone could not figure out what the heck I was asking her to do. </p>
<p>Seriously, for a company as large as BCBS is and in a state with many, many competent unemployed people, you’d think they could get someone that could get it together on the phone. I’ve <em>never</em> had a good experience calling them. </p>
<p>I ended up running out of time and just hanging up. I’ll call back on Friday. Oy vey.</p>
<p>ETA: It might be a blessing in disguise though because I might just stick with my old plan until April and then switch to Medicaid. The cost is about the same and then I won’t have to justify my income because I honestly have no idea what it was this year and apparently some sort of verification is triggered if you claim to make more than 110% of your income this year. The copay and deductible difference isn’t a big deal as most basic medical services are covered for free by the U.</p>
<p>My 27 yr old son paid $110 per month to BCBSNC this year. He can continue this plan in 2014 at a rate of $129 per month. If he could somehow make $12,000 in 2014 (he is a student and will graduate in May, but will he get a job??) he could get an ACA policy with a list price of $250 subsidized down to $20 per month. That would be nice, huh? But if he estimates income at $12,000 he will have to submit proof/verification at some point early in the year or his plan will be canceled. My advice to him is to stick with his old non ACA policy at the new rate of $129.</p>
<p>Too bad my new ACA policy will not cover eye exams - I could use one. My current policy covers a visit to the eye doctor once a year for a copay. Too late now to schedule an appointment this year. They require maternity coverage, but not eye exams.</p>
<p>^^why not take a Medicaid policy for free?</p>
<p>Romanigypsyeyes, so now you expect good service, too, for free insurance. :)</p>
<p>^ She doesn’t have free insurance. And, we all need to be mindful of cancelling the plan we no longer want, if that applies. Also, in my case, I signed up and paid the exchange- but had to cancel the old one directly with BC. Even though old and new are served by BC.</p>
<p>Hey look, GP, yet ANOTHER swing and a miss. Honestly, every dig you’ve gotten in at me has been completely off the mark. </p>
<p>Why, on earth, would I have bills for a policy that I don’t pay for? Even if I got bills that said $0, why would I call them to make sure that I only have one account? Let’s think about this logically for two seconds. Plus, considering you’re one of the most prolific posters on here, you know darn well that I have a plan that I am paying for.</p>
<p>Blue, if that’s to NJ- I believe he/she is in a non-expansion state (IIRC). If it’s to me, (I can’t tell because of the ^^ arrows lol) my state does not expand Medicaid until April. </p>
<p>I pay for my policies.</p>
<p>I’ll tell you what GP. My taxes are going up to pay the insurance companies these subsidies, and my rates have gone up, and I damn well expect everyone to get good service for the guaranteed profits the insurance companies now get. Most of us want everyone to get quality health care. If we are going to allow insurance companies to continue to be the administrators of this transaction? They can do their job.</p>
<p>They wrote the law. They can provide some service. To everyone.</p>
<p>Darn right, poetgrl. Even for people who, unlike romani, are paying zero, the insurance company is paid the full premium. And the insurance company should damn well provide competent, courteous service for their money.</p>
<p>Let’s see…will insurance companies provide better or worse service under Obamacare? Now, it would be hard to believe it can get any worse, but I have enormous faith in their capacity to outdo themselves.</p>
<p>I would expect service to get worse regardless of what the companies are being paid, because they have a captive audience by force of law. Yes, you might be able to switch to another company in the open enrollment period if you are frustrated with the service of one, but it won’t be easy to do so if it means changing providers and premium cost, too.</p>
<p>Insurance companies are being asked to do some crazy things right now such as ignore parts of the law they spent 3 years gearing up to enforce and go ahead and cover people even though they haven’t paid and cover drugs for the time being and we’ll figure it out later. On top of that the government website is sending them gibberish.
It’s ridiculous and should be no surprise to anyone that it’s a mess.</p>
<p>I’m not seeing the business case here, Bay. Surly Insurance Company might have customers who have a contract for a year, but Surly wants them to re-up next year, and not change over to Nice Friendly Insurance Company instead. Surly wants to stay in business for more than a year. They don’t want to alienate all their customers by living up to their name. </p>
<p>(There actually is a company called Surly: Surly Bikes. But they don’t live up to their name as far as customer service; actually they are nice. I’m about to buy one of their bikes.)</p>
<p>CF, I don’t think they have much to worry about when many people will only have a choice of one or two companies.</p>
<p>CF,
As I’ve written before, we haven’t had all that much contact with insurance companies, as we are small users of medical care (knock wood again), but in my minimal experience, they were never that easy to deal with before people were required by law to contract with them, and even when there was a myriad of companies and plans to choose from. I don’t see any reason why service will improve under the ACA, and it is basic economics that it could get much worse. When competition decreases, quality (service, in this case) decreases. It makes sense to expect this, anyway.</p>
<p>I’ve had numerous contacts with insurance companies over the last 5 or so years. I’ve had one medical misbilling after another since I was 17 (that’s when my parents gave up and handed the phone over to me). I’ve dealt with numerous different insurance companies and they’re all about the same. I don’t know WHY it’s so hard to find people that are competent at their jobs. </p>
<p>No, I don’t think it’ll get better after this year, but I don’t think it’ll get worse either. I think it will continue to be poor.</p>