I think the folks wondering are not the ones who actually donated. The daughters reached out to their followers, it wasn’t a random post on nextdoor (every 3rd post on my nextdoor is a gofundme). I’m guessing her bill will be higher, she was in for a while (the longest one of my immediate family members was in the hospital was 4 nights and I remember being shocked at the bill before insurance.
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Wonder if, given her history, her premiums will be $$$$$$$$$$$$$
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I thought pre existing conditions no longer were considered.
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Pre-existing conditions are always considered. That is why if you are a smoker and overweight many times you pay more for health insurance.
Having health insurance for a good majority of the population is an extra. For someone, who has no income coming in (pandemic), $8400 a year is not doable. Remember she does not work for a company with benefits… I am sure has to self-insure.
Per the U.S. Department of Health and Human Services:
Health insurance companies cannot refuse coverage or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.
Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.
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With $0 income, wouldn’t Medicaid be an option? Also, some ranges of income are eligible for highly subsidized ACA plans. However, in states that did not expand Medicaid, there is an income range just above unexpanded Medicaid that is not eligible for ACA subsidies that begin where expanded Medicaid stops.
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I do not know her specific situation. That said, medicaid and public programs have lots of red-tape and hoops. Given her status it would not surprise me if she did not pursue this path.
Sounds good but the reality is not necessarily as advertised. Unless you have had to deal with the insurance industry….
Again someone who has no income coming in and is worried about keeping her house, food, etc will let the insurance slide since that is not the most important need at the moment.
Many folks on CC are planners. Clearly, think towards the future…
Companies can’t charge more for pre-existing, but if you have risk factors (eg smoking) that increase the likelihood you will develop an illness,I believe they can charge more.
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Tomorrow is the interview.
I have applied for and been on state marketplace insurance plans in 2 states. They never asked for any medical/health information. They only want age and income level. They do use these to determine your premium. (especially the income level). With no income you can get shifted to the state insurer of last resort (so in MA it is Masshealth). These are the Medicaid plans and cheapest options.
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Both my kids got on Medicaid and they have bleeding disorders, a major pre existing condition. They were working but just not making a lot.
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My guess with Medicaid you probably need several years with proven poverty, assets, etc. Someone who has a more complicated financial picture will have a more difficult time qualifying.
It’s NOT several years.
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Nope. They just asked for the income. It was way too simple, actually.
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In my state, for those who qualify for medicaid, there are several different choices. I believe they call them CMOs (Care management organizations) and the applicant can choose from Amerigroup, Caresource, peach state health plan, etc, and the coverage differs (kinda like some HMOs). For instance, and what I find disgraceful, is that some provide no mental health coverage after age 21 (or at least that was true last I checked).
Again one year of income to get the state plan. (You do need to document it).
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Wow, that illness has really aged her. Hard to see the bouncy little sprite looking so frail.
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Eligibility for Medicaid has nothing to do with assets. It’s based on your MAGI (same as AGI for most people.) You can enroll or on and off as your income changes from year to year and the application is basically the same as the marketplace app for regular insurance.
If you buy your insurance through the marketplace, your premiums are determined only by age and whether or not you are a smoker. Your eligibility for tax credits/subsidies is based on your income. I just looked…in our area a Silver plan policy for a 55 year old with 30k income can be had for $0 or $7/month net premium. Since payments are deducted automatically, an insured person is unlikely to let that slide.
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I believe Mary Lou lives in Houston. Texas did not expand Medicaid, so depending on her income, she may fall into the gap between Medicaid and ACA subsidies. That gap is one of the most shameful things in the US in terms of providing medical care for low-income people. If she has income to qualify for ACA (the federal poverty level), she might be eligible for a silver plan with subsidies not only for premiums but also for deductible/coinsurance. The only medical question asked for ACA policies is about smoking. Pre-existing conditions are not considered. A social worker at the hospital should have worked with the family to figure out their best options for insurance/payment. Jan 16 is the deadline to enroll for 2024.
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