PPACA Marketplace Update:
The Marketplace and Medicaid eligibility
Friends,
We now have some strong Health Insurance Marketplace (HIM) experience under our belt after a very hectic 4th quarter in 2013. We have been doing our best to take notes on the process and keep you informed on aspects of the HIM that you will likely not hear on the nightly news or read in the paper. One most important aspect we have discovered thus far is the requirement that you apply for Medicaid/MIChild if you are under a certain income range.
If you have an Modified Adjusted Gross Income (MAGI) of 200% or less, the Health insurance Marketplace requires you to apply your child/children in MIChild
Below you will see a chart detailing the following:
- 133% of the Federal Poverty Level (FPL) = potential eligibility for Medicaid in the State of Michigan
- 200% of the Federal Poverty Level (FPL) = potential eligibility of MIChild in the State of Michigan
- 400% of the Federal Poverty Level (FPL) or less = potential eligibility of a subsidy in the Health Insurance Marketplace
- Please Note: These figures are approximations and may fluctuate as we get more guidance on the PPACA
Family Size | 133% FPL | 200% FPL | 400% FPL | 2 | $20,628 | $31,020 | $62,040 | 3 | $25,975 | $39,060 | $78.,120 | 4 | $31,322 | $47,100 | $94,200 | 5 | $36,668 | $55,240 | $110,280 | 6 | $42,015 | $63,180 | $126,360 |
Please note the following about these figures and the Health Insurance Marketplace:
133% of the Federal Poverty Level (FPL)
- If you attempt to enroll in the Marketplace and your income is at or below this level, you will likely be required to apply for Medicaid.
- You can CLICK HERE for information on Medicaid eligibility requirements and information on how to apply
- If the Marketplace requires you to apply for Medicaid you must do so
- If you are denied Medicaid you have to provide that notice to the Marketplace so they can determine if you are eligible for a subsidy in the Marketplace
- Instructions and information for submitting information to the Marketplace can be found on your Subsidy Eligibility Notice, which your advisor will provide you with
200% of the Federal Poverty Level (FPL)
- If you attempt to enroll in the Marketplace and your income is at or below this level, you will likely be required to enroll your child/children in MIChild
- You can CLICK HERE for information on MIChild eligibility requirements and information on how to apply
- If the Marketplace requires you to enroll your child/children in MIChild you must do so
- If you are denied MIChild you have to provide your declination letter to the Marketplace and they should allow you to add your child to your plan
- Instructions and information for submitting information to the Marketplace can be found on your Subsidy Eligibility Notice, which your advisor will provide you with
This process was a huge surprise to our team since we were never notified that this would be the case prior to 10/01/2013 when the Marketplace opened. We understand that this process may be frustrating for our clients but it is necessary. If we do not follow these processes based on our income we will not be able to qualify for the subsidy our income may justify.
We will continue to keep you informed about the nuances of the Marketplace as we experience them. If you have any questions or concerns about these processes please contact Altruis Benefit Consulting at 877.442.5878 or [email protected]
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