Can I Get Obamacare Instead of Medicaid?

Can I Get Obamacare Instead of Medicaid?

Obamacare (or Affordable Care Act, ACA), seeks to make health insurance more accessible for all Americans by protecting consumers against insurers who deny coverage for preexisting conditions or drop patients without cause. It provides consumer safeguards against this practice as well.

Lower income individuals may qualify for premium subsidies to assist them with paying their monthly health insurance premiums, however residents of states which have not expanded Medicaid may not qualify.

What is Obamacare?

The Affordable Care Act (ACA), signed into law by President Obama in 2010, offers health coverage to millions of American who had difficulty previously due to preexisting conditions, limited income or job loss. Furthermore, tax credits help lower costs for low and middle income individuals and families; an employer mandate requires large employers to offer health insurance or face penalties starting in 2014; as well as mandating that all individual plans include essential benefits.

The Affordable Care Act ensures that you get value for your premium dollar by mandating that insurers spend at least 80 percent of premium dollars on actual medical services and quality improvements, rather than advertising, overhead or bonuses for executives. Furthermore, discrimination of any sort such as gender, age or health status are prohibited as is penalty for not having health coverage; young adults can remain on their parent’s plan until age 26.

What is Medicaid?

Medicaid is a health insurance program for low-income Americans that operates as an entitlement. All eligible recipients are guaranteed coverage. Federal regulations mandate states provide mandatory services like hospital and physician care, prescription drugs, laboratory and X-ray tests, home health and nursing facility care as well as any optional ones they might offer.

Many low-income seniors and individuals with disabilities who qualify for both Medicaid and Medicare – two separate forms of health insurance coverage – have both services covered; these people are known as “dual eligibles”. Medicare pays for most Medicare-covered services while Medicaid covers any remaining.

The Patient Protection and Affordable Care Act, commonly referred to as Obamacare, mandates that most individuals obtain health insurance or face a penalty. The Affordable Care Act makes it easier for Americans to gain affordable individual coverage by expanding the Marketplace and offering financial aid; additionally it prohibits insurers from discriminating against individuals with preexisting conditions by charging higher prices or discriminating against them altogether.

Do I qualify for Medicaid?

People can qualify for Medicaid based on their income; rules vary by state. In New York, for instance, applicants must be legal residents who earn less than 400% of poverty threshold and meet other specific criteria in order to be considered for coverage.

To assess eligibility, individuals should complete an application through their state health insurance exchange established under the Affordable Care Act. Based on their category of eligibility, their state Medicaid agency will then begin enrolling them into coverage.

As long as both Medicare and Obamacare plans meet certain criteria, it is possible to have both at the same time; however it is generally advised that individuals drop individual coverage when becoming eligible for original Medicare Parts A and B or Medicare Advantage plans. In order to qualify for premium tax credit on an Obamacare plan, nine out of every 12 months (unless special exception applies ) of having coverage should have passed without interruption unless exception was granted – therefore notifying your exchange about any income changes throughout the year may help ensure eligibility for tax credits and premium tax credits may apply when filing returns / paying tax returns/ paying taxes/claims/claims/claims etc.

How do I get Medicaid?

If your state has not expanded Medicaid and your income falls below the poverty level, consider filling out an application through the Marketplace. In some cases you may qualify for financial help with premiums through this forum as well.

Also, Medicaid applications may be submitted any time throughout the year and outside of an open enrollment period. If successful, your private healthcare administrator will issue you with a Medicaid ID card to prove coverage.

If your income exceeds state eligibility rules for Medicaid eligibility, spending down some assets may help. To do this, incur medical and remedial expenses to bring down countable assets below Medicaid limit; visit New York State Medicaid website for more details about “spend down.” Additionally, food stamp benefits could help if you do not have enough money for health insurance plans.

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About the Author: Raymond Donovan