One Spouse on Medicare and ACA

[roadrunner]

Met with a couple today in TN. She is 59 with no income. He is 66 on Medicare.

He receives 1200 a month for medicare. We had to add him to the application for household income. (other) There is no medicare choice for income. When calculating for a subsidy it is calculating for a plan for a family rather than an individual plan. He does not need a plan.

Problem is it is stating they qualify for Medicaid (as a couple) But the income for the household should qualify the spouse without coverage for a subsidy.

Has anyone else ran into this challenge? If so how did you work around this? Or is a household with a medicare eligible person going to be paying for a family plan?

Shouldn't the application pull him back out of the calculation based on his age?

It is NOT her income, it is the husbands, but it is household income. She would prefer not to be on Medicaid , but can not afford a plan without help.

Thanks in advance for any wisdom.

I have called Healthcare.gov - waste of time
BCBST - dunno
Humana- huh????
Cigna- what??
CHA- focusing on group - no help

 

[jefflange]

Yup, I posted something similar in another recent post.
Meeting with the my clients tomorrow to file an appeal for them

 

[kulkan]

I was really hoping a forum like this would have a better answer to this. My wife and I are in the same spot. She is on Medicare and her income adds to the household income, including SS. If we were separate, the cost of my insurance on the ACA would drop about $3,000 including both lower rates and lower deductibles. Apparently the same plan's deductible also drops from 2500 to 750 if the household income is less. Luckily (?) for us, we keep our finances very separated so we can just get divorced for a couple of years and save about $6,000. Add to that that if we have joint income and it goes up by $8,000 that also would add about $3,000. That amount of income variance to our semi-retired state would not be surprising. This is pretty screwy for quite a few people I would expect.

 

[Yagents]

I was really hoping a forum like this would have a better answer to this. My wife and I are in the same spot. She is on Medicare and her income adds to the household income, including SS. If we were separate, the cost of my insurance on the ACA would drop about $3,000 including both lower rates and lower deductibles. Apparently the same plan's deductible also drops from 2500 to 750 if the household income is less. Luckily (?) for us, we keep our finances very separated so we can just get divorced for a couple of years and save about $6,000. Add to that that if we have joint income and it goes up by $8,000 that also would add about $3,000. That amount of income variance to our semi-retired state would not be surprising. This is pretty screwy for quite a few people I would expect.

It's the new marriage penalty.............It's affecting a number of my clients with age disparities. It creates a buy 1 get 1 free scenario if both under age 65. But once one goes onto medicare, the extra cost of medicare is added to the total outlay. Get ready for people to delay taking social security also to keep income down, and credits high, and the trust fund to be extended by 10 yrs.........mark my words.....and they will say the reason is due to a better economy.

 

[bluediamond]

Met with a couple today in TN. She is 59 with no income. He is 66 on Medicare.

He receives 1200 a month for medicare. We had to add him to the application for household income. (other) There is no medicare choice for income. When calculating for a subsidy it is calculating for a plan for a family rather than an individual plan. He does not need a plan.

Problem is it is stating they qualify for Medicaid (as a couple) But the income for the household should qualify the spouse without coverage for a subsidy.

Has anyone else ran into this challenge? If so how did you work around this? Or is a household with a medicare eligible person going to be paying for a family plan?

Shouldn't the application pull him back out of the calculation based on his age?

It is NOT her income, it is the husbands, but it is household income. She would prefer not to be on Medicaid , but can not afford a plan without help.

Thanks in advance for any wisdom.

I have called Healthcare.gov - waste of time
BCBST - dunno
Humana- huh????
Cigna- what??
CHA- focusing on group - no help

That income is not medicare income it is social security and there sure is a place to put in on application. His gross income is $14,400 a year and a couple filing jointly will put her into medicaid. Also, is his whole social security taxable income? I have run into several different scenario's recently where some of it is and some of it is not.

 

[Yagents]

That income is not medicare income it is social security and there sure is a place to put in on application. His gross income is $14,400 a year and a couple filing jointly will put her into medicaid. Also, is his whole social security taxable income? I have run into several different scenario's recently where some of it is and some of it is not.

There is a difference between whether it is federally taxable SS income (line 20b) and Non Taxable SS income (line 20a). ACA is MAGI, which counts ALL regular SS income, federally income taxable or not:

(Line 37 AGI - Line 20b) + Line 20a
Or
Line 37 + (Line 20a - 20b)

I've attached Ann's cheat sheet again: