Losing Texas Medicaid or CHIPs and Need Obamacare

 

Many people are getting the notice these days.

Your income is too high and you're no longer eligible for Medicaid OR the other requirements no longer apply.

The main one is pregnancy (congrats by the way).

What options do people have if they're losing their Medicaid or CHIPs coverage?

Good news is that we'll likely qualify for very rich versions of the silver plan (more on that below) PLUS very big subsidies that can bring the cost all the way down to zero depending on your income.

 

First, our credentials here:

This is what we'll cover:

• Why am I losing Texas Medicaid or CHIPs coverage?
• How to get Texas Obamacare if losing Medicaid or CHIPs
• How the subsidy works for people losing Medicaid
• The enhanced silver plans for people losing Medicaid
• How to quote and enroll in Texas Obamacare

Let's get started!

Why am I losing Texas Medicaid or CHIPs coverage?

Texas has a pretty strict view of eligibility for Medicaid. They did not go with the expansion allowed by the ACA law.

There is an income piece to it, and we ALSO need income below 100% of the FPL limit.

Here's the chart:

 

You can't qualify just based on income though in Texas as with other States. You need to meet other requirements.

Here are the main triggers:

• Pregnant, or
• Be responsible for a child 18 years of age or younger, or
• Blind, or
• Have a disability or a family member in your household with a disability.
• Be 65 years of age or older.

So, we must be low income AND one of the above.

Again, it's strict.

So people are constantly "falling off" of Medicaid in Texas all the time.

Changes in income are generally the trigger as the 100% level is pretty low.

There's a silver lining though if we lose Medicaid in Texas.

Depending on income, we'll likely be eligible for Obamacare (ACA plans) with very low premiums and very rich benefits.

 

It's not uncommon to see premiums down to zero depending on the income range.

Let's look at these options.

How to get Texas Obamacare if losing Medicaid or CHIPs

You'll notice in the chart above, above the 100% level, we start to get two things:

• Subsidies based on income that directly bring down the monthly cost
• Richer versions of the silver plan (73, 87, or 94)

 

The good news is that with the loss of Medicaid, we can enroll outside of open enrollment.

For example, let's say our Medicaid is ending May 31st. We'll be able to get Obamacare June 1st, but we need to enroll by the end of May!

We can only get the 1st of the month after enrollment and if we wait past 60 days (so after July in the above example), we'll lose our special enrollment trigger tied to loss of coverage.

Don't delay if you're losing Medicaid or CHIPs.

We're happy to help with the transition and there's zero cost for our assistance:

How the subsidy works for people losing Medicaid

The big deal with the 2014 ACA law revolves around subsidies based on income.

Here's how the subsidies work:

 

For people losing Medicaid, unless their income skyrockets, they generally can get very rich subsidies and bring down the cost significantly.

Below, you can run your quote to see exactly what you're looking at for your particular situation, but it's not uncommon to see costs drop under $100/month depending on age and plan selection.

Sometimes, all the way to zero.

Learn how to get the most tax credit in Texas or get help with the subsidy.

Then there's the other bit of good news.

The enhanced silver plans for people losing Medicaid

Again, unless your income is really exploding higher for the year, we usually see people who are losing Medicaid qualify for one of the enhanced silver plans.

The silver 87 and 94 is essentially a platinum level plan that we get for the same price as the normal silver.

Here's the benchmark plan chart:

 

You can see how rich the silver 87 and 94 are compared to the standard silver, especially around the out-of-pocket maximum (how plan treats the big bills).

The "flavor" of silver plan you're eligible for completely depends on income estimate for the year, and the chart above shows the different income ranges for each.

Learn what income is used for this estimate but let's see what we're eligible for now.

How to quote and enroll in Texas Obamacare after losing Medicaid or CHIPs

We make this fast, free, and easy here:

A few notes to get the most accurate quote:

• Income is the estimate of the AGI on the 1040 tax form; next April's filing
• Household is everyone that files together on that 1040 tax form even if not enrolling

 

This can get confusing especially if we just added a new baby, so reach out to us for free assistance.

We'll quickly be able to figure out your max subsidy and which plans you're eligible for.

The good news is that you can now choose from the full networks and carrier options in your area.

One complaint we hear about Medicaid is that the networks are small and very impacted! This move to Obamacare is a fresh start and we can change our carrier and network accordingly!

Learn how to compare the Texas Obamacare plans or Texas carriers.

Happy to help with any questions!