Category: Uncategorized

If You Lose Your Medicaid, You Still Have Options

The headlines can be pretty stark, and scary:

82K Louisiana Medicaid Patients Could Be Booted from Program… (Associated Press, Oct. 11, 2019)
After thousands booted from Medicaid rolls… (The Advocate, June 13, 2019)
Another 11,500 people removed from Louisiana Medicaid rolls… (WAFB TV, July 1, 2019)

 What the heck is going on?

Last summer the state implemented a stronger Medicaid eligibility system that checks enrollees’ eligibility more often than the previous system. This means that each month, thousands of Louisianians are added and removed from the state’s Medicaid rolls. So, one day you could have comprehensive health insurance that covered all your needs with ZERO out-of-pocket spending, and the next day, it could be totally gone!

Have you or someone you know been dropped from Medicaid? If so, what do you do now?

Straight Talk is, I have really, really good news for you. The first thing you need to do is NOT PANIC. You will still have a chance to get healthcare coverage without spending lots of money. But don’t wait too long.

Act now!

If the state has notified you that your Medicaid has ended, be sure you move quickly. You have 60 days from the day your Medicaid coverage ends to enroll in a new health plan. If you miss that window, you’ll need to wait until Nov. 1, and you won’t have coverage until Jan. 1!

You can do one of two things to access affordable healthcare coverage:

  1. Call 1-800-821-2758. Blue Cross representatives will connect you to a LICENSED AGENT, who, at no charge to you, will walk you through the process of enrolling for individual coverage. (Note: WALK AWAY from any agents who say you must pay them money, especially money “up front.” A legit agent will not cold-call you or ask you for money before helping you.)
  2. Go to healthcare.gov. This is the federal health insurance exchange website. On your first visit, it will ask you for some basic information, like whether you qualify for a special enrollment. Losing coverage qualifies as a special event. It will also ask you where you live, how many people need insurance on your plan, your age and your household income. Then, you can go shopping online.

From Medicaid to healthcare.gov

How good are the deals you’ll find in the individual market? Check out this handy chart:

Click to view larger.

This chart assumes you are buying healthcare coverage for one person, but the savings can be the same for more than one person. Look at the percentages of FPL to determine where your family might fall.

If you are in good health today, but don’t want to risk going without coverage, the least-expensive plans (blue line) may work just fine for you. At 250% of Federal Poverty Line, there are at least three plans with zero premiums and sometimes more.

IF you are currently on medications and/or have chronic conditions, you might do better buying the “benchmark plan,” represented by the orange line on the graph. The premiums are a bit more, but the out-of-pocket costs can be much, much lower. At incomes just over the Medicaid threshold, the annual deductible is only $100 for a full-blown, major medical and drug coverage Blue Cross benchmark plan.

Deductible Information:
Cheapest Plan:
Regardless of income = $4,550

Benchmark Plan:
Income <150% FPL = $100
Income <200% FPL = $500
Income <250% FPL = $2,000
Income >251% FPL = $3,400

We want to be sure you know that while adults may lose their Medicaid once they earn anything over 138% of Federal Poverty Level ($17,609), people under 20 years old can STAY on Medicaid up to earning a household income of 250% of Federal Poverty Level ($31,900). Don’t panic if Mom and/or Dad get Blue Cross coverage, but the kids stay on Medicaid – that could be a good thing!

No matter which plan you take, there are more than 40 tests, treatments and services that you can get, all at $0 cost to you. Things like annual checkups and mammograms. That’s the law under the Affordable Care Act, and all these policies cover those “essential health benefits” for you.

How’s that for a deal?

Remember! You have 60 days from the day your Medicaid coverage ends to enroll in a new health plan. If you miss that window, you’ll need to wait until Nov. 1, and you won’t have coverage until Jan. 1!

If you move from Medicaid to a commercial Blue Cross plan, you’ll find more specialists, labs and imaging centers in your network, and more pharmacies will accept your drug coverage. You will have to spend more out of pocket, but it might be just a tiny bit more.

The key is, don’t panic. Medicaid ending for you does not close the door on comprehensive, quality healthcare coverage. You have options.

Give it a try. Straight Talk is, the coverage here is very good, and the prices are potentially very low.

Posted on: February 13, 2020

4 comments on “If You Lose Your Medicaid, You Still Have Options

    • Michael Bertaut

      David! Thanks for the kind words!
      It is most distressing to me that tens of thousands of people here in Louisiana are losing Medicaid coverage each month or two, even if it is for all the right reasons (moved out of state, citizenship questions, rising income). I feel compelled to do everything we can to help these people be informed so they can keep health insurance and not have to wander around uninsured like the bad old days. Please help me spread the word on this, it is my Quest for 2020.
      Great Day to you!…mrb

      Reply
  1. Michael R Bertaut

    Jeff!!! This is an excellent question!
    Because of the way the ACA tax credits are structured, AGE only matters at income levels of 400% of poverty and above. So if your income is in the zone where you are eligible for advanced premium tax credits (say 138% of federal poverty level all the way to 350% of FPL) age will not affect the price you must pay much at all.

    The major factors in the ACA markets are which product you select, which market you are in (Lake Charles, Shreveport, and Alexandria have fewer low price options because a new competitor forced down federal assistance with their pricing policy, long story!) and your income, with the income being the most important factor.

    Thanks for playing here at Straight Talk!…mrb

    Reply

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