I am uninsurable in my state - has anyone else encountered this situation?

[thisis354]

After resigning my job for medical reasons while on my 8th month of medical leave, I elected COBRA for the last few months. The COBRA cost me 694.00 per month in premiums for just me, but since I had already reached my out of pocket cap, I decided to keep it until the end of December.

I started researching the plans available on the ACA Marketplace for the state of Arizona for 2018. The cheapest Bronze plan premium is 677.82 with a 7000.00 deductible and a 7000.00 out of pocket cap. The plan is not good, covers little and has a small provider list. It appears, there is only 1 insurer in my state.

Because I have to have insurance in 2018 to avoid a fine, I filled out an application online. When asked for my 2018 MAGI (income), I correctly listed 0, because the Federal marketplace MAGI does not include non-taxable long term disability benefits as income. As a result of my income being 0, I am not eligible for a premium tax credit and I am forced to apply for Medicaid. The Medicaid program in the state of Arizona counts non-taxable long term disability benefits as income. My income from long term disability is way too high to qualify for Medicaid in the state of Arizona.

I looked up the rules for the hardship exemption. The Premium must be over 8.13% of one's income after tax credits. I have applied for the exemption.

My other option might be to move, as I would qualify for Medicaid in California because they do not include non-taxable long term disability in the MAGI for Medi-Cal.

Has anyone else encountered this situation?

[KoKo]

Hello thisis354

I haven't encountered your situation - but wouldn't you qualify for Medicare, since you are on disability?

Take Care

[thisis354]

Denied for SSDI. Waiting for a hearing, so no, I don't qualify for Medicare yet.

[KoKo]

Denied for SSDI. Waiting for a hearing, so no, I don't qualify for Medicare yet.

Sorry to hear that.

Hopefully there is a way for you to be covered during this waiting period, and someone who has experience will respond.

Take Care

[MSW1963]

Have you contacted an insurance agent in your area? I know the first year my daughter qualified for ACA as a student I talked with one and received expert advice.

[lukeduke]

Hey I know where you are coming from. I lost my health insurance at the end of August due.to no longer being able to afford almost $600/month for myself. I am trying to get SSDI but they don't want. to pay me my money. I recently started a job which will offer benefits if I am able to stay. I used to insure our whole family through my job but lost it then was diagnosed with narcolepsy as well. Hopefully I will be able to get the insurance before my supply of Provigil runs out.

[thisis354]

Hey Luke, good luck- I hope you are able to continue with the new job.
MSW I consulted with some Customer Service reps on the Federal Health Exchange and the AZ Medicaid organization. They confirmed my understanding is correct- I am uninsurable in the state of Arizona. I was issued my denial letter for the Medicaid application a few weeks ago. Because my state has only 1 ACA insurer, there are no catastrophic plans offered and no short term plans. I was able to apply for a waiver for 2018 so I will not get a penalty for mo health insurance.