Health insurance and 'the dougnut hole'

[john70t]

I have assets on paper(a few properties) but very little income and high overhead expenses.
The joys of property ownership.

A few years ago I went through a round-robin situation where I did not earn enough to even 'qualify' for Obamacare aka Health Insurance Marketplace.
-Legally I could not buy health insurance.-
At tax time, I earned less than $16,500 which unbeknownst to me was the cutoff to automatically being signed up for Michigan Medicare.
So without consent I was signed up for Medicare which I did not want.
I wanted affordable catastrophic health insurance, and I wanted to pay for it.
My understanding also is that the State will eventually go after any assets for medical costs incurred through Medicare.
That sounds entirely like a blank check situation which I don't want to pass along to others...
To add insult, a few months after that Medicaid 'disqualified' me with some unknown code. No other explanation or recourse was provided.
Thus I was left without health insurance.

This last December, I again signed up at the Health Insurance Marketplace dot gov and accidentally clicked through the website with an estimated $17,000 income.
But unbeknownst to me, the poverty cutoff was adjusted above that.
(There wasn't any information provided on the Marketplace website regarding this change.)
So this year I was again automatically signed up for Michigan Medicaid.

I am willing to not claim legal tax deductions in order to qualify for federal insurance subsidies.
It goes against my political grain, but my high taxes have long been subsidizing others and I'd like something back.
In the long run, I can't afford to pay $500+ per month for health insurance.
It's simply not sustainable with my budget.

I went back to the Heathcare dot gov and changed my income to $20,000 to 'qualify' for the fed program.
I don't think paying taxes is a crime...is it?
It had no effect.
Both Michigan Medicaid and Healthcaredotgov kept sending me letters.
(Having two forms of insurance apparently disqualifies someone from the federal subsidy program.)
The Marketplace needed me to send them proof that I had dropped Michigan Medicaid.
They didn't do that directly and apparently the process was not automatic. I had to be the middleman.
In the meantime I paid both my insurance companies every month on time.

Early in the process, I phoned my local Michigan Medicaid adjuster about ten times but it went to voicemail and he did not return calls or email.
It took the Healthcare adjuster making a direct 3-way call to get the Michigan Medicaid adjuster to answer the phone and agree to send me a cancellation letter.
(All the fed website employees I've ever dealt with at Healthcaredotgov were extremely friendly and helpful surprisingly. Top notch.)
A week or two later the letter still hadn't arrived.
Local mail takes 1 or 2 days here.
I drove 30 minutes to the Medicaid building, got a copy of the cancellation, scanned it, and uploaded it to my account at the Healthcaredotgov website per instructions.
My mistake was waiting until the last minute...but I completed all the requirements within the deadlines.

Apparently something went wrong.
I just received a Health Insurance Marketplace letter stating that I am now dropped from their program for "insufficient documentation".
Additionally, I received a new subscriber letter from the insurance company stating that my insurance will begin May 1st.
I've been paying them and dental for the last three months.


(edited for typos but can't fix thread title)

[Zeke]

Doug-nut. That's funny.

I had to read up on your situation to understand. That's a tough one and varies from state to state.
So, w/o knowing where you live, no one answer can be given.

[john70t]

tldr: I was bounced between agencies and ended up with nothing.

[RKDinOKC]

Try to get disability if you are actually disabled. You have to make less than $10,000/yr for 1 to 2 years. SSID pays you back disability from when you first apply to when accepted, but the required lawyers to get you accepted take up to 50% of that.

[LWJ]

I have a child that is disabled. Navigating the red-tape you describe is beyond ridiculous. My very intelligent wife has spend around a couple hundred hours and still we are confused.

You are correct. It is a broken system and nobody seems to have a complete understanding. I have no words of comfort for you but I do empathize.


I may have some advice: the only beacon of hope we have to make sense of this is a financial planner who specializes in planning for families that have a disabled person. He had a strong grasp of at least a portion of this. Can you find someone who is in the business of working with people in your situation? Please do NOT search for low-level social services. They are the worst in my experience. Look for someone that is in the "business" of doing this.

I know that my office (commercial insurance) refers all our individual cases to one agent who seems to be very competent Can you find an individual agent?

[greglepore]

Originally Posted by RKDinOKC

Try to get disability if you are actually disabled. You have to make less than $10,000/yr for 1 to 2 years. SSID pays you back disability from when you first apply to when accepted, but the required lawyers to get you accepted take up to 50% of that.

You need to be on SSDI for 1 year but you then qualify for Medicare. Even if you voluntarily terminate your SSDI you remain Medicare eligible for something like 9 years. This is a viable solution if you're actually disabled.

[RKDinOKC]

Am currently able to work from home with my job of 40yrs. But not sure how long that will be viable so trying to weigh my options. SSDI lawyers are saying live on insurance till approved. Don't think that works.

Two months ago had enough 401K to live on that till retirement, then retirement plus interest from 401K rolled into IRA. But Virus has caused 401K to evaporate.