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Thu Feb 27, 2014, 10:07 AM

Affordable Care Act Appeal

I have a problem. No, my stepdaughter has a problem and I want to help her, but I need help in doing so. My son-in-law died at the age of 46, leaving behind my stepdaughter and four kids. She has been on social security since then and worked very little. Last year she made under $1,000. Here's my (her) issue. She has three of the kids on MChip health coverage. The oldest two kids no longer receive a social security survivor benefit and are in college. My stepdaughter has signed up for ACA coverage thru the Maryland exchange and has been told that she does not qualify for government health insurance premium assistance. This is due to the kids being on MChip and her income. Between the family members (four kids and their mother) there is an income of approximately $45,000.

I don't get it. Am I missing something? A mother of four, with three on MChip and she cannot get help with assistance on her ACA premium? This doesn't make sense. She lives hand to mouth. She is hiding nothing and only wants to get herself covered under ACA insurance. She currently pays over $400 per month for a high deductible coverage and needs to get away from that company. But ACA is saying she doesn't qualify for assistance. I cannot see what it would take to get her government assistance for this coverage.

I'm asking with a big PLEASE. I need help so I can giver her help in getting this taken care of.

Thank you.

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Reply Affordable Care Act Appeal (Original post)
Beearewhyain Feb 2014 #1
OLDMDDEM Feb 2014 #2

Response to OLDMDDEM (Original post)

Thu Feb 27, 2014, 10:47 AM

1. I am not an expert on this

but with just a quick view of the situation I am going to guess your daughter has insurance offered through her employer. If that is the case then subsidies are not generally offered. Per the tool on the kaiser site...

In general, employees who are offered insurance through work are not eligible for subsidized exchange coverage, so long as their insurance meets specified requirements. You would only be eligible for subsidized exchange coverage if your income is between 1 and 4 times the federal poverty level and you would have to pay more than 9.5% of your household income for your own coverage through the insurance offered by your employer.

Run through this tool and see what it might say for you as you know the situation better.

It might also be a good idea to give a navigator a call and see what they might be able to help you with.
Consumer Support Center

Sorry I couldn't be more help.

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Response to Beearewhyain (Reply #1)

Thu Feb 27, 2014, 11:24 AM

2. Affordable Care Act Appeal

I went to the Kaiser Foundation website that you referenced and read the "FAQ" section as well as other parts of the site. I then filled in the info needed to find out what premiums and premium assistance would be for my stepdaughter. According to the website, she should only be paying $1,485 per year for a silver plan. That's about $125/month. Even if she included all the kids (three of them) on the policy, her premium would still be $125/month as her subsidey goes up due to her income being so low.

This is great news. I appreciate your help. I realize that this is only a start but it's something to fight with. We did not have that before today.

I truly thank you.

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