Obamacare FAQ: What Happens If I Travel -- or Move?
Obamacare FAQ: Are You Eligible for a Subsidy?
Obamacare FAQ: Do Immigrants Qualify?
Obamacare FAQ: Your Questions Answered on KQED's Forum
Obamacare FAQ: Determining Your Family Size
Obamacare FAQ: What Are Options for College Students and Young Adults?
Obamacare FAQ: Will You Qualify for Medi-Cal?
Obamacare FAQ: Can I Drop My Employer-Offered Insurance?
For Legal Immigrants, Obamacare Has Options for Aging Parents
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Since 2011, she's been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including\u003cem> Dateline NBC\u003c/em> and San Francisco's CBS affiliate, KPIX-TV. She also wrote up a \u003ca title=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\">handy guide to the Affordable Care Act\u003c/a>, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for \"Best Topical Reporting\" from the Online News Association. You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>","avatar":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twitter":"laliferis","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["subscriber"]},{"site":"stateofhealth","roles":["subscriber"]},{"site":"science","roles":["subscriber"]},{"site":"food","roles":["contributor"]}],"headData":{"title":"Lisa Aliferis | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lisaaliferis"},"state-of-health":{"type":"authors","id":"8344","meta":{"index":"authors_1591205172","id":"8344","found":true},"name":"State of Health","firstName":"State of Health","lastName":null,"slug":"state-of-health","email":"stateofhealth@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":null,"avatar":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"stateofhealth","roles":["editor"]}],"headData":{"title":"State of Health | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/state-of-health"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal 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Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_16843":{"type":"posts","id":"stateofhealth_16843","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16843","score":null,"sort":[1387488065000]},"guestAuthors":[],"slug":"obamacare-faq-what-happens-if-i-travel-or-move","title":"Obamacare FAQ: What Happens If I Travel -- or Move?","publishDate":1387488065,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16847\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/5976264120_7476b52226_b-e1387481951180.jpg\">\u003cimg class=\"size-large wp-image-16847\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/5976264120_7476b52226_b-640x360.jpg\" alt=\"(Kuster & Wildhaber Photography/Flickr)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kuster & Wildhaber Photography/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/how-will-young-adults-and-college-students-fare-under-obamacare1145\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>About 130,000 Americans pick up and move somewhere else every single day, \u003ca href=\"http://www.census.gov/newsroom/releases/archives/american_community_survey_acs/cb13-52.html\" target=\"_blank\">the U.S. Census Bureau estimates\u003c/a>. And guess who are among the most mobile? We itchy Californians.\u003c/p>\n\u003cp>Perhaps you’re wondering what moving around has to do with Obamacare. Quite a lot, actually.\u003c/p>\n\u003cp>Your health plan options – and prices – vary by geography, and the Golden State is divided into 19 regions. Los Angeles is so large that it accounts for two regions, and that doesn’t even include the Inland Empire or Orange County.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, I’ll tell you what happens to your coverage when you travel or move, and whether you’ll be able to see a doctor when you’re in Boise, Berlin or even Berkeley.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Q: I am considering enrolling in one of the Covered California plans. How will my coverage work if I am traveling out of state or out of the country and need medical care?\u003c/strong>\u003c/p>\n\u003cp>I’m adding one other part to Suellen’s question: What happens when traveling \u003cem>within\u003c/em> California?\u003c/p>\n\u003cp>As I mentioned above, health plans sold on the open market and through our health insurance exchange, \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, vary by region. That means not all plans are sold in all regions. In fact, some have a very limited geographic reach, including the \u003ca href=\"http://www.cchphmo.com/\" target=\"_blank\">Chinese Community Health Plan\u003c/a> and the \u003ca href=\"http://cchealth.org/healthplan/\" target=\"_blank\">Contra Costa Health Plan\u003c/a>, both in the Bay Area.\u003c/p>\n\u003cp>So, if you’re traveling within the state and need care, it depends on who your insurer is and what kind of network of doctors and hospitals it offers. If, say, you have a Kaiser plan, you can visit a Kaiser doctor or hospital outside of your region and have the costs covered.\u003c/p>\n\u003cp>If, however, your insurer’s network doesn’t extend to your travel destination, you will only be reimbursed for emergency and urgent care services, not routine services, says Lizelda Lopez of Covered California.\u003c/p>\n\u003cp>When you’re traveling \u003cem>outside\u003c/em> of California, your insurer doesn’t matter: You are only eligible to have emergency and urgent medical services covered.\u003c/p>\n\u003cp>“None of our plans have out-of-state networks,” Lopez says.\u003c/p>\n\u003cp>By the way, this isn’t necessarily new. Earlier this year when I visited the East Coast, I got a scary infection that needed immediate attention. I called my insurer first, which directed me to choose from specific ERs and urgent cares. I dutifully complied, but still had to fight to get my urgent care visit covered.\u003c/p>\n\u003cp>Lopez’s advice? Wherever you’re visiting, do what I did and double-check with your insurer to find out if a provider is covered. My advice: Be prepared for a fight afterward.\u003c/p>\n\u003cp>\u003cstrong>Q: What happens if an individual moves from one state to another after signing up for a plan? I’ll be living in California for the first few months of 2014, but there’s a definite chance I may be moving to Washington. Will it be possible to transfer my plan to a different state partway through the year?\u003c/strong>\u003c/p>\n\u003cp>A: Once again, I’m adding another part to John’s question that may sound familiar: What if you move \u003cem>within\u003c/em> California?\u003c/p>\n\u003cp>The answer also may sound familiar: It depends on your insurer. If you have a plan that also is offered in your new locale, you keep that plan. If you want to change it, you’ll have to wait until the next open-enrollment period.\u003c/p>\n\u003cp>If you can’t get the same plan in your new hometown, you’ll be eligible for a special-enrollment period and can sign up for a new plan.\u003c/p>\n\u003cp>And now, back to John’s question. If you move to another state, you will need to enroll in a new plan through that state’s exchange or buy on the open market. If that state doesn’t run its own exchange (\u003ca href=\"https://www.wahealthplanfinder.org/HBEWeb/Annon_DisplayHomePage.action?authn_try_count=0&contextType=external&username=string&contextValue=%2Foam&password=sercure_string&challenge_url=https%3A%2F%2Fwww.wahealthplanfinder.org%2FHBEWeb%2FAnnon_DisplayHomePag\" target=\"_blank\">Washington state does\u003c/a>), you would use the federal exchange, \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">healthcare.gov\u003c/a>.\u003c/p>\n\u003cp>Moving to another state also triggers a special enrollment period, so you’d be able to choose a new plan immediately.\u003c/p>\n\u003cp>\u003cstrong>Q: What about American citizens living in another country such as Sweden, where health insurance is covered? Why should I be required to have health insurance in the states when I don’t even live there?\u003c/strong>\u003c/p>\n\u003cp>A: As most of you know, Ask Emily is geared toward a California audience. But that doesn’t stop people from writing from all corners of the country. And, it turns out, from all corners of the world. I have received similar questions similar from readers in New Zealand, Thailand, Malaysia and Australia.\u003c/p>\n\u003cp>The answer depends on how long you live abroad during a calendar year. \u003ca href=\"http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision\" target=\"_blank\">According to the Internal Revenue Service\u003c/a>, U.S. citizens who live abroad for at least 330 days within a 12-month period don’t have to comply with the Obamacare insurance mandate, which requires most Americans to have health insurance as of Jan. 1.\u003c/p>\n\u003cp>That also means you won’t have to pay a tax penalty for not having insurance.\u003c/p>\n\u003cp>You don’t even have to be insured in your country of residence, like Artie is, to get out of the insurance requirement, \u003ca href=\"https://www.healthcare.gov/am-i-eligible-for-coverage-in-the-marketplace/\" target=\"_blank\">the feds say\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, if you don’t want to trigger the mandate, try to keep your annual trips back home to under five weeks each year!\u003c/p>\n\n","blocks":[],"excerpt":"Q: I am considering enrolling in one of the Covered California plans. How will my coverage work if I am traveling out of state or out of the country and need medical care?\r\n\r\nI’m adding one other part to Suellen’s question: What happens when traveling within California?","status":"publish","parent":0,"modified":1387493918,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1014},"headData":{"title":"Obamacare FAQ: What Happens If I Travel -- or Move? | KQED","description":"Q: I am considering enrolling in one of the Covered California plans. How will my coverage work if I am traveling out of state or out of the country and need medical care?\r\n\r\nI’m adding one other part to Suellen’s question: What happens when traveling within California?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16843 http://blogs.kqed.org/stateofhealth/?p=16843","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/19/obamacare-faq-what-happens-if-i-travel-or-move/","disqusTitle":"Obamacare FAQ: What Happens If I Travel -- or Move?","path":"/stateofhealth/16843/obamacare-faq-what-happens-if-i-travel-or-move","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16847\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/5976264120_7476b52226_b-e1387481951180.jpg\">\u003cimg class=\"size-large wp-image-16847\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/5976264120_7476b52226_b-640x360.jpg\" alt=\"(Kuster & Wildhaber Photography/Flickr)\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kuster & Wildhaber Photography/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/how-will-young-adults-and-college-students-fare-under-obamacare1145\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>About 130,000 Americans pick up and move somewhere else every single day, \u003ca href=\"http://www.census.gov/newsroom/releases/archives/american_community_survey_acs/cb13-52.html\" target=\"_blank\">the U.S. Census Bureau estimates\u003c/a>. And guess who are among the most mobile? We itchy Californians.\u003c/p>\n\u003cp>Perhaps you’re wondering what moving around has to do with Obamacare. Quite a lot, actually.\u003c/p>\n\u003cp>Your health plan options – and prices – vary by geography, and the Golden State is divided into 19 regions. Los Angeles is so large that it accounts for two regions, and that doesn’t even include the Inland Empire or Orange County.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, I’ll tell you what happens to your coverage when you travel or move, and whether you’ll be able to see a doctor when you’re in Boise, Berlin or even Berkeley.\u003c!--more-->\u003c/p>\n\u003cp>\u003cstrong>Q: I am considering enrolling in one of the Covered California plans. How will my coverage work if I am traveling out of state or out of the country and need medical care?\u003c/strong>\u003c/p>\n\u003cp>I’m adding one other part to Suellen’s question: What happens when traveling \u003cem>within\u003c/em> California?\u003c/p>\n\u003cp>As I mentioned above, health plans sold on the open market and through our health insurance exchange, \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, vary by region. That means not all plans are sold in all regions. In fact, some have a very limited geographic reach, including the \u003ca href=\"http://www.cchphmo.com/\" target=\"_blank\">Chinese Community Health Plan\u003c/a> and the \u003ca href=\"http://cchealth.org/healthplan/\" target=\"_blank\">Contra Costa Health Plan\u003c/a>, both in the Bay Area.\u003c/p>\n\u003cp>So, if you’re traveling within the state and need care, it depends on who your insurer is and what kind of network of doctors and hospitals it offers. If, say, you have a Kaiser plan, you can visit a Kaiser doctor or hospital outside of your region and have the costs covered.\u003c/p>\n\u003cp>If, however, your insurer’s network doesn’t extend to your travel destination, you will only be reimbursed for emergency and urgent care services, not routine services, says Lizelda Lopez of Covered California.\u003c/p>\n\u003cp>When you’re traveling \u003cem>outside\u003c/em> of California, your insurer doesn’t matter: You are only eligible to have emergency and urgent medical services covered.\u003c/p>\n\u003cp>“None of our plans have out-of-state networks,” Lopez says.\u003c/p>\n\u003cp>By the way, this isn’t necessarily new. Earlier this year when I visited the East Coast, I got a scary infection that needed immediate attention. I called my insurer first, which directed me to choose from specific ERs and urgent cares. I dutifully complied, but still had to fight to get my urgent care visit covered.\u003c/p>\n\u003cp>Lopez’s advice? Wherever you’re visiting, do what I did and double-check with your insurer to find out if a provider is covered. My advice: Be prepared for a fight afterward.\u003c/p>\n\u003cp>\u003cstrong>Q: What happens if an individual moves from one state to another after signing up for a plan? I’ll be living in California for the first few months of 2014, but there’s a definite chance I may be moving to Washington. Will it be possible to transfer my plan to a different state partway through the year?\u003c/strong>\u003c/p>\n\u003cp>A: Once again, I’m adding another part to John’s question that may sound familiar: What if you move \u003cem>within\u003c/em> California?\u003c/p>\n\u003cp>The answer also may sound familiar: It depends on your insurer. If you have a plan that also is offered in your new locale, you keep that plan. If you want to change it, you’ll have to wait until the next open-enrollment period.\u003c/p>\n\u003cp>If you can’t get the same plan in your new hometown, you’ll be eligible for a special-enrollment period and can sign up for a new plan.\u003c/p>\n\u003cp>And now, back to John’s question. If you move to another state, you will need to enroll in a new plan through that state’s exchange or buy on the open market. If that state doesn’t run its own exchange (\u003ca href=\"https://www.wahealthplanfinder.org/HBEWeb/Annon_DisplayHomePage.action?authn_try_count=0&contextType=external&username=string&contextValue=%2Foam&password=sercure_string&challenge_url=https%3A%2F%2Fwww.wahealthplanfinder.org%2FHBEWeb%2FAnnon_DisplayHomePag\" target=\"_blank\">Washington state does\u003c/a>), you would use the federal exchange, \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">healthcare.gov\u003c/a>.\u003c/p>\n\u003cp>Moving to another state also triggers a special enrollment period, so you’d be able to choose a new plan immediately.\u003c/p>\n\u003cp>\u003cstrong>Q: What about American citizens living in another country such as Sweden, where health insurance is covered? Why should I be required to have health insurance in the states when I don’t even live there?\u003c/strong>\u003c/p>\n\u003cp>A: As most of you know, Ask Emily is geared toward a California audience. But that doesn’t stop people from writing from all corners of the country. And, it turns out, from all corners of the world. I have received similar questions similar from readers in New Zealand, Thailand, Malaysia and Australia.\u003c/p>\n\u003cp>The answer depends on how long you live abroad during a calendar year. \u003ca href=\"http://www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision\" target=\"_blank\">According to the Internal Revenue Service\u003c/a>, U.S. citizens who live abroad for at least 330 days within a 12-month period don’t have to comply with the Obamacare insurance mandate, which requires most Americans to have health insurance as of Jan. 1.\u003c/p>\n\u003cp>That also means you won’t have to pay a tax penalty for not having insurance.\u003c/p>\n\u003cp>You don’t even have to be insured in your country of residence, like Artie is, to get out of the insurance requirement, \u003ca href=\"https://www.healthcare.gov/am-i-eligible-for-coverage-in-the-marketplace/\" target=\"_blank\">the feds say\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, if you don’t want to trigger the mandate, try to keep your annual trips back home to under five weeks each year!\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16843/obamacare-faq-what-happens-if-i-travel-or-move","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16847","label":"stateofhealth"},"stateofhealth_16798":{"type":"posts","id":"stateofhealth_16798","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16798","score":null,"sort":[1387398494000]},"guestAuthors":[],"slug":"obamacare-faq-who-is-eligible-for-a-subsidy","title":"Obamacare FAQ: Are You Eligible for a Subsidy?","publishDate":1387398494,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16141\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-e1383845514894.jpg\">\u003cimg class=\"size-large wp-image-16141\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. State of Health is running one post a day with questions and answers on both the Affordable Care Act and Covered California until that deadline. This installment comes from \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003ch5>I've Heard the Government Is Offering Subsidies to Buy Insurance. Tell Me More.\u003c/h5>\n\u003cp>You may qualify for a subsidy — in the form of a tax credit — to help you pay for health insurance. Tax credits are available on a sliding scale, according to your income. More than 2 million Californians will qualify for a tax credit.\u003c/p>\n\u003cp>If you earn between 138 and 400 percent of poverty ($15,850 - $46,000 for an individual; $32,500 - $94,200 for a family of four), you may qualify for a \u003ca href=\"https://www.healthcare.gov/glossary/premium-tax-credit/\" target=\"_blank\">federal tax credit\u003c/a>. The credit will be applied to the cost of your premium. You choose when you want to receive the credit. You might want to receive it monthly, so that you will pay less each month, or you may elect to receive it all at once when you file your taxes in the following year.\u003c!--more-->\u003c/p>\n\u003cp>In order to receive the subsidy, you must buy a plan through Covered California. You cannot apply the subsidy to a plan you find outside of the marketplace.\u003c/p>\n\u003cp>Covered California \u003ca href=\"https://www.coveredca.com/shopandcompare/#calculator\" target=\"_blank\">offers a calculator\u003c/a> to help you estimate the cost of your insurance after the tax credit has been applied -- and to help you compare the prices of the different plans available to you. The tax credit is based on your ability to pay for the second-lowest-cost silver plan. But you can apply the credit to any plan you wish to buy (except for a catastrophic plan).\u003c/p>\n\u003ch5>I Can't Even Afford the Copayment or Deductible. What Do I Do Now?\u003c/h5>\n\u003cp>In addition to the tax credit, the federal government also offers special subsidies based on income and family size. If your income is less than about 2.5 times the poverty level — that's $28,000 for an individual or about $58,000 for a family of four — you may be eligible. These subsidies can help reduce what you have to pay -- called copayments -- when you see the doctor or get other health care.\u003c/p>\n\u003ch5>What If My Income Changes During the Year?\u003c/h5>\n\u003cp>If your income changes, your subsidy amount may go up or down. You should contact Covered California right away to adjust the amount of subsidy you receive. If you estimate your income too low — and get a higher subsidy as a result — you could have to pay back some of the subsidy at tax time. Alternatively, if you estimate too high, you could get a refund.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"I've Heard the Government Is Offering Subsidies to Buy Insurance. Tell Me More.\r\n\r\nYou may qualify for a subsidy — in the form of a tax credit — to help you pay for health insurance. Tax credits are available on a sliding scale, according to your income. More than 2 million Californians will qualify for a tax credit.","status":"publish","parent":0,"modified":1387671668,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":9,"wordCount":484},"headData":{"title":"Obamacare FAQ: Are You Eligible for a Subsidy? | KQED","description":"I've Heard the Government Is Offering Subsidies to Buy Insurance. Tell Me More.\r\n\r\nYou may qualify for a subsidy — in the form of a tax credit — to help you pay for health insurance. Tax credits are available on a sliding scale, according to your income. More than 2 million Californians will qualify for a tax credit.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16798 http://blogs.kqed.org/stateofhealth/?p=16798","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/18/obamacare-faq-who-is-eligible-for-a-subsidy/","disqusTitle":"Obamacare FAQ: Are You Eligible for a Subsidy?","path":"/stateofhealth/16798/obamacare-faq-who-is-eligible-for-a-subsidy","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16141\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-e1383845514894.jpg\">\u003cimg class=\"size-large wp-image-16141\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/140007839-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. State of Health is running one post a day with questions and answers on both the Affordable Care Act and Covered California until that deadline. This installment comes from \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003ch5>I've Heard the Government Is Offering Subsidies to Buy Insurance. Tell Me More.\u003c/h5>\n\u003cp>You may qualify for a subsidy — in the form of a tax credit — to help you pay for health insurance. Tax credits are available on a sliding scale, according to your income. More than 2 million Californians will qualify for a tax credit.\u003c/p>\n\u003cp>If you earn between 138 and 400 percent of poverty ($15,850 - $46,000 for an individual; $32,500 - $94,200 for a family of four), you may qualify for a \u003ca href=\"https://www.healthcare.gov/glossary/premium-tax-credit/\" target=\"_blank\">federal tax credit\u003c/a>. The credit will be applied to the cost of your premium. You choose when you want to receive the credit. You might want to receive it monthly, so that you will pay less each month, or you may elect to receive it all at once when you file your taxes in the following year.\u003c!--more-->\u003c/p>\n\u003cp>In order to receive the subsidy, you must buy a plan through Covered California. You cannot apply the subsidy to a plan you find outside of the marketplace.\u003c/p>\n\u003cp>Covered California \u003ca href=\"https://www.coveredca.com/shopandcompare/#calculator\" target=\"_blank\">offers a calculator\u003c/a> to help you estimate the cost of your insurance after the tax credit has been applied -- and to help you compare the prices of the different plans available to you. The tax credit is based on your ability to pay for the second-lowest-cost silver plan. But you can apply the credit to any plan you wish to buy (except for a catastrophic plan).\u003c/p>\n\u003ch5>I Can't Even Afford the Copayment or Deductible. What Do I Do Now?\u003c/h5>\n\u003cp>In addition to the tax credit, the federal government also offers special subsidies based on income and family size. If your income is less than about 2.5 times the poverty level — that's $28,000 for an individual or about $58,000 for a family of four — you may be eligible. These subsidies can help reduce what you have to pay -- called copayments -- when you see the doctor or get other health care.\u003c/p>\n\u003ch5>What If My Income Changes During the Year?\u003c/h5>\n\u003cp>If your income changes, your subsidy amount may go up or down. You should contact Covered California right away to adjust the amount of subsidy you receive. If you estimate your income too low — and get a higher subsidy as a result — you could have to pay back some of the subsidy at tax time. Alternatively, if you estimate too high, you could get a refund.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16798/obamacare-faq-who-is-eligible-for-a-subsidy","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_294","stateofhealth_38","stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16803","label":"stateofhealth"},"stateofhealth_16770":{"type":"posts","id":"stateofhealth_16770","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16770","score":null,"sort":[1387311180000]},"guestAuthors":[],"slug":"obamacare-faq-do-immigrants-qualify","title":"Obamacare FAQ: Do Immigrants Qualify?","publishDate":1387311180,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_15577\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408.jpg\">\u003cimg class=\"size-large wp-image-15577\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408-640x472.jpg\" alt=\"A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\" width=\"640\" height=\"472\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. State of Health is running one post a day with questions and answers on both the Affordable Care Act and Covered California until that deadline. This installment comes from \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>The headline for immigrants is that if you are \"lawfully present\" (the legal term of art), you are eligible for the benefits -- and responsibilities -- of the Affordable Care Act. This means you may qualify for subsidies to purchase insurance, but it also means you may have to pay a penalty if you do not carry health insurance. While naturalized citizens and green card holders may be aware of how Obamacare affects them, for other immigrants, access to these kinds of benefits is new. Undocumented immigrants are not eligible for any benefits of the ACA. They do not have to pay a penalty if they do not carry health insurance.\u003c/p>\n\u003ch5>I Am in the U.S. Legally, But I Do Not Have a Green Card. I Am Here under a Different Kind of Visa. What Does the Health Law Mean to Me?\u003c/h5>\n\u003cp>U.S. law includes a wide variety of ways in which immigrants can be lawfully present, even if they are not green card holders.\u003c!--more-->\u003c/p>\n\u003cp>The Affordable Care Act provides benefits to immigrants lawfully present under many different kinds of immigration status. You can check \u003ca href=\"https://www.healthcare.gov/immigration-status-and-the-marketplace/\" target=\"_blank\">this list\u003c/a> from the federal government to see if you qualify.\u003c/p>\n\u003cp>If your immigration status is one of those that makes you eligible for ACA benefits, here's what you need to know:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Depending on your income and the number of people in your family, you may be eligible for subsidies to help you pay for insurance. If you earn less than 400 percent of poverty (about $46,000 for an individual or $94,000 for a family of four), you likely qualify for a sliding scale subsidy.\u003c/p>\n\u003cp>Covered California has a \u003ca href=\"https://www.coveredca.com/shopandcompare/#calculator\" target=\"_blank\">cost calculator\u003c/a> so you can estimate how much you might have to pay for health insurance. The cost calculator will also indicate if you are eligible for Medi-Cal.\u003c/p>\n\u003cp>Even if you make too much money to qualify for a subsidy, you can still purchase health insurance on the Covered California marketplace.\u003c/p>\n\u003ch5>I Am Lawfully Present and Want My Parents to Immigrate. Are They Eligible for Any Benefits?\u003c/h5>\n\u003cp>If your parents are lawfully present, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/09/for-legal-immigrants-obamacare-has-options-for-aging-parents/\" target=\"_blank\">they are eligible\u003c/a> to buy insurance on the Covered California marketplace. They may also be eligible for subsidies, depending on their income.\u003c/p>\n\u003ch5>We Are a Mixed-Status Family. How Do We Handle Our Application?\u003c/h5>\n\u003cp>\u003c/p>\n\u003cp>A mixed-status family is a household of individuals present in the United States under different immigration or citizenship statuses. While undocumented immigrants are not eligible for benefits under the health law, lawfully present members of a mixed-status family likely are eligible for benefits. Please consult \u003ca href=\"http://nilc.org/aca_mixedstatusfams.html\" target=\"_blank\">this document\u003c/a> from the National Immigration Law Center.\u003c/p>\n\n","blocks":[],"excerpt":"I Am in the U.S. Legally, But I Do Not Have a Green Card. I Am Here under a Different Kind of Visa. What Does the Health Law Mean to Me?\r\n\r\nU.S. law includes a wide variety of ways in which immigrants can be lawfully present, even if they are not green card holders.\r\n\r\nThe Affordable Care Act provides benefits to immigrants lawfully present under many different kinds of immigration status. You can check this list from the federal government to see if you qualify.","status":"publish","parent":0,"modified":1387436083,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":529},"headData":{"title":"Obamacare FAQ: Do Immigrants Qualify? | KQED","description":"I Am in the U.S. Legally, But I Do Not Have a Green Card. I Am Here under a Different Kind of Visa. What Does the Health Law Mean to Me?\r\n\r\nU.S. law includes a wide variety of ways in which immigrants can be lawfully present, even if they are not green card holders.\r\n\r\nThe Affordable Care Act provides benefits to immigrants lawfully present under many different kinds of immigration status. You can check this list from the federal government to see if you qualify.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16770 http://blogs.kqed.org/stateofhealth/?p=16770","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/17/obamacare-faq-do-immigrants-qualify/","disqusTitle":"Obamacare FAQ: Do Immigrants Qualify?","path":"/stateofhealth/16770/obamacare-faq-do-immigrants-qualify","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15577\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408.jpg\">\u003cimg class=\"size-large wp-image-15577\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408-640x472.jpg\" alt=\"A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\" width=\"640\" height=\"472\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. State of Health is running one post a day with questions and answers on both the Affordable Care Act and Covered California until that deadline. This installment comes from \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>The headline for immigrants is that if you are \"lawfully present\" (the legal term of art), you are eligible for the benefits -- and responsibilities -- of the Affordable Care Act. This means you may qualify for subsidies to purchase insurance, but it also means you may have to pay a penalty if you do not carry health insurance. While naturalized citizens and green card holders may be aware of how Obamacare affects them, for other immigrants, access to these kinds of benefits is new. Undocumented immigrants are not eligible for any benefits of the ACA. They do not have to pay a penalty if they do not carry health insurance.\u003c/p>\n\u003ch5>I Am in the U.S. Legally, But I Do Not Have a Green Card. I Am Here under a Different Kind of Visa. What Does the Health Law Mean to Me?\u003c/h5>\n\u003cp>U.S. law includes a wide variety of ways in which immigrants can be lawfully present, even if they are not green card holders.\u003c!--more-->\u003c/p>\n\u003cp>The Affordable Care Act provides benefits to immigrants lawfully present under many different kinds of immigration status. You can check \u003ca href=\"https://www.healthcare.gov/immigration-status-and-the-marketplace/\" target=\"_blank\">this list\u003c/a> from the federal government to see if you qualify.\u003c/p>\n\u003cp>If your immigration status is one of those that makes you eligible for ACA benefits, here's what you need to know:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Depending on your income and the number of people in your family, you may be eligible for subsidies to help you pay for insurance. If you earn less than 400 percent of poverty (about $46,000 for an individual or $94,000 for a family of four), you likely qualify for a sliding scale subsidy.\u003c/p>\n\u003cp>Covered California has a \u003ca href=\"https://www.coveredca.com/shopandcompare/#calculator\" target=\"_blank\">cost calculator\u003c/a> so you can estimate how much you might have to pay for health insurance. The cost calculator will also indicate if you are eligible for Medi-Cal.\u003c/p>\n\u003cp>Even if you make too much money to qualify for a subsidy, you can still purchase health insurance on the Covered California marketplace.\u003c/p>\n\u003ch5>I Am Lawfully Present and Want My Parents to Immigrate. Are They Eligible for Any Benefits?\u003c/h5>\n\u003cp>If your parents are lawfully present, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/10/09/for-legal-immigrants-obamacare-has-options-for-aging-parents/\" target=\"_blank\">they are eligible\u003c/a> to buy insurance on the Covered California marketplace. They may also be eligible for subsidies, depending on their income.\u003c/p>\n\u003ch5>We Are a Mixed-Status Family. How Do We Handle Our Application?\u003c/h5>\n\u003cp>\u003c/p>\n\u003cp>A mixed-status family is a household of individuals present in the United States under different immigration or citizenship statuses. While undocumented immigrants are not eligible for benefits under the health law, lawfully present members of a mixed-status family likely are eligible for benefits. Please consult \u003ca href=\"http://nilc.org/aca_mixedstatusfams.html\" target=\"_blank\">this document\u003c/a> from the National Immigration Law Center.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16770/obamacare-faq-do-immigrants-qualify","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_38","stateofhealth_368","stateofhealth_620","stateofhealth_674"],"featImg":"stateofhealth_15577","label":"stateofhealth"},"stateofhealth_16729":{"type":"posts","id":"stateofhealth_16729","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16729","score":null,"sort":[1387233473000]},"guestAuthors":[],"slug":"obamacare-faq-listener-questions-answered-on-kqeds-forum","title":"Obamacare FAQ: Your Questions Answered on KQED's Forum","publishDate":1387233473,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16736\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/154126477-e1387233135649.jpg\">\u003cimg class=\"size-large wp-image-16736\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/154126477-640x412.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"412\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Just a week to go. The deadline to enroll in health insurance starting Jan. 1 is next Monday, Dec. 23.\u003c/p>\n\u003cp>This morning on \u003ca href=\"http://www.kqed.org/a/forum/R201312160900\" target=\"_blank\">KQED's Forum\u003c/a>, Emily Bazar, of the \u003ca href=\"http://centerforhealthreporting.org/project/ask-emily-answers-consumer-questions-about-obamacare\" target=\"_blank\">Center for Health Reporting\u003c/a>, and I answered listener questions about enrolling in insurance via Covered California.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/125166464&color=ff6600&auto_play=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>Host Michael Krasny started by asking us some of the basics. Yes, you can still buy coverage after Dec. 23; open enrollment runs until Mar. 31, 2014. After that, if you don't have health insurance, you will likely need to pay a penalty, $95 per adult or 1 percent of your income, whichever is greater.\u003c!--more-->\u003c/p>\n\u003cp>But we quickly got into some specifics. One listener said he had been buying a separate health insurance policy for his two young children, but their policy was canceled because it did not comply with the ACA. New policies are significantly more expensive. In addition, he has employer-based insurance for himself -- but his employer's insurance is very expensive for his family.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It was that last bit of his story that put him into the \"kid glitch.\" If \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/09/obamacare-qa-work-based-health-insurance-what-is-the-kid-glitch-consumer-questions-answers-aca/\" target=\"_blank\">your employer offers you \u003c/a>\"affordable\" insurance, and they also offer coverage to your dependents, even if the dependent coverage is very expensive, you do not qualify for subsidies on the Covered California marketplace.\u003c/p>\n\u003cp>Another caller wanted to know if she bought insurance, if her son who goes to college in Portland, OR would be covered. Bazar explained that some plans offer a multi-state option, and consumers should be sure to check what is covered outside California.\u003c/p>\n\u003cp>More than one caller wanted to know a variation of \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/12/obamacare-faq-determining-your-family-size-household/\" target=\"_blank\">who's in my household?\u003c/a>\" In short, your eligibility for a subsidy is determined by your income and household size. In short, your household is determined by who you claim as a dependent on your federal income tax return. So, if you claim your college student daughter as a dependent, you must also claim any income she might earn.\u003c/p>\n\u003cp>Another caller wanted to know why her children qualified for Medi-Cal but she and her husband did not. While adults who earn up to 138 percent of poverty are eligible for Medi-Cal, for children the threshold is 250 percent of poverty. Here's an example: say a family of four has household income of $55,000. That's much more than 138 percent of poverty -- and just under 250 percent of poverty -- for a family of four. So, the children qualify for Medi-Cal, but the adults must buy on the Covered California marketplace. They will qualify for subsidies to help them afford insurance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But many people had questions that Bazar and I simply could not answer. If you're having trouble with your specific question, we both encouraged listeners to seek in-person assistance. You can \u003ca href=\"https://www.coveredca.com/enrollment-assistance/\" target=\"_blank\">click here\u003c/a> to visit Covered California's links to find someone near you to help you.\u003c/p>\n\n","blocks":[],"excerpt":"Just a week to go. The deadline to enroll in health insurance starting Jan. 1 is next Monday, Dec. 23.\r\n\r\nThis morning on KQED's Forum, Emily Bazar, of the Center for Health Reporting, and I answered listener questions about enrolling in insurance via Covered California.","status":"publish","parent":0,"modified":1389998396,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://w.soundcloud.com/player/"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":12,"wordCount":486},"headData":{"title":"Obamacare FAQ: Your Questions Answered on KQED's Forum | KQED","description":"Just a week to go. The deadline to enroll in health insurance starting Jan. 1 is next Monday, Dec. 23.\r\n\r\nThis morning on KQED's Forum, Emily Bazar, of the Center for Health Reporting, and I answered listener questions about enrolling in insurance via Covered California.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16729 http://blogs.kqed.org/stateofhealth/?p=16729","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/16/obamacare-faq-listener-questions-answered-on-kqeds-forum/","disqusTitle":"Obamacare FAQ: Your Questions Answered on KQED's Forum","path":"/stateofhealth/16729/obamacare-faq-listener-questions-answered-on-kqeds-forum","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16736\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/154126477-e1387233135649.jpg\">\u003cimg class=\"size-large wp-image-16736\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/154126477-640x412.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"412\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Just a week to go. The deadline to enroll in health insurance starting Jan. 1 is next Monday, Dec. 23.\u003c/p>\n\u003cp>This morning on \u003ca href=\"http://www.kqed.org/a/forum/R201312160900\" target=\"_blank\">KQED's Forum\u003c/a>, Emily Bazar, of the \u003ca href=\"http://centerforhealthreporting.org/project/ask-emily-answers-consumer-questions-about-obamacare\" target=\"_blank\">Center for Health Reporting\u003c/a>, and I answered listener questions about enrolling in insurance via Covered California.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/125166464&color=ff6600&auto_play=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>Host Michael Krasny started by asking us some of the basics. Yes, you can still buy coverage after Dec. 23; open enrollment runs until Mar. 31, 2014. After that, if you don't have health insurance, you will likely need to pay a penalty, $95 per adult or 1 percent of your income, whichever is greater.\u003c!--more-->\u003c/p>\n\u003cp>But we quickly got into some specifics. One listener said he had been buying a separate health insurance policy for his two young children, but their policy was canceled because it did not comply with the ACA. New policies are significantly more expensive. In addition, he has employer-based insurance for himself -- but his employer's insurance is very expensive for his family.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It was that last bit of his story that put him into the \"kid glitch.\" If \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/09/obamacare-qa-work-based-health-insurance-what-is-the-kid-glitch-consumer-questions-answers-aca/\" target=\"_blank\">your employer offers you \u003c/a>\"affordable\" insurance, and they also offer coverage to your dependents, even if the dependent coverage is very expensive, you do not qualify for subsidies on the Covered California marketplace.\u003c/p>\n\u003cp>Another caller wanted to know if she bought insurance, if her son who goes to college in Portland, OR would be covered. Bazar explained that some plans offer a multi-state option, and consumers should be sure to check what is covered outside California.\u003c/p>\n\u003cp>More than one caller wanted to know a variation of \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/12/12/obamacare-faq-determining-your-family-size-household/\" target=\"_blank\">who's in my household?\u003c/a>\" In short, your eligibility for a subsidy is determined by your income and household size. In short, your household is determined by who you claim as a dependent on your federal income tax return. So, if you claim your college student daughter as a dependent, you must also claim any income she might earn.\u003c/p>\n\u003cp>Another caller wanted to know why her children qualified for Medi-Cal but she and her husband did not. While adults who earn up to 138 percent of poverty are eligible for Medi-Cal, for children the threshold is 250 percent of poverty. Here's an example: say a family of four has household income of $55,000. That's much more than 138 percent of poverty -- and just under 250 percent of poverty -- for a family of four. So, the children qualify for Medi-Cal, but the adults must buy on the Covered California marketplace. They will qualify for subsidies to help them afford insurance.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But many people had questions that Bazar and I simply could not answer. If you're having trouble with your specific question, we both encouraged listeners to seek in-person assistance. You can \u003ca href=\"https://www.coveredca.com/enrollment-assistance/\" target=\"_blank\">click here\u003c/a> to visit Covered California's links to find someone near you to help you.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16729/obamacare-faq-listener-questions-answered-on-kqeds-forum","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_294","stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16736","label":"stateofhealth"},"stateofhealth_16648":{"type":"posts","id":"stateofhealth_16648","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16648","score":null,"sort":[1386874918000]},"guestAuthors":[],"slug":"obamacare-faq-determining-your-family-size-household","title":"Obamacare FAQ: Determining Your Family Size","publishDate":1386874918,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16653\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/mikeygottawa/398496381/sizes/o/in/photolist-Bdp6g-BBViz-EPCKv-FXkYh-GX1uh-MoFbh-MKaPQ-2egFxZ-2hqZzs-2FTGtW-2QHzWh-2XKsUV-49NrV2-4bme2x-4bnfeR-4e9hqB-4fwRJE-4gjuyq-4m9DFh-4m9DGd-4mc6M8-4nXM53-4o8o2Z-4pDx2q-4uxAcG-4GDVdm-4KZiGJ-4Wov4u-4YxfLb-5gpgNv-5i8uYo-5rGUkb-5vVJhS-5Facdc-5NYbH7-5ViCsf-61iVKE-62PpGg-6ddgFG-6io7bb-6k7FVk-6Po4F4-6PsdCu-6RfRUt-6Sjxxh-6UCR18-7hwrT5-7ibhq7-aQKMS4-9Bvyxw-e31tST/\">\u003cimg class=\"size-full wp-image-16653 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/398496381_2d246202cb_z.jpg\" alt=\"Family size of four? Only your federal tax return knows for sure. (Mikey G Ottawa/Flickr)\" width=\"640\" height=\"503\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/12/398496381_2d246202cb_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/398496381_2d246202cb_z-400x314.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/398496381_2d246202cb_z-320x252.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Family size of four? Only your federal tax return knows for sure. (Mikey G Ottawa/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/how-will-young-adults-and-college-students-fare-under-obamacare1145\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Q: I have been on the Covered California website and the calculator asks for family size, which I presume means the taxpayer plus number of dependents claimed on federal tax forms. If a consumer claims non-child family members (like aging parents) do they count as part of family size?\u003c/strong>\u003c/p>\n\u003cp>A: What’s a family? In our shifting social landscape, it could be a single-parent household, a domestic partnership, a same-sex marriage, an unwed cohabitating couple and more.\u003c/p>\n\u003cp>But when it comes to Obamacare, as Rich from Santa Ana notes, it’s all about taxes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As if Obamacare needed something more to test its popularity. But let’s face it, the law – officially known as the Affordable Care Act – relies heavily on our tax data to determine program eligibility and financial assistance, and also changes some tax rules.\u003c!--more-->\u003c/p>\n\u003cp>“For anyone who purchases their insurance through the exchange (\u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>), their returns will be more complicated,” warns Garry Browning, a Certified Public Accountant in Modesto who trains other CPAs in Obamacare matters.\u003c/p>\n\u003cp>Yay.\u003c/p>\n\u003cp>Thankfully, the answer to Rich’s question is relatively straightforward.\u003c/p>\n\u003cp>In general, spouses (as long as they file a joint return) and other relatives are considered part of the household if they’re claimed as tax dependents, Browning says.\u003c/p>\n\u003cp>Kids don’t have to be biological children to be dependents. As long as they meet certain criteria, they can be step-children, siblings, nieces/nephews and grandchildren.\u003c/p>\n\u003cp>That goes for aging parents and other relatives who also meet certain criteria.\u003c/p>\n\u003cp>If you’re applying for a family plan, dependents will figure into the calculation for tax credits, which will defray the cost of insurance premiums for those whose incomes qualify.\u003c/p>\n\u003cp>I know how badly you want to dig further into the nuances, so check out \u003ca href=\"http://www.healthreformbeyondthebasics.org/wp-content/uploads/2013/08/Household-Definitions-Webinar-7Aug13.pdf\" target=\"_blank\">this helpful guide\u003c/a> from the Washington, D.C.-based \u003ca href=\"http://www.cbpp.org/\" target=\"_blank\">Center on Budget and Policy Priorities\u003c/a>, a nonprofit that studies the effects of policy on low- and middle-income families and individuals. The guide\u003cstrong> \u003c/strong>includes several different household scenarios.\u003c/p>\n\u003cp>And please, please, as with this or any other tax issue, consult a tax professional to be sure.\u003c/p>\n\u003cp>\u003cstrong>Q: \u003c/strong>\u003cstrong>I am on Medicare and my wife, who is 61 and not yet eligible for Medicare, will soon be unemployed. … T\u003c/strong>\u003cstrong>he tax credit through Covered California is based on “household income.” Currently, we file a joint tax return. But suppose we decide to file separately. \u003c/strong>\u003cstrong>How is household income then calculated?\u003c/strong> \u003cstrong>Without my income, she would be eligible for a much larger tax credit.\u003c/strong>\u003c/p>\n\u003cp>A: Stan, I have some tough love for you here: If your wife wants a tax credit at all, you can’t file separately.\u003c/p>\n\u003cp>In order to be eligible for tax credits from Covered California, spouses \u003ca href=\"https://www.coveredca.com/FAQs/\" target=\"_blank\">must file their federal tax returns jointly\u003c/a>.\u003c/p>\n\u003cp>That rule applies when both spouses are seeking health coverage. It also applies in cases like this, when just one spouse is buying a plan from Covered California.\u003c/p>\n\u003cp>That means both incomes will be used to determine the amount of tax credits for one plan. So what does that \u003cem>really\u003c/em> mean? It means that the more income in the calculation, the lower the credit.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Just in case you thought you’d get away without a caveat, there’s at least one exception to this rule: If a couple is separated and living apart for the last six months of the year, the spouse who is caring for a dependent child could claim a special filing status that would NOT include the other spouse’s income, says Tara Straw, a senior health policy analyst at the Center on Budget and Policy Priorities\u003cstrong>.\u003c/strong>\u003c/p>\n\n","blocks":[],"excerpt":"Q: I have been on the Covered California website and the calculator asks for family size, which I presume means the taxpayer plus number of dependents claimed on federal tax forms. If a consumer claims non-child family members (like aging parents) do they count as part of family size?\r\n\r\nA: What’s a family? In our shifting social landscape, it could be a single-parent household, a domestic partnership, a same-sex marriage, an unwed cohabitating couple and more.\r\n\r\nBut when it comes to Obamacare, as Rich from Santa Ana notes, it’s all about taxes.","status":"publish","parent":0,"modified":1386874918,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":723},"headData":{"title":"Obamacare FAQ: Determining Your Family Size | KQED","description":"Q: I have been on the Covered California website and the calculator asks for family size, which I presume means the taxpayer plus number of dependents claimed on federal tax forms. If a consumer claims non-child family members (like aging parents) do they count as part of family size?\r\n\r\nA: What’s a family? In our shifting social landscape, it could be a single-parent household, a domestic partnership, a same-sex marriage, an unwed cohabitating couple and more.\r\n\r\nBut when it comes to Obamacare, as Rich from Santa Ana notes, it’s all about taxes.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16648 http://blogs.kqed.org/stateofhealth/?p=16648","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/12/obamacare-faq-determining-your-family-size-household/","disqusTitle":"Obamacare FAQ: Determining Your Family Size","path":"/stateofhealth/16648/obamacare-faq-determining-your-family-size-household","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16653\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/mikeygottawa/398496381/sizes/o/in/photolist-Bdp6g-BBViz-EPCKv-FXkYh-GX1uh-MoFbh-MKaPQ-2egFxZ-2hqZzs-2FTGtW-2QHzWh-2XKsUV-49NrV2-4bme2x-4bnfeR-4e9hqB-4fwRJE-4gjuyq-4m9DFh-4m9DGd-4mc6M8-4nXM53-4o8o2Z-4pDx2q-4uxAcG-4GDVdm-4KZiGJ-4Wov4u-4YxfLb-5gpgNv-5i8uYo-5rGUkb-5vVJhS-5Facdc-5NYbH7-5ViCsf-61iVKE-62PpGg-6ddgFG-6io7bb-6k7FVk-6Po4F4-6PsdCu-6RfRUt-6Sjxxh-6UCR18-7hwrT5-7ibhq7-aQKMS4-9Bvyxw-e31tST/\">\u003cimg class=\"size-full wp-image-16653 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/398496381_2d246202cb_z.jpg\" alt=\"Family size of four? Only your federal tax return knows for sure. (Mikey G Ottawa/Flickr)\" width=\"640\" height=\"503\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/12/398496381_2d246202cb_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/398496381_2d246202cb_z-400x314.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/398496381_2d246202cb_z-320x252.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Family size of four? Only your federal tax return knows for sure. (Mikey G Ottawa/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/how-will-young-adults-and-college-students-fare-under-obamacare1145\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Q: I have been on the Covered California website and the calculator asks for family size, which I presume means the taxpayer plus number of dependents claimed on federal tax forms. If a consumer claims non-child family members (like aging parents) do they count as part of family size?\u003c/strong>\u003c/p>\n\u003cp>A: What’s a family? In our shifting social landscape, it could be a single-parent household, a domestic partnership, a same-sex marriage, an unwed cohabitating couple and more.\u003c/p>\n\u003cp>But when it comes to Obamacare, as Rich from Santa Ana notes, it’s all about taxes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As if Obamacare needed something more to test its popularity. But let’s face it, the law – officially known as the Affordable Care Act – relies heavily on our tax data to determine program eligibility and financial assistance, and also changes some tax rules.\u003c!--more-->\u003c/p>\n\u003cp>“For anyone who purchases their insurance through the exchange (\u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>), their returns will be more complicated,” warns Garry Browning, a Certified Public Accountant in Modesto who trains other CPAs in Obamacare matters.\u003c/p>\n\u003cp>Yay.\u003c/p>\n\u003cp>Thankfully, the answer to Rich’s question is relatively straightforward.\u003c/p>\n\u003cp>In general, spouses (as long as they file a joint return) and other relatives are considered part of the household if they’re claimed as tax dependents, Browning says.\u003c/p>\n\u003cp>Kids don’t have to be biological children to be dependents. As long as they meet certain criteria, they can be step-children, siblings, nieces/nephews and grandchildren.\u003c/p>\n\u003cp>That goes for aging parents and other relatives who also meet certain criteria.\u003c/p>\n\u003cp>If you’re applying for a family plan, dependents will figure into the calculation for tax credits, which will defray the cost of insurance premiums for those whose incomes qualify.\u003c/p>\n\u003cp>I know how badly you want to dig further into the nuances, so check out \u003ca href=\"http://www.healthreformbeyondthebasics.org/wp-content/uploads/2013/08/Household-Definitions-Webinar-7Aug13.pdf\" target=\"_blank\">this helpful guide\u003c/a> from the Washington, D.C.-based \u003ca href=\"http://www.cbpp.org/\" target=\"_blank\">Center on Budget and Policy Priorities\u003c/a>, a nonprofit that studies the effects of policy on low- and middle-income families and individuals. The guide\u003cstrong> \u003c/strong>includes several different household scenarios.\u003c/p>\n\u003cp>And please, please, as with this or any other tax issue, consult a tax professional to be sure.\u003c/p>\n\u003cp>\u003cstrong>Q: \u003c/strong>\u003cstrong>I am on Medicare and my wife, who is 61 and not yet eligible for Medicare, will soon be unemployed. … T\u003c/strong>\u003cstrong>he tax credit through Covered California is based on “household income.” Currently, we file a joint tax return. But suppose we decide to file separately. \u003c/strong>\u003cstrong>How is household income then calculated?\u003c/strong> \u003cstrong>Without my income, she would be eligible for a much larger tax credit.\u003c/strong>\u003c/p>\n\u003cp>A: Stan, I have some tough love for you here: If your wife wants a tax credit at all, you can’t file separately.\u003c/p>\n\u003cp>In order to be eligible for tax credits from Covered California, spouses \u003ca href=\"https://www.coveredca.com/FAQs/\" target=\"_blank\">must file their federal tax returns jointly\u003c/a>.\u003c/p>\n\u003cp>That rule applies when both spouses are seeking health coverage. It also applies in cases like this, when just one spouse is buying a plan from Covered California.\u003c/p>\n\u003cp>That means both incomes will be used to determine the amount of tax credits for one plan. So what does that \u003cem>really\u003c/em> mean? It means that the more income in the calculation, the lower the credit.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Just in case you thought you’d get away without a caveat, there’s at least one exception to this rule: If a couple is separated and living apart for the last six months of the year, the spouse who is caring for a dependent child could claim a special filing status that would NOT include the other spouse’s income, says Tara Straw, a senior health policy analyst at the Center on Budget and Policy Priorities\u003cstrong>.\u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16648/obamacare-faq-determining-your-family-size-household","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_294","stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16653","label":"stateofhealth"},"stateofhealth_16627":{"type":"posts","id":"stateofhealth_16627","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16627","score":null,"sort":[1386782366000]},"guestAuthors":[],"slug":"obamacare-faq-what-are-options-for-college-students-and-young-adults","title":"Obamacare FAQ: What Are Options for College Students and Young Adults?","publishDate":1386782366,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16635\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/39274732@N05/4998398713/in/photolist-8BG6Na-cEHJ9d-8F6mwa-8ETDSC-8F6muF-bPP71V-9WHy5y-9WEJE8-9WEQCk-9WHQou-9WHrUf-9WERei-9WHHRj-9WHNc5-9WHEa5-9WHUmq-9WEZzM-9WEHZD-9WHBuL-9WF2Uz-9WEYND-9WHui7-9WHPx9-9WEDna-9WHCuQ-9WHszQ-9WHts7-9WEL62-9WHyUA-9WEUut-9WEPBB-9WHDcL-9WF1BM-9WHJML-9WHNXQ-9WEEtK-9WETP8-9WHG5h-9WHMMs-9WHxmC-9WF2qp-9WENYx-9WHRZN-9WHLUU-cEJAgJ-ce1HnA-bYbpKb-aqzLvN-aM4MWP-82a21N-8ETDVC\">\u003cimg class=\"size-full wp-image-16635\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/4998398713_88352f0375_z.jpg\" alt=\"(Mike Adams/Flickr)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/12/4998398713_88352f0375_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/4998398713_88352f0375_z-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/4998398713_88352f0375_z-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mike Adams/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/how-will-young-adults-and-college-students-fare-under-obamacare1145\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Q: My youngest child is 21 and graduated from college in May. My other daughter is 24 and is still a college student in Stockton. What are my options with them under the Affordable Care Act?\u003c/strong>\u003c/p>\n\u003cp>A: The good news, Simona, is that your daughters may have several options and their coverage could fall into place easily.\u003c/p>\n\u003cp>Or not.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Let’s cross our fingers and begin with “could fall into place easily.”\u003c/p>\n\u003cp>Starting in January, \u003ca href=\"http://centerforhealthreporting.org/article/obamacare%E2%80%99s-insurance-requirement-where-do-you-fit1104\" target=\"_blank\">most Americans\u003c/a> will be required to carry a minimum level of health insurance or pay a tax penalty. That includes your daughters and other young adults 18 and over.\u003c!--more-->\u003c/p>\n\u003cp>\u003ca href=\"https://www.healthcare.gov/how-does-the-health-care-law-protect-me/#part=7\" target=\"_blank\">One provision of Obamacare that already went into effect\u003c/a> allows parents to keep their young-adult children on their insurance policies up to age 26.\u003c/p>\n\u003cp>“I suspect that’s the route that many college students are going to take,” says Steven Bloom, director of federal relations for the American Council on Education.\u003c/p>\n\u003cp>If that’s not an option, many universities offer health insurance that will meet Obamacare requirements, Bloom says.\u003c/p>\n\u003cp>But it could cost. My editor just received a bill for a semester’s worth of health coverage for his daughter, who attends Prescott College in Arizona: $767.\u003c/p>\n\u003cp>So, shop around because two major Obamacare-related changes coming in January could provide new, affordable options to young adults:\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.dhcs.ca.gov/Services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\">Medi-Cal\u003c/a>, public health insurance for low-income Californians, will broaden its eligibility requirements, raising the income threshold and opening the program to those who were previously ineligible, such as childless adults.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>This could be promising because young adults often don’t work full time -- whether they’re attending college or not -- and may soon qualify.\u003c/p>\n\u003cp>Please note that if you claim your young-adult child as a tax dependent, your income will count toward your child’s income for Medi-Cal eligibility purposes, says Tony Cava of the state Department of Health Care Services.\u003c/p>\n\u003cp>The result? Your child may not qualify.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the state's insurance marketplace, begins open enrollment in October sells a variety of health plans. To make those plans more affordable, it also will offer sliding-scale tax credits to Californians earning between 138 percent and 400 percent of the federal poverty level (click \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">here\u003c/a> for FPL guidelines).\u003c/li>\n\u003c/ul>\n\u003cp>Young adults, even those who have access to college health plans, can purchase a plan from Covered California instead. Students \u003ca href=\"http://www.npr.org/blogs/health/2013/07/02/197994339/federal-rule-extends-subsidies-for-college-students\" target=\"_blank\">will be eligible for tax credits\u003c/a> if their incomes fall within the guidelines.\u003c/p>\n\u003cp>But beware the dreaded tax caveat: For a student to be eligible for tax subsidies, no one can claim him or her as a dependent on tax returns.\u003c/p>\n\u003cp>To complicate matters further, the student won’t even qualify for the subsidies if he or she is merely \u003cem>eligible\u003c/em> to be claimed as a dependent, says Anne Gonzales, a Covered California spokeswoman.\u003c/p>\n\u003cp>(One way around that: If you as a parent qualify for tax credits, you can add your young-adult child to a family plan and receive financial assistance for premiums that way, Gonzales notes.)\u003c/p>\n\u003cp>Whew. Now you know what I meant earlier by “Or not.”\u003c/p>\n\u003cp>Here’s one final option: Covered California will offer a low-cost catastrophic plan for young adults under 30 and for individuals who cannot find affordable health coverage. (Click \u003ca href=\"http://www.bcbsm.com/content/microsites/health-care-reform/en/reform-alerts/cms-issues-proposed-rule-catastrophic-plans.html\" target=\"_blank\">here\u003c/a> to learn more about what’s considered “affordable.”)\u003c/p>\n\u003cp>All costs (except for preventive care and the first three office visits each year) will be out-of-pocket until the $6,400 annual deductible is reached.\u003c/p>\n\u003cp>\u003cstrong>Q: What about my daughter who just graduated?\u003c/strong>\u003c/p>\n\u003cp>A: She will have many of the same options as college students. And if she lands a job, her new employer may offer coverage.\u003c/p>\n\u003cp>More campuses also may start allowing graduating students to remain on their health plan for a limited period, such as three to six months, Bloom says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Once that period is over,” he adds, “then former students, like all other Americans, are going to have to find health insurance.”\u003c/p>\n\n","blocks":[],"excerpt":"Q: My youngest child is 21 and graduated from college in May. My other daughter is 24 and is still a college student in Stockton. What are my options with them under the Affordable Care Act?\r\n\r\nA: The good news, Simona, is that your daughters may have several options and their coverage could fall into place easily.\r\n\r\nOr not.\r\n\r\nLet’s cross our fingers and begin with “could fall into place easily.”","status":"publish","parent":0,"modified":1386915065,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":774},"headData":{"title":"Obamacare FAQ: What Are Options for College Students and Young Adults? | KQED","description":"Q: My youngest child is 21 and graduated from college in May. My other daughter is 24 and is still a college student in Stockton. What are my options with them under the Affordable Care Act?\r\n\r\nA: The good news, Simona, is that your daughters may have several options and their coverage could fall into place easily.\r\n\r\nOr not.\r\n\r\nLet’s cross our fingers and begin with “could fall into place easily.”","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16627 http://blogs.kqed.org/stateofhealth/?p=16627","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/11/obamacare-faq-what-are-options-for-college-students-and-young-adults/","disqusTitle":"Obamacare FAQ: What Are Options for College Students and Young Adults?","path":"/stateofhealth/16627/obamacare-faq-what-are-options-for-college-students-and-young-adults","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16635\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/39274732@N05/4998398713/in/photolist-8BG6Na-cEHJ9d-8F6mwa-8ETDSC-8F6muF-bPP71V-9WHy5y-9WEJE8-9WEQCk-9WHQou-9WHrUf-9WERei-9WHHRj-9WHNc5-9WHEa5-9WHUmq-9WEZzM-9WEHZD-9WHBuL-9WF2Uz-9WEYND-9WHui7-9WHPx9-9WEDna-9WHCuQ-9WHszQ-9WHts7-9WEL62-9WHyUA-9WEUut-9WEPBB-9WHDcL-9WF1BM-9WHJML-9WHNXQ-9WEEtK-9WETP8-9WHG5h-9WHMMs-9WHxmC-9WF2qp-9WENYx-9WHRZN-9WHLUU-cEJAgJ-ce1HnA-bYbpKb-aqzLvN-aM4MWP-82a21N-8ETDVC\">\u003cimg class=\"size-full wp-image-16635\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/4998398713_88352f0375_z.jpg\" alt=\"(Mike Adams/Flickr)\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/12/4998398713_88352f0375_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/4998398713_88352f0375_z-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/12/4998398713_88352f0375_z-320x214.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Mike Adams/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We are running one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/how-will-young-adults-and-college-students-fare-under-obamacare1145\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Q: My youngest child is 21 and graduated from college in May. My other daughter is 24 and is still a college student in Stockton. What are my options with them under the Affordable Care Act?\u003c/strong>\u003c/p>\n\u003cp>A: The good news, Simona, is that your daughters may have several options and their coverage could fall into place easily.\u003c/p>\n\u003cp>Or not.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Let’s cross our fingers and begin with “could fall into place easily.”\u003c/p>\n\u003cp>Starting in January, \u003ca href=\"http://centerforhealthreporting.org/article/obamacare%E2%80%99s-insurance-requirement-where-do-you-fit1104\" target=\"_blank\">most Americans\u003c/a> will be required to carry a minimum level of health insurance or pay a tax penalty. That includes your daughters and other young adults 18 and over.\u003c!--more-->\u003c/p>\n\u003cp>\u003ca href=\"https://www.healthcare.gov/how-does-the-health-care-law-protect-me/#part=7\" target=\"_blank\">One provision of Obamacare that already went into effect\u003c/a> allows parents to keep their young-adult children on their insurance policies up to age 26.\u003c/p>\n\u003cp>“I suspect that’s the route that many college students are going to take,” says Steven Bloom, director of federal relations for the American Council on Education.\u003c/p>\n\u003cp>If that’s not an option, many universities offer health insurance that will meet Obamacare requirements, Bloom says.\u003c/p>\n\u003cp>But it could cost. My editor just received a bill for a semester’s worth of health coverage for his daughter, who attends Prescott College in Arizona: $767.\u003c/p>\n\u003cp>So, shop around because two major Obamacare-related changes coming in January could provide new, affordable options to young adults:\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.dhcs.ca.gov/Services/medi-cal/pages/whatismedi-cal.aspx\" target=\"_blank\">Medi-Cal\u003c/a>, public health insurance for low-income Californians, will broaden its eligibility requirements, raising the income threshold and opening the program to those who were previously ineligible, such as childless adults.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>This could be promising because young adults often don’t work full time -- whether they’re attending college or not -- and may soon qualify.\u003c/p>\n\u003cp>Please note that if you claim your young-adult child as a tax dependent, your income will count toward your child’s income for Medi-Cal eligibility purposes, says Tony Cava of the state Department of Health Care Services.\u003c/p>\n\u003cp>The result? Your child may not qualify.\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the state's insurance marketplace, begins open enrollment in October sells a variety of health plans. To make those plans more affordable, it also will offer sliding-scale tax credits to Californians earning between 138 percent and 400 percent of the federal poverty level (click \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">here\u003c/a> for FPL guidelines).\u003c/li>\n\u003c/ul>\n\u003cp>Young adults, even those who have access to college health plans, can purchase a plan from Covered California instead. Students \u003ca href=\"http://www.npr.org/blogs/health/2013/07/02/197994339/federal-rule-extends-subsidies-for-college-students\" target=\"_blank\">will be eligible for tax credits\u003c/a> if their incomes fall within the guidelines.\u003c/p>\n\u003cp>But beware the dreaded tax caveat: For a student to be eligible for tax subsidies, no one can claim him or her as a dependent on tax returns.\u003c/p>\n\u003cp>To complicate matters further, the student won’t even qualify for the subsidies if he or she is merely \u003cem>eligible\u003c/em> to be claimed as a dependent, says Anne Gonzales, a Covered California spokeswoman.\u003c/p>\n\u003cp>(One way around that: If you as a parent qualify for tax credits, you can add your young-adult child to a family plan and receive financial assistance for premiums that way, Gonzales notes.)\u003c/p>\n\u003cp>Whew. Now you know what I meant earlier by “Or not.”\u003c/p>\n\u003cp>Here’s one final option: Covered California will offer a low-cost catastrophic plan for young adults under 30 and for individuals who cannot find affordable health coverage. (Click \u003ca href=\"http://www.bcbsm.com/content/microsites/health-care-reform/en/reform-alerts/cms-issues-proposed-rule-catastrophic-plans.html\" target=\"_blank\">here\u003c/a> to learn more about what’s considered “affordable.”)\u003c/p>\n\u003cp>All costs (except for preventive care and the first three office visits each year) will be out-of-pocket until the $6,400 annual deductible is reached.\u003c/p>\n\u003cp>\u003cstrong>Q: What about my daughter who just graduated?\u003c/strong>\u003c/p>\n\u003cp>A: She will have many of the same options as college students. And if she lands a job, her new employer may offer coverage.\u003c/p>\n\u003cp>More campuses also may start allowing graduating students to remain on their health plan for a limited period, such as three to six months, Bloom says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Once that period is over,” he adds, “then former students, like all other Americans, are going to have to find health insurance.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16627/obamacare-faq-what-are-options-for-college-students-and-young-adults","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_294","stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16635","label":"stateofhealth"},"stateofhealth_16598":{"type":"posts","id":"stateofhealth_16598","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16598","score":null,"sort":[1386701226000]},"guestAuthors":[],"slug":"will-you-qualify-for-medi-cal-under-obamacare","title":"Obamacare FAQ: Will You Qualify for Medi-Cal?","publishDate":1386701226,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16605\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450746397-e1386701134397.jpg\">\u003cimg class=\"size-large wp-image-16605\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450746397-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We will run one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/will-you-qualify-medi-cal-under-obamacare1178\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>While more than \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/22/both-young-and-old-signing-up-for-covered-california/\" target=\"_blank\">80,000 people have enrolled\u003c/a> in coverage through Covered California, an additional 140,000 people appear to be eligible for Medi-Cal, the state's version of the Medicaid program for low-income residents. It's part of the Medicaid expansion, which is expected to include people of all stripes, from young adults and college students to single, older men. It could include you.\u003c/p>\n\u003cp>\u003cstrong>Q: How will Medi-Cal eligibility be expanded? My 37-year-old, single daughter is currently not eligible.\u003c/strong>\u003c/p>\n\u003cp>A: Medi-Cal provides medical services to more than 8 million low-income Californians. The expansion is expected to make roughly 1.4 million state residents newly eligible.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Will Jack of San Clemente’s daughter be among them? I don’t know for sure, but at least one detail he shared sounds promising.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dhcs.ca.gov/Pages/Medi-CalExpansionInformation.aspx\" target=\"_blank\">Under the expansion\u003c/a>, the income threshold to qualify for Medi-Cal will go up to 138 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">Federal Poverty Level\u003c/a>. This year, that computes to about $15,800 for an individual and $32,500 for a family of four.\u003c/p>\n\u003cp>Perhaps even more momentous (pay attention here, Jack), the program will be open to childless adults, who were previously ineligible. This is where the college students and single, older males come in, and single, 37-year-old females, too.\u003c/p>\n\u003cp>A few other important details:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>If you’re newly eligible, most of you will have to enroll in Medi-Cal managed care.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Most lawfully present immigrants will be eligible for full benefits under the Medi-Cal expansion. Those who are in the country without proper documents will not.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Asset tests and property limits will go away for most new applicants. \u003ca href=\"http://healthconsumer.org/New_Health_Law_CA_IssueBrief_6_Final.pdf\" target=\"_blank\">There are some exceptions\u003c/a>, especially if you’re \u003ca href=\"http://centerforhealthreporting.org/article/searching-right-insurance-under-obamacare1101\" target=\"_blank\">65 or older\u003c/a> or have a disability.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>If you’re eligible for Medi-Cal, that makes you ineligible for tax credits from Covered California. You could still opt out of Medi-Cal and buy a plan from the exchange, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/17/medi-cal-and-obamacare-some-surprising-twists/\" target=\"_blank\">but you’d have to pay full price\u003c/a>.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Q: I’m 55 years old with no dependents and am employed part-time. I currently have individual health insurance that costs me almost 20 percent of my monthly income. My income makes me eligible for Medi-Cal starting next year. Will I still be eligible even though I currently have individual insurance? \u003c/strong>\u003c/p>\n\u003cp>A: This may come as a surprise to Howard, who hails from Fresno, but you don’t have to be unemployed -- or uninsured -- to qualify for the Medi-Cal expansion.\u003c/p>\n\u003cp>You can drop your expensive, individual market plan and enroll in Medi-Cal instead. Assuming that you qualify.\u003c/p>\n\u003cp>The same goes for those who have health coverage through an employer. You, too, can join Medi-Cal if you qualify.\u003c/p>\n\u003cp>This won’t be a rare occurrence. According to \u003ca href=\"http://laborcenter.berkeley.edu/healthcare/resources/CalSIM_Statewide.pdf\" target=\"_blank\">an analysis\u003c/a> by the UC Berkeley Center for Labor Research and Education, 310,000 Californians who would have otherwise gotten job-based insurance next year will be newly eligible for Medi-Cal. About 240,000 more would have had individual market plans, like Howard.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained -- A Guide for Californians\u003c/a>]\u003c/p>\n\u003cp>“Many folks in the individual market or who have job-based coverage are finding the premiums they’re paying now are unaffordable,” says Laurel Lucia, an Obamacare expert at the center.\u003c/p>\n\u003cp>“There won’t be any premiums in Medi-Cal and the benefits will be more generous than what they’re probably getting in the individual market.”\u003c/p>\n\u003cp>\u003cstrong>Q: How do I sign up?\u003c/strong>\u003c/p>\n\u003cp>A: Start with the Covered California -- with its \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">website\u003c/a> or phone number: 1-800-300-1506. The idea is that Covered California agents will act as a one-stop-shop to help you figure out what program you’re eligible for and sign you up. If they can’t close the transaction themselves, they’ll transfer you to your county Medi-Cal office.\u003c/p>\n\u003cp>Let’s hope it’s as simple and easy as the bigwigs say it will be.\u003c/p>\n\u003cp>A final reminder: You have until Dec. 23 to enroll for coverage that starts Jan. 1. The open-enrollment period will last for six months, through March 31, 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Q: How will Medi-Cal eligibility be expanded? My 37-year-old, single daughter is currently not eligible.\r\n\r\nA: Medi-Cal provides medical services to more than 8 million low-income Californians. The expansion is expected to make roughly 1.4 million state residents newly eligible.\r\n\r\nWill Jack of San Clemente’s daughter be among them? I don’t know for sure, but at least one detail he shared sounds promising.","status":"publish","parent":0,"modified":1386782396,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":794},"headData":{"title":"Obamacare FAQ: Will You Qualify for Medi-Cal? | KQED","description":"Q: How will Medi-Cal eligibility be expanded? My 37-year-old, single daughter is currently not eligible.\r\n\r\nA: Medi-Cal provides medical services to more than 8 million low-income Californians. The expansion is expected to make roughly 1.4 million state residents newly eligible.\r\n\r\nWill Jack of San Clemente’s daughter be among them? I don’t know for sure, but at least one detail he shared sounds promising.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16598 http://blogs.kqed.org/stateofhealth/?p=16598","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/10/will-you-qualify-for-medi-cal-under-obamacare/","disqusTitle":"Obamacare FAQ: Will You Qualify for Medi-Cal?","path":"/stateofhealth/16598/will-you-qualify-for-medi-cal-under-obamacare","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16605\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450746397-e1386701134397.jpg\">\u003cimg class=\"size-large wp-image-16605\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/450746397-640x425.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor’s note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We will run one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED’s Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/will-you-qualify-medi-cal-under-obamacare1178\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>While more than \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/11/22/both-young-and-old-signing-up-for-covered-california/\" target=\"_blank\">80,000 people have enrolled\u003c/a> in coverage through Covered California, an additional 140,000 people appear to be eligible for Medi-Cal, the state's version of the Medicaid program for low-income residents. It's part of the Medicaid expansion, which is expected to include people of all stripes, from young adults and college students to single, older men. It could include you.\u003c/p>\n\u003cp>\u003cstrong>Q: How will Medi-Cal eligibility be expanded? My 37-year-old, single daughter is currently not eligible.\u003c/strong>\u003c/p>\n\u003cp>A: Medi-Cal provides medical services to more than 8 million low-income Californians. The expansion is expected to make roughly 1.4 million state residents newly eligible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Will Jack of San Clemente’s daughter be among them? I don’t know for sure, but at least one detail he shared sounds promising.\u003c/p>\n\u003cp>\u003ca href=\"http://www.dhcs.ca.gov/Pages/Medi-CalExpansionInformation.aspx\" target=\"_blank\">Under the expansion\u003c/a>, the income threshold to qualify for Medi-Cal will go up to 138 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">Federal Poverty Level\u003c/a>. This year, that computes to about $15,800 for an individual and $32,500 for a family of four.\u003c/p>\n\u003cp>Perhaps even more momentous (pay attention here, Jack), the program will be open to childless adults, who were previously ineligible. This is where the college students and single, older males come in, and single, 37-year-old females, too.\u003c/p>\n\u003cp>A few other important details:\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>If you’re newly eligible, most of you will have to enroll in Medi-Cal managed care.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Most lawfully present immigrants will be eligible for full benefits under the Medi-Cal expansion. Those who are in the country without proper documents will not.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>Asset tests and property limits will go away for most new applicants. \u003ca href=\"http://healthconsumer.org/New_Health_Law_CA_IssueBrief_6_Final.pdf\" target=\"_blank\">There are some exceptions\u003c/a>, especially if you’re \u003ca href=\"http://centerforhealthreporting.org/article/searching-right-insurance-under-obamacare1101\" target=\"_blank\">65 or older\u003c/a> or have a disability.\u003c/li>\n\u003c/ul>\n\u003cul>\n\u003cli>If you’re eligible for Medi-Cal, that makes you ineligible for tax credits from Covered California. You could still opt out of Medi-Cal and buy a plan from the exchange, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/17/medi-cal-and-obamacare-some-surprising-twists/\" target=\"_blank\">but you’d have to pay full price\u003c/a>.\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>Q: I’m 55 years old with no dependents and am employed part-time. I currently have individual health insurance that costs me almost 20 percent of my monthly income. My income makes me eligible for Medi-Cal starting next year. Will I still be eligible even though I currently have individual insurance? \u003c/strong>\u003c/p>\n\u003cp>A: This may come as a surprise to Howard, who hails from Fresno, but you don’t have to be unemployed -- or uninsured -- to qualify for the Medi-Cal expansion.\u003c/p>\n\u003cp>You can drop your expensive, individual market plan and enroll in Medi-Cal instead. Assuming that you qualify.\u003c/p>\n\u003cp>The same goes for those who have health coverage through an employer. You, too, can join Medi-Cal if you qualify.\u003c/p>\n\u003cp>This won’t be a rare occurrence. According to \u003ca href=\"http://laborcenter.berkeley.edu/healthcare/resources/CalSIM_Statewide.pdf\" target=\"_blank\">an analysis\u003c/a> by the UC Berkeley Center for Labor Research and Education, 310,000 Californians who would have otherwise gotten job-based insurance next year will be newly eligible for Medi-Cal. About 240,000 more would have had individual market plans, like Howard.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Related:\u003c/strong> \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained -- A Guide for Californians\u003c/a>]\u003c/p>\n\u003cp>“Many folks in the individual market or who have job-based coverage are finding the premiums they’re paying now are unaffordable,” says Laurel Lucia, an Obamacare expert at the center.\u003c/p>\n\u003cp>“There won’t be any premiums in Medi-Cal and the benefits will be more generous than what they’re probably getting in the individual market.”\u003c/p>\n\u003cp>\u003cstrong>Q: How do I sign up?\u003c/strong>\u003c/p>\n\u003cp>A: Start with the Covered California -- with its \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">website\u003c/a> or phone number: 1-800-300-1506. The idea is that Covered California agents will act as a one-stop-shop to help you figure out what program you’re eligible for and sign you up. If they can’t close the transaction themselves, they’ll transfer you to your county Medi-Cal office.\u003c/p>\n\u003cp>Let’s hope it’s as simple and easy as the bigwigs say it will be.\u003c/p>\n\u003cp>A final reminder: You have until Dec. 23 to enroll for coverage that starts Jan. 1. The open-enrollment period will last for six months, through March 31, 2014.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16598/will-you-qualify-for-medi-cal-under-obamacare","authors":["8344"],"categories":["stateofhealth_15"],"tags":["stateofhealth_294","stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16605","label":"stateofhealth"},"stateofhealth_16564":{"type":"posts","id":"stateofhealth_16564","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16564","score":null,"sort":[1386616777000]},"guestAuthors":[],"slug":"obamacare-qa-work-based-health-insurance-what-is-the-kid-glitch-consumer-questions-answers-aca","title":"Obamacare FAQ: Can I Drop My Employer-Offered Insurance?","publishDate":1386616777,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16572\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/120724245-e1386616233892.jpg\">\u003cimg class=\"size-large wp-image-16572\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/120724245-640x480.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor's note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We will run one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Today's installment comes from the \u003ca href=\"http://centerforhealthreporting.org/project/ask-emily-answers-consumer-questions-about-obamacare\" target=\"_blank\">Center for Health Reporting's Ask Emily\u003c/a> column. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED's Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Q: If my husband’s employer offers health care insurance but it is unaffordable, where does that leave us? Will we qualify for help under Obamacare or will we be out in the cold? We make about $45,000 annually.\u003c/strong>\u003c/p>\n\u003cp>A: Apparently, lots of you dislike the health insurance options offered by your employers.\u003c/p>\n\u003cp>Carrie from the Sacramento suburbs submitted this question, but I’ve received a crush of similar queries from all over the state.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Your most common complaint? The coverage is too expensive. The runner-up: The plans your employers offer don’t cover certain benefits, doctors or hospitals.\u003c!--more-->\u003c/p>\n\u003cp>Work is where most of us get our health insurance (if we have it). Though the rate has dropped over time, \u003ca href=\"http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf405434\" target=\"_blank\">53 percent of Californians\u003c/a> received their coverage through an employer (or the employer of a family member) in 2010-2011.\u003c/p>\n\u003cp>Starting Jan. 1, when the major provisions of the Affordable Care Act take effect, you’ll be free to ditch your employer’s coverage and shop for plans on your own, either through the state-run insurance marketplace called \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> or on the open insurance market.\u003c/p>\n\u003cp>Whether you will be eligible for tax credits to offset your premiums is a whole other matter.\u003c/p>\n\u003cp>Covered California will offer \u003ca href=\"https://www.coveredca.com/coverage-basics/PDFs/CC-health-plans-booklet-rev3.pdf\" target=\"_blank\">2-6 health plans in each region of the state\u003c/a> that cover a standard set of benefits. Individuals and families who earn between 138 percent and 400 percent of the federal poverty level will be eligible for sliding-scale tax credits. That's about $15,800 to $46,00 for an individual or $32,500 to $94,000 for a family of four.\u003c/p>\n\u003cp>Do you clear the income hurdle? Don’t get too excited yet, because even if you fall within that income range, you’re not automatically eligible for the tax credits through Covered California.\u003c/p>\n\u003cp>Instead, you qualify for the credits if your employer’s insurance is considered “\u003ca href=\"http://mn.gov/health-reform/images/WG-Access-2012-03-08-Summary-of-Health-Care-Affordability%20Provisions.pdf\" target=\"_blank\">unaffordable\u003c/a>.” That happens when:\u003c/p>\n\u003cul>\n\u003cli>The employee’s share of the insurance premium to cover him- or herself only is more than 9.5 percent of annual household income. If the employer offers multiple plan options, the test applies to the lowest-cost option.\u003c/li>\n\u003c/ul>\n\u003cp>or\u003c/p>\n\u003cul>\n\u003cli>Your employer’s insurance covers, on average, less than 60 percent of your medical expenses, leaving you with expenses of 40 percent or more.\u003c/li>\n\u003c/ul>\n\u003cp>The income and affordability tests are two big hurdles. You’d need to clear them both if you want the tax credits. (For more details, check out this \u003ca href=\"http://www.irs.gov/uac/Newsroom/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act\" target=\"_blank\">Internal Revenue Service Q&A\u003c/a>.)\u003c/p>\n\u003cp>But there's a third hurdle for readers like Carrie, who need family or dependent coverage. It’s what \u003ca href=\"http://hpm.ph.ucla.edu/faculty/dylan-roby-phd\" target=\"_blank\">Dylan Roby\u003c/a>, a health reform expert at UCLA, calls “\u003ca href=\"http://centerforhealthreporting.org/article/%E2%80%9Ckid-glitch%E2%80%9D-could-your-family-fall-obamacare%E2%80%99s-affordability-gap1131\" target=\"_blank\">the kid glitch\u003c/a>.”\u003c/p>\n\u003cp>In Carrie's case, the employer-sponsored health plan options for herself, her husband and their 14-year old daughter run from $677 to $924 each month, which is expensive for them. But then Carrie told me this: “In fairness, the company DOES cover the employee alone much more generously.”\u003c/p>\n\u003cp>Gulp.\u003c/p>\n\u003cp>That last sentence may put Carrie and her family in a category of people -- specifically spouses, children and dependents -- who will not be able to take advantage of affordable options under Obamacare.\u003c/p>\n\u003cp>Here’s the glitch: If coverage for the employee alone is less than 9.5 percent of household income, then that employee AND his or her family members are ineligible for tax subsidies. Not even if the cost of family coverage exceeds 9.5 percent of household income.\u003c/p>\n\u003cp>“You’ll end up with some kids who would have gotten subsidized coverage from the exchange on a family plan who won’t because the employer is offering single coverage that’s affordable, but family coverage that is not,” Roby explains.\u003c/p>\n\u003cp>So, where does that leave Carrie and others in her situation? They need to do the math –- carefully -– and cross their fingers that they’re not victims of the kid glitch.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Q: If my husband’s employer offers health care insurance but it is unaffordable, where does that leave us? Will we qualify for help under Obamacare or will we be out in the cold? We make about $45,000 annually.\r\n\r\nA: Apparently, lots of you dislike the health insurance options offered by your employers.\r\n\r\nCarrie from the Sacramento suburbs submitted this question, but I’ve received a crush of similar queries from all over the state.","status":"publish","parent":0,"modified":1386782444,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":771},"headData":{"title":"Obamacare FAQ: Can I Drop My Employer-Offered Insurance? | KQED","description":"Q: If my husband’s employer offers health care insurance but it is unaffordable, where does that leave us? Will we qualify for help under Obamacare or will we be out in the cold? We make about $45,000 annually.\r\n\r\nA: Apparently, lots of you dislike the health insurance options offered by your employers.\r\n\r\nCarrie from the Sacramento suburbs submitted this question, but I’ve received a crush of similar queries from all over the state.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"16564 http://blogs.kqed.org/stateofhealth/?p=16564","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/09/obamacare-qa-work-based-health-insurance-what-is-the-kid-glitch-consumer-questions-answers-aca/","disqusTitle":"Obamacare FAQ: Can I Drop My Employer-Offered Insurance?","path":"/stateofhealth/16564/obamacare-qa-work-based-health-insurance-what-is-the-kid-glitch-consumer-questions-answers-aca","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16572\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/120724245-e1386616233892.jpg\">\u003cimg class=\"size-large wp-image-16572\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/12/120724245-640x480.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cem>Editor's note: For people buying on the individual market who want health insurance starting Jan. 1, the deadline to sign up is Monday, Dec. 23. We will run one post a day with questions and answers on the Affordable Care Act and Covered California until that deadline. Today's installment comes from the \u003ca href=\"http://centerforhealthreporting.org/project/ask-emily-answers-consumer-questions-about-obamacare\" target=\"_blank\">Center for Health Reporting's Ask Emily\u003c/a> column. Readers can also consult \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">KQED's Obamacare Guide\u003c/a>, written specifically for Californians.\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>By Emily Bazar\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Q: If my husband’s employer offers health care insurance but it is unaffordable, where does that leave us? Will we qualify for help under Obamacare or will we be out in the cold? We make about $45,000 annually.\u003c/strong>\u003c/p>\n\u003cp>A: Apparently, lots of you dislike the health insurance options offered by your employers.\u003c/p>\n\u003cp>Carrie from the Sacramento suburbs submitted this question, but I’ve received a crush of similar queries from all over the state.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Your most common complaint? The coverage is too expensive. The runner-up: The plans your employers offer don’t cover certain benefits, doctors or hospitals.\u003c!--more-->\u003c/p>\n\u003cp>Work is where most of us get our health insurance (if we have it). Though the rate has dropped over time, \u003ca href=\"http://www.rwjf.org/content/dam/farm/reports/reports/2013/rwjf405434\" target=\"_blank\">53 percent of Californians\u003c/a> received their coverage through an employer (or the employer of a family member) in 2010-2011.\u003c/p>\n\u003cp>Starting Jan. 1, when the major provisions of the Affordable Care Act take effect, you’ll be free to ditch your employer’s coverage and shop for plans on your own, either through the state-run insurance marketplace called \u003ca href=\"http://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a> or on the open insurance market.\u003c/p>\n\u003cp>Whether you will be eligible for tax credits to offset your premiums is a whole other matter.\u003c/p>\n\u003cp>Covered California will offer \u003ca href=\"https://www.coveredca.com/coverage-basics/PDFs/CC-health-plans-booklet-rev3.pdf\" target=\"_blank\">2-6 health plans in each region of the state\u003c/a> that cover a standard set of benefits. Individuals and families who earn between 138 percent and 400 percent of the federal poverty level will be eligible for sliding-scale tax credits. That's about $15,800 to $46,00 for an individual or $32,500 to $94,000 for a family of four.\u003c/p>\n\u003cp>Do you clear the income hurdle? Don’t get too excited yet, because even if you fall within that income range, you’re not automatically eligible for the tax credits through Covered California.\u003c/p>\n\u003cp>Instead, you qualify for the credits if your employer’s insurance is considered “\u003ca href=\"http://mn.gov/health-reform/images/WG-Access-2012-03-08-Summary-of-Health-Care-Affordability%20Provisions.pdf\" target=\"_blank\">unaffordable\u003c/a>.” That happens when:\u003c/p>\n\u003cul>\n\u003cli>The employee’s share of the insurance premium to cover him- or herself only is more than 9.5 percent of annual household income. If the employer offers multiple plan options, the test applies to the lowest-cost option.\u003c/li>\n\u003c/ul>\n\u003cp>or\u003c/p>\n\u003cul>\n\u003cli>Your employer’s insurance covers, on average, less than 60 percent of your medical expenses, leaving you with expenses of 40 percent or more.\u003c/li>\n\u003c/ul>\n\u003cp>The income and affordability tests are two big hurdles. You’d need to clear them both if you want the tax credits. (For more details, check out this \u003ca href=\"http://www.irs.gov/uac/Newsroom/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act\" target=\"_blank\">Internal Revenue Service Q&A\u003c/a>.)\u003c/p>\n\u003cp>But there's a third hurdle for readers like Carrie, who need family or dependent coverage. It’s what \u003ca href=\"http://hpm.ph.ucla.edu/faculty/dylan-roby-phd\" target=\"_blank\">Dylan Roby\u003c/a>, a health reform expert at UCLA, calls “\u003ca href=\"http://centerforhealthreporting.org/article/%E2%80%9Ckid-glitch%E2%80%9D-could-your-family-fall-obamacare%E2%80%99s-affordability-gap1131\" target=\"_blank\">the kid glitch\u003c/a>.”\u003c/p>\n\u003cp>In Carrie's case, the employer-sponsored health plan options for herself, her husband and their 14-year old daughter run from $677 to $924 each month, which is expensive for them. But then Carrie told me this: “In fairness, the company DOES cover the employee alone much more generously.”\u003c/p>\n\u003cp>Gulp.\u003c/p>\n\u003cp>That last sentence may put Carrie and her family in a category of people -- specifically spouses, children and dependents -- who will not be able to take advantage of affordable options under Obamacare.\u003c/p>\n\u003cp>Here’s the glitch: If coverage for the employee alone is less than 9.5 percent of household income, then that employee AND his or her family members are ineligible for tax subsidies. Not even if the cost of family coverage exceeds 9.5 percent of household income.\u003c/p>\n\u003cp>“You’ll end up with some kids who would have gotten subsidized coverage from the exchange on a family plan who won’t because the employer is offering single coverage that’s affordable, but family coverage that is not,” Roby explains.\u003c/p>\n\u003cp>So, where does that leave Carrie and others in her situation? They need to do the math –- carefully -– and cross their fingers that they’re not victims of the kid glitch.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16564/obamacare-qa-work-based-health-insurance-what-is-the-kid-glitch-consumer-questions-answers-aca","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_38","stateofhealth_368","stateofhealth_674"],"featImg":"stateofhealth_16572","label":"stateofhealth"},"stateofhealth_15574":{"type":"posts","id":"stateofhealth_15574","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"15574","score":null,"sort":[1381340337000]},"guestAuthors":[],"slug":"for-legal-immigrants-obamacare-has-options-for-aging-parents","title":"For Legal Immigrants, Obamacare Has Options for Aging Parents","publishDate":1381340337,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_15577\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408.jpg\">\u003cimg class=\"size-large wp-image-15577\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408-640x472.jpg\" alt=\"A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\" width=\"640\" height=\"472\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Mohan Iyer has been in a bind. He's lived in the U.S. since he came here for college from India in 1980. He ultimately got a job, a green card and became a citizen in 1994. Most of his siblings live here now, too.\u003c/p>\n\u003cp>After his father passed away two years ago, Iyer and his siblings have wanted their mother to move here. But there's one big problem: she is effectively barred from any kind of reliable health insurance.\u003c/p>\n\u003cp>\"Health care has been a big issue,\" said Iyer, who is 50 and lives in Menlo Park.\u003c/p>\n\u003caside class=\"pullquote alignleft\">New immigrants of any age can purchase health insurance on Covered California\u003c/aside>\n\u003cp>That's because new immigrants over age 65 are not eligible for Medicare. For legal immigrants like Iyer, who are people of working age, the impossibility of obtaining health insurance for their parents has been a barrier in their hopes of moving aging parents or grandparents to the U.S.\u003c/p>\n\u003cp>Americans over 65 tend not to worry much about health insurance, because of Medicare, the government insurance program for the elderly and the disabled. But while Medicare is available to virtually all citizens, starting at age 65, immigrants legally present in the U.S. for less than five years are not eligible.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And because of the very existence of Medicare, private insurance companies generally do not offer health insurance plans for those over 65. \"There are health insurance options,\" Iyer said, \"but these are usually catastrophic traveler's insurance. They usually have a very high deductible and they're expensive.\"\u003c/p>\n\u003cp>They also tend to exclude pre-existing conditions, he said.\u003c!--more-->\u003c/p>\n\u003cp>\"We've heard horror stories of elderly parents visiting their kids here, having a fall or a cardiac problem and the bill arrives in the range of $100,000.\"\u003c/p>\n\u003cp>As our conversation went on, Iyer was clearly at a loss of what to do. \"It's one thing to say I'll support my mom, and another to say I'm ready for a sudden, six-figure bill that I have to cover.\"\u003c/p>\n\u003cp>I asked him if he was aware that immigrants, even those here less than 5 years (a big cutoff point in immigration policy) were eligible to purchase health insurance In the Covered California marketplace, the new exchange set up to comply with the Affordable Care Act.\u003c/p>\n\u003cp>Iyer lit up. \"Oh, really? Wow, that is huge!\" he exclaimed. \"This has been something I've been sweating.\" He said that finding peace of mind on this issue would be \"a huge deal.\"\u003c/p>\n\u003cp>Tanya Broder in the Oakland office of the National Immigration Law Center said there's \"a lot of confusion\" about immigrants and the ACA. \"Most of the outreach materials and most of the material online are directed at citizens.\"\u003c/p>\n\u003cp>She pointed out that the ACA seems to make the presumption that most people over 65 are receiving Medicare.\u003c/p>\n\u003cp>\"But there's nothing prohibiting someone who is lawfully present in the U.S. but ineligible for Medicare or Medicaid from purchasing coverage in the exchange,\" Broder said.\u003c/p>\n\u003cp>Obamacare provides new options for immigrants under age 65 as well. California is participating in the Medicaid expansion, called Medi-Cal in California. For the first time, individuals (citizens and legal immigrants alike) who do not have children and are not disabled can apply to the program, as long as their income is less than 138 percent of poverty, about $15,500. Immigrants must be here legally, but they do not need to have a green card.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We have more detail in our popular \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Guide\u003c/a>. Click on the \"I am an immigrant\" section.\u003c/p>\n\n","blocks":[],"excerpt":"People over 65 tend not to worry much about health insurance, because of Medicare, the government insurance program for the elderly and the disabled. But while Medicare is available to virtually all citizens, starting at age 65, immigrants legally present in the U.S. for less than five years are not eligible.","status":"publish","parent":0,"modified":1387643480,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":620},"headData":{"title":"For Legal Immigrants, Obamacare Has Options for Aging Parents | KQED","description":"People over 65 tend not to worry much about health insurance, because of Medicare, the government insurance program for the elderly and the disabled. But while Medicare is available to virtually all citizens, starting at age 65, immigrants legally present in the U.S. for less than five years are not eligible.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"15574 http://blogs.kqed.org/stateofhealth/?p=15574","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/10/09/for-legal-immigrants-obamacare-has-options-for-aging-parents/","disqusTitle":"For Legal Immigrants, Obamacare Has Options for Aging Parents","path":"/stateofhealth/15574/for-legal-immigrants-obamacare-has-options-for-aging-parents","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15577\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408.jpg\">\u003cimg class=\"size-large wp-image-15577\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/172615408-640x472.jpg\" alt=\"A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\" width=\"640\" height=\"472\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A view of the the Statue of Liberty. (Timothy Clary/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Mohan Iyer has been in a bind. He's lived in the U.S. since he came here for college from India in 1980. He ultimately got a job, a green card and became a citizen in 1994. Most of his siblings live here now, too.\u003c/p>\n\u003cp>After his father passed away two years ago, Iyer and his siblings have wanted their mother to move here. But there's one big problem: she is effectively barred from any kind of reliable health insurance.\u003c/p>\n\u003cp>\"Health care has been a big issue,\" said Iyer, who is 50 and lives in Menlo Park.\u003c/p>\n\u003caside class=\"pullquote alignleft\">New immigrants of any age can purchase health insurance on Covered California\u003c/aside>\n\u003cp>That's because new immigrants over age 65 are not eligible for Medicare. For legal immigrants like Iyer, who are people of working age, the impossibility of obtaining health insurance for their parents has been a barrier in their hopes of moving aging parents or grandparents to the U.S.\u003c/p>\n\u003cp>Americans over 65 tend not to worry much about health insurance, because of Medicare, the government insurance program for the elderly and the disabled. But while Medicare is available to virtually all citizens, starting at age 65, immigrants legally present in the U.S. for less than five years are not eligible.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And because of the very existence of Medicare, private insurance companies generally do not offer health insurance plans for those over 65. \"There are health insurance options,\" Iyer said, \"but these are usually catastrophic traveler's insurance. They usually have a very high deductible and they're expensive.\"\u003c/p>\n\u003cp>They also tend to exclude pre-existing conditions, he said.\u003c!--more-->\u003c/p>\n\u003cp>\"We've heard horror stories of elderly parents visiting their kids here, having a fall or a cardiac problem and the bill arrives in the range of $100,000.\"\u003c/p>\n\u003cp>As our conversation went on, Iyer was clearly at a loss of what to do. \"It's one thing to say I'll support my mom, and another to say I'm ready for a sudden, six-figure bill that I have to cover.\"\u003c/p>\n\u003cp>I asked him if he was aware that immigrants, even those here less than 5 years (a big cutoff point in immigration policy) were eligible to purchase health insurance In the Covered California marketplace, the new exchange set up to comply with the Affordable Care Act.\u003c/p>\n\u003cp>Iyer lit up. \"Oh, really? Wow, that is huge!\" he exclaimed. \"This has been something I've been sweating.\" He said that finding peace of mind on this issue would be \"a huge deal.\"\u003c/p>\n\u003cp>Tanya Broder in the Oakland office of the National Immigration Law Center said there's \"a lot of confusion\" about immigrants and the ACA. \"Most of the outreach materials and most of the material online are directed at citizens.\"\u003c/p>\n\u003cp>She pointed out that the ACA seems to make the presumption that most people over 65 are receiving Medicare.\u003c/p>\n\u003cp>\"But there's nothing prohibiting someone who is lawfully present in the U.S. but ineligible for Medicare or Medicaid from purchasing coverage in the exchange,\" Broder said.\u003c/p>\n\u003cp>Obamacare provides new options for immigrants under age 65 as well. California is participating in the Medicaid expansion, called Medi-Cal in California. For the first time, individuals (citizens and legal immigrants alike) who do not have children and are not disabled can apply to the program, as long as their income is less than 138 percent of poverty, about $15,500. Immigrants must be here legally, but they do not need to have a green card.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We have more detail in our popular \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Guide\u003c/a>. Click on the \"I am an immigrant\" section.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/15574/for-legal-immigrants-obamacare-has-options-for-aging-parents","authors":["240"],"categories":["stateofhealth_15"],"tags":["stateofhealth_28","stateofhealth_620","stateofhealth_105","stateofhealth_674","stateofhealth_461"],"featImg":"stateofhealth_15577","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. 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