Affordable Care Act Medicaid Eligibility #162167 - Ask Extension


Affordable Care Act Medicaid Eligibility #162167

Asked December 11, 2013, 8:19 PM EST

Our family is 4 people in a Medicaid expansion state - Maryland. A 54 yr old male and 53 female working but no employer offered healthcare. We have a son 25 and daughter 19. The son and daughter each make less than $15,000 per year.

If I understand this new ACA: they can apply for Medicaid and claim their household is one for each (as long as they file individual tax return for 2014) and therefore they don't include the income of 3 others in our "household". Then the 2 parents (using the Maryland Healthcare Exchange) should add only their 2 incomes -approx $50,000 total and exclude the income of the daughter and son since they file own tax returns.

Therefore the number of people in the family = the same number enrolling in the exchange = 2. Is this correct?

Montgomery County Maryland

Expert Response

Reading your question, there are a few points to consider and there are credible places to call, visit or file online questions specific both to open enrollment through the Maryland Health Connection and through Medicaid help services normally accessed through your local health department. I think the answer, if in fact a Medicaid eligibility determining factor is household size (and I believe it is), at the center of your available options who is living where in this scenario.

Please call or visit your local health department and discuss the living arrangements, income and health care coverage needs of each family member as soon as possible. Incidentally, a 19 year old and a 25 year old child can remain on an employer-based plan as a dependent under the ACA rules (until they turn 26 years old). If either parent has an employer-based insurance plan, this is also an option to consider. Your local health department has trained enrollment specialists available daily to help you weigh the costs and benefits of both Medicaid and/or Exchange coverage as appropriate to your personal circumstances. My best advice is to go talk with the folks at the health department at your earliest convenience. 
Megan O'Neil Replied December 15, 2013, 7:10 PM EST

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