Unique Subsidies/Medicaid Situation in Missouri
My relative reported a one time monthly income of $20,055 before going on a subsidized silver plan through the marketplace starting Jan 1st 2023. It stated in the eligibility PDF that "Likely not eligible for Medicaid because this month's household income of $20,055 is too high". Their income comes strictly from an IRA, which they make withdrawals from.
They live in Missouri. Their estimated yearly income on the top right of the PDF for eligibility states they estimated an ANNUAL income of $20,500
The marketplace apparently also checked them for Medicaid in MO known as MO healthnet.
Here is what has happened and has been happening all year:
1) The marketplace determined $20,055 was eligible for premium subsidies and gave them to her.
2) The medicaid for the state determined they were also eligible for medicaid due them being under 138% of the poverty level. In 2023, that amounts to $20,120 (this is just below a monthly estimate they mistakenly made of $20,055, even though their annual estimate according to the eligibility PDF on healthcare.gov is $20,500, I cannot even access the portion of the application with their stated incomes and how they arranged things without it asking me questions I CAN NOT ANSWER as i Do not have the concrete answers to them!!!), i can only see their eligibility PDF
3) The marketplace granted her both premium subsidies for a silver plan AND sent their details for them up to be determined for medicaid (this is verified by the state, they are signed up). Why this is I assume is due to their inputted monthly income at the time of signing up at healthcare.gov in ~december 2022 to be exactly $20,055 for January (this SOMEHOW is enough to get both medicaid and advance premium tax subsidies). This caused them to be enrolled in Medicaid because of a difference of $~65 in income. Again I can not access their healthcare.gov application aside from their eligibility PDF because I do not know the answers to the questions they are asking, and do not want to screw things up.
What should we do here? What should we expect come tax time? They have just sent a note to the state of Missouri stating to cancel the Medicaid plan for them.
They NEVER used the Medicaid they were given, they only used the marketplace silver plan they signed up (with subsidies). Are they going to have to pay back all of these subsidies?!?! This will not be able to afford housing or food if this is the case.
I have attempted to "report life changes" on their healthcare.gov account so that I can up their estimated annual income (which will actually be $21,000 which would be too much for Medicaid) and it is asking me questions that i DO NOT KNOW the answers to, such as "has this person lost medicaid", if I answer yes (because she sent a notice over the phone and internet guided by a missouri healthnet representatives to cancel the medicaid), it hasn't been cancelled yet, they said it could take until Monday for it to even be seen and confirmed by Missouri's medicaid system. So I can not answer this question!
Now the application on healthcare.gov is stuck in limbo, it was 'Completed' then after I attempted to report life changes it is in the processing stage again, I cannot answer these questions I do not have answers to! I am trying to change the estimated income but I cannot access it without answering questions I have no concrete answers to yet! Help!
Please help this is so confusing it is causing an enormous deal of stress to an already sick person and myself. I have very little idea of what to do here! Missouri Medicaid was of very little help and healthcare.gov is of very little help!
submitted by /u/Electronic_Phase_976
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