Monday, October 20, 2014
Inquirer Daily News

Does lack of income prevent me from buying coverage on an exchange?

The home page of www.healthcare.gov.
The home page of www.healthcare.gov.

Question: If you are currently unemployed and do not make an income in 2014, but currently buy private insurance, will you be allowed to buy insurance through the state exchanges besides Medicaid? If you can afford private insurance premiums will you still be forced into Medicaid, or will you be able to buy coverage in the exchange without the discounts and subsidies? I guess I do not understand if you are near retirement and are drawing off savings but have the ability to pay how you could be forced into Medicaid. I have gone on my state sight punched in my little income and Medicaid keeps coming up...so I can!t buy anything else at the exchange? And if this is the case and I have to go back to the private insurance market can they charge those exorbant fees since they cannot deny anyone coverage? This is very unclear. A gentleman on your site asked the same question and you told him he would be able to buy on an exchange, but what will you be able to buy?

-Nancy

Answer: Your lack of income does not prevent you from purchasing private coverage on an exchange. However, you would not be able to receive a subsidy to help with the cost, if youare eligible for Medicaid. For those who are close to retirement age, a subsidy could be especially helpful because the premiumsfor private coverage can be quite high. Insurance companies are permitted to charge older people up to three times the amount they charge younger ones.

The exchange website you visitedwas designed to direct youautomatically to Medicaid because most people who are eligible for the program would chose it. To find private coverage options instead, it may be easiest to contact insurance companies directly. They can sell you coverageoutside of an exchange. As long as the policy you purchase meets “minimum essential coverage” requirements, you will avoid the penalty for going without insurance. The insurance company must provide you with a Summary of Benefits and Coverage that states whether the policycomplies.

 


Robert I. Field, Ph.D., J.D., M.P.H. is a professor of law at the Earle Mack School of Law and professor of health management and policy at the School of Public Health at Drexel University. He also writes for The Field Clinic blog. Ask Rob your questions about the new healthcare law.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, Earle Mack School of Law & Drexel School of Public Health
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