I have no income and don't qualify for Medicaid in Pa. or financial support for the exchanges. What now?

Question: I am a full-time graduate student with no income. I applied for Medicaid several years ago, but was turned down because I had too much money in savings. I have spent some of my savings, but I believe it is still more than what is required to qualify for Medicaid based on the reason I was rejected several years ago. It sounds like I will not qualify for any financial support for the healthcare exchange because I have no income and with no income I should be applying for Medicaid. So unless Medicaid in PA changes their rules on savings, I will not qualify for that either. Does this sound about right? Does the amount of savings one has also get calculated in for the healthcare exchange?

- Gigi

Answer: Gigi, your eligibility for financial assistance will depend on whether you have any income at all. If you earn between 100% and 400% of the federal poverty level, which is between $11,490 and $45,960 in 2013, you will qualify for a subsidy that reduces the cost of insurance that you buy on an exchange. The amount you have in savings will not matter. At 100% of the poverty level, the subsidy will bring the cost to near zero.

If you earn less than that, you will not qualify for a subsidy on an exchange. However, you would qualify for Medicaid, if you live in a state that has chosen to expand their program. Those include New Jersey but, unfortunately, not Pennsylvania.

If you live in a state, like Pennsylvania, that has not expanded Medicaid, you may have one other option for affordable coverage. If you are below the age of 30, you will be able to purchase an inexpensive catastrophic-only policy on an exchange. The coverage will be limited to major medical expenses, but the premiums will be quite low.


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.