Could be a real problem as she sometimes has to have surgeries to fix her tubing.
For anyone that doesnt know, she has hydrocephalous so, without a drain, she gets a build up of fluid on the brain.
Anyway, point is, if she loses medicaid we will likely have to pay for supplemental insurance as an unexpected surgery could break us, or at minimum set us back financially a great deal.
Fluid drains out and makes her go to the bathroom alot. Was a real problem when toilet was clogging, lol, as I had to drive her up to the store to use their bathroom like 4 times in an hour or so one day. lol.
I honestly dont know that much about Obamacare. I was going crazy while he was in office and then got put on disability shortly thereafter. So, I have never really looked at what that all entails.
In other words, I am hardly an expert on insurance.
To be eligible for health coverage under the Affordable Care Act (ACA), individuals generally must live in the United States, be a U.S. citizen or have a lawful immigration status, and not be incarcerated. Additionally, they cannot be eligible for other coverage like Medicare.
Here’s a more detailed breakdown:
General Eligibility Requirements:
Residency: You must live in the United States.
Citizenship/Lawful Presence: You must be a U.S. citizen, U.S. national, or lawfully present in the U.S.
Incarceration: You cannot be incarcerated.
Other Coverage: Generally, you cannot be eligible for other coverage like Medicare.
Specific Scenarios:
Income:
Many individuals and families can receive subsidies (tax credits) to help lower the cost of Marketplace plans, based on their income.
Immigration Status:
Lawful permanent residents (green card holders), refugees, asylees, and certain other non-citizens may also be eligible.
Life Changes:
Certain life events, like losing other coverage, moving, getting married, or having a baby, may qualify you for a special enrollment period, even outside of the annual open enrollment period.
That’s what a lot of people do. @Bowens even just one surgery can put you back $30,000 easily. This is a huge deal and not even sligthtly fixed by switching to Medicare
Both of you are getting older, medical expenses are not an if but when. Maybe dont get the marriage finalized and do the wedding and everything. IDK it seems like an unnecessary risk to assume for no real benefit
[If someone loses Medicaid due to getting married, they should explore options like enrolling in their spouse’s employer-sponsored health plan, or applying for a Marketplace plan through HealthCare.gov, taking advantage of a special enrollment period. They may also be eligible for other state or federal programs. Explanation: 1. Special Enrollment Period: Getting married triggers a special enrollment period, allowing individuals to sign up for a Marketplace plan outside of the usual open enrollment window. This period typically lasts for 60 days before or after the date of the qualifying life event (marriage). 2. Marketplace Plans: Through HealthCare.gov, individuals can browse and enroll in a variety of health insurance plans offered by different insurance companies. Depending on income, these plans may be subsidized, making them more affordable. 3. Employer-Sponsored Coverage: If the spouse has employer-sponsored health insurance, the newly married individual may be eligible to enroll in that plan. This is usually done during the employer’s open enrollment period or within a specific timeframe after marriage. 4. Other Options: Depending on individual circumstances, other state or federal programs might be available. Florida, for example, automatically refers individuals not eligible for Medicaid to other programs like Florida KidCare or Medically Needy. 5. Reporting Changes: It’s crucial to report the change in marital status to Medicaid promptly. Failure to do so can result in penalties or future ineligibility. The change can usually be reported online or by phone through the state’s Medicaid portal or HealthCare.gov. ]–CoPilot
Do you receive healthcare benefits from Amazon? If so, check to see if you can add your future wife to your plan. Also, you may want to see if your future wife qualifies for a Marketplace Plan (you can find out by visiting HealthCare.gov ).
That’s only for fully covered procedures, though, right? I know it varies by state, but I was helping my grandma with switching to a different medicare plan a while ago, and when we factored in all her treatments that aren’t fully covered, it raised the cost well over the maximum out of pocket. This was under the guidance of a medicare representative, who did all the calculations for us. This isn’t my area of expertise, so I apologize if I am way wrong about this. I just had this experience, as well as the experience of having a brain surgery claim denied and being slapped with a bill the size of a mortgage, so it made me worried.
Maximum out of pocket doesn’t include prescription drugs or out of network or services not covered by the plan.
It’s best to know what types of services you’ll most likely need and ask each plan if they cover it before signing up for that particular plan. That’s what I do.
I also check with my insurance for copays for meds for my issues before deciding what meds I can afford. Most of my meds have a $0 copay.
If you need help with this let me know. I used to deal with insurance a lot when I worked in the medical field
When I was married, my wife had a Medigap plan and Medicare and a prescription plan and I had a Medicare advantage plan. It was high premiums but probably saved us money in the long run because she ended in the hospital many times and had multiple surgeries and even an ICU stay. The biggest inconvenience was applying for help directly from drug companies when she hit the donut hole in her prescription plan around July every year.
It was pretty hard living without any section 8 housing help though and we had to get some help from our families in return for caregiving to help cover rent and other expenses.