Question about medical insurance in PA as a new resident

Submitted by bbystrwbrry t3_zvxa7d in Pennsylvania

Hello! I’m a new resident in PA and I really need help figuring out medical insurance, just for myself . Im a stay at home mom, unmarried, with no income. My son is covered under his fathers insurance, but we are not married so I’m not on his insurance. I tried to apply on Pennie but it requires proof that I have no income….I don’t have proof as I don’t receive any tax documents for just being a stay at home mom lol. Does anyone have any experience like mine, or any advice?? Thank you!!

5

Comments

You must log in or register to comment.

colormeslowly t1_j1rruzt wrote

Curious - no income, how are you supporting yourself?

6

PinsAndBeetles t1_j1ruhvu wrote

It appears OP might live with her child’s father, so I would assume he pays the bills while she’s not working. If they’re unmarried his income will not count in determining her eligibility for Medicaid.

10

ask_the_fisherman t1_j1taif9 wrote

The household income is used to determine eligibility. So what he earns does matter if they live together. The majority of insurance carriers cover the live in partner if the mother of his child. You put them on the family plan as one of the dependants.

0

PinsAndBeetles t1_j1uaf5n wrote

Household income is used for LIHeap but Medicaid is determined differently. I am a caseworker for DHS. His income will not count for her Medicaid.

3

ask_the_fisherman t1_j1vrn8t wrote

Then why was it used for people I know. They were denied mediaid because of the household income. Same with food stamps and other services.

0

PinsAndBeetles t1_j1vv49d wrote

Food stamps are different. People who are mandatory to a household budget (biological and adopted children up to age 22 have to receive with parents, and those with common children under 22 must receive together) and those who purchase and prepare meals together must be on one SNAP budget per FNS/USDA policy. Program eligibility differs across programs depending on how the programs are funded. The policies are all public and can viewed on DHS website. If income calculations were incorrect for someone you know I’d suggest they reapply and file an appeal if denied again. A common problem I also see is people listing partners as “husband” or “wife” and children in the home as “stepchildren” when they’re not actually married.

1

bbystrwbrry OP t1_j1ru2z6 wrote

I’m still with my partner and we live together, so he pays for everything we need. However times are hard right now and paying $300-400 a month for me to have insurance is not possible. I was hoping to get on Medicaid or something cheaper. I’m young and not in need of anything too expansive. Anyway I was told he can claim me on his taxes, which is awesome, but he can’t put me on his medical at work because we are not married I was told. So I’m trying to find out how other people in this situation are getting medical lol

5

colormeslowly t1_j1rx1qf wrote

So technically you do have an income, its just not wages - its money in the form of him taking care of you.

Not sure if any rules have changed but to qualify for medical assistance, they will want to know how you’re financially survivng and telling them you don’t get an income is not going to cut it. That’s why they want proof that you don’t get an income but that in of itself, makes them dig deeper - how are you financially survivng.

They’ll want to know the household income, the household size and living expenses.

Even if you were separated, living on your own with your child - if you get child support, they’ll want to know - it might not be used as income but they’ll still want to know.

If his income exceeds the threshold, then you won’t qualify for pennie/medicaid.

This has been my experience, years ago, i am not sure if things have changed.

3

bbystrwbrry OP t1_j1rxc2y wrote

Thank you for your insight! I totally understand why they want proof. I was confused on how I can obtain proof based on their drop down options on the Pennie website, but I think I got my answer in another comment :)

4

Confident_End_3848 t1_j1uct3j wrote

Anybody without coverage could buy insurance on pennie. But to get the subsidy and not pay full price, you have to meet income limits. Medicaid is a completely different program for low income residents with no insurance.

1

gay_gypsy_barmitzvah t1_j1trg9y wrote

Even though you are unmarried, the good news is you can still be a dependent on your partners health insurance, just like you can be a dependent he can claim on taxes.

3

Confident_End_3848 t1_j1tuqbj wrote

So you are saying your husband’s employer does not allow you to be on his insurance as a domestic partner?

1

bbystrwbrry OP t1_j1u8dbx wrote

Is that a thing in this state? Sorry I’m still pretty new here… My partners father, who has lived here 35 years, is the one who told me I can’t be put on the insurance…..he also has the same insurance and works at the same company so I just assumed he knew what he was talking about

2

Confident_End_3848 t1_j1u9jgs wrote

I would have your husband check to see if domestic partners can be added to his policy. My PA employer covers unmarried partners, but it is not law so some companies do and some don’t.

1

bbystrwbrry OP t1_j1uars3 wrote

I’ll have him double check today. Thank you!

1

dogmomdrinkstea t1_j1uelmd wrote

AFAIK, that's not a thing for everyone in PA. I wasn't eligible to be put on my husband's insurance before we got married, we lived together and I didn't have a job that offered it. It's for spouses and children only.

The good news is the family glitch loophole should be done away with in 2023. It used to be what was considered legally "affordable" was if your spouse's employer offered spousal insurance and the percentage of your income that was paid to insurance was under a certain number - if it was affordable for employee then it was considered affordable for the whole family. For example, my husband paid like $100/mo for his own insurance, but to add me it would be an additional $400+ (and it's not any cheaper if I went through the regular marketplace). That's not actually affordable for us, but legally it was defined as so. Thank the universe, bc I would have had to make the choice to go without health insurance.

Here is a link to read more about the end of the family glitch loophole and how more people can qualify for reduced insurance premiums now.

ETA - "The family loophole glitch was not an accident – basing affordability on the whole family’s premiums would have increased federal costs significantly."

The government is an unlubed dildo.

1

MyCatIsUgly6 t1_j1vjh30 wrote

You can get a statement from SSA. I have no idea if they accept that but…

0

karabo29 t1_j1ty999 wrote

Call Pennie. I just got enrolled. Super SUPER helpful call center reps. I've been at war with health insurance for a while. Pennie really did help me out. Also, vote for any politician who wants to provide healthcare to all of us. So, write in Jesus.

5

Wordnerdinthecity t1_j1rtgub wrote

You can write a note explaining your situation, just like you did here, and upload that as proof. Make sure you also sign and date it.

2

blinkdmb t1_j1rtopd wrote

Fill out a pwea6 form and have it notarized by a local government official for free.

2

blinkdmb t1_j1rtum7 wrote

Also look at your local public assistance as you will prob qualify for Medicaid which is great insurance.

2

bbystrwbrry OP t1_j1rveo0 wrote

Thank you friend. I’m happy to hear Medicaid is also actually a quality option haha.

2

blinkdmb t1_j1rvmyf wrote

Pa also has apple is a great option if you wish to work. It is substadized child care.

1

__sweetpea__ t1_j1u9zdr wrote

Don’t bother getting it notarized. The county assistance office doesn’t care about anything notarized. I’m a former supervisor at a CAO. If you have any specific questions you can message me.

1

PinsAndBeetles t1_j1ru985 wrote

You will qualify for Medicaid and you can supply a statement detailing how your needs are met without income. I’m assuming your partner pays the bills, and if you’re unmarried their income will not count for your Medicaid.

1

bbystrwbrry OP t1_j1rv00i wrote

Thank you! This is what I was hoping to hear.

Edit: can I apply directly through Medicaid or should I continue to go through Pennie? There doesn’t seem to be an option to supply a personal statement

1

discogeek t1_j1s73ok wrote

Just a quick warning... usually *everyone* gets rejected the first time around. This is mostly by design, just follow up with the appeal. Seems some in Harrisburg would rather see who has the need to apply and appeal instead of apply and give up.

If you get turned down the first time don't fret, just do the next step. If you need help, contact your state or local rep, both can help (it's a state program administered by the counties).

2

PinsAndBeetles t1_j1rwhyx wrote

You can apply at your local assistance office or on COMPASS. The COMPASS app is free and you can take a photo of your income statement and upload it with your application.

1

__sweetpea__ t1_j1uai79 wrote

If you apply on pennie and you list you have no income it will be transferred to your local county assistance office anyway. It’s a quicker process to apply directly on compass.

Anyone who applies on Pennie, if the data you enter falls in line with being eligible for Medicaid your application is transferred to the CAO. If you misrepresent your income the CAO sends it back to Pennie. Is a viscous cycle so just be 100% honest on your application. And for others reading this (since you have no income) that means gross income, not net.

1

axeville t1_j1ukqme wrote

Call Medicaid. Typically the insurance company is contracted to run the Medicaid program in each state on a per head basis. They want to find a way to enroll you and the person you speak with is a contractor for the insurance company not a govt person. Eg talk to a human who wants to help vs a computer is designed to follow rules / programming.

1

mfj182 t1_j1uksr9 wrote

Compass.pa.state.us. You can apply for any kind of assistance you need. Or just google Pennsylvania Compass. It’s very easy.

1

dclxvi616 t1_j206m0s wrote

https://www.irs.gov/individuals/get-transcript

An official IRS transcript of your return would probably go a long way if not be sufficient. If you didn't file a return (presumably because you weren't required to) this process results in an official verification of non-filing, which is essentially telling people you didn't have any reportable income.

1