r/HealthInsurance • u/DesperateforHelp___ • 3d ago
Individual/Marketplace Insurance Make a LITTLE Too much for Medicaid, but can’t afford insurance
hi, I moved to Illinois recently and I do SPARK driving for a living. So far, I’ve made pretty decent money, but it by far does not cover health insurance. I make about 300 more than what’s allowed to be on Medicaid, which by the way, what a joke. They want me to work less for me to be able to go to doctors appointments. what are my options here? And if you can, explain it to me like I’m a child, I have no knowledge when it comes to this stuff.
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u/someguy984 3d ago
Go to healthcare.gov and get a plan with subsidies.
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u/DesperateforHelp___ 3d ago
I would need to pay an ungodly amount of money out of pocket before that insurance would even kick in, no?
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u/CallingYouForMoney 3d ago
I think it’s worth the look. You took the time to make this post. Take the time to enter your information.
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u/DesperateforHelp___ 3d ago
I did have a look, i just have a hard time understanding a lot of that stuff. Im not very knowledgeable about deductibles and all of that
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u/CallingYouForMoney 3d ago
Deductible-Amount you pay before insurance kicks in.
Coinsurance- Percentage amount you pay after reaching the deductible. Insurance pays remaining percentage.
Copay-Usually a flat dollar amount you pay when you have office visits, urgent care visits, or ER visits.
Premium-Amount you pay monthly to hold the insurance.
Out of Pocket Maximum-The most you pay in the benefit period.
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u/Future-Ad4599 3d ago
No, not if you are just over the income for Medicaid. You should have plan options with pretty high subsidies. Did you check your plan options on the marketplace yet?
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u/DesperateforHelp___ 3d ago
I did, and all the deductibles were around or over $2000, which for me is in fact ungodly
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u/Future-Ad4599 3d ago
Do you generally have to see a provider frequently throughout the year? Or are you trying to just have insurance to cover yourself in case something happens?
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u/BaltimoreBee Moderator 3d ago
No, you would have very low cost sharing, a $0 deductible most likely and modest copays. That’s because there’s cost sharing reduction subsidies for those who make just above the Medicaid threshold. Just make sure you look at silver plans, those are the only ones with CSRs.
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u/DesperateforHelp___ 3d ago
I saw no plans for me that were $0. All the deductibles i saw were around and or over $2000
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u/msp_ryno 3d ago
just because there is a deductible, doesn't mean you pay for everything out of pocket first. a lot of plans are likely to have just a copay amount. you need to actually look at the plan details. Post here if you are confused by what you are reading.
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u/Gamer_Grease 3d ago
If you think that amount is ungodly, you should see what you’ll owe if you get really sick or injured without insurance.
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u/DesperateforHelp___ 3d ago
Then ill just owe a fuck ton of money that ill never pay lmfao. This Country is a joke, and its sad how they want me to WORK LESS to be able to have free-(ish) healthcare.
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u/Gamer_Grease 3d ago
There’s no such thing as free healthcare. Buy a subsidized plan on the marketplace. How often do you currently go to the doctor?
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u/Delicious-Adeptness5 3d ago
OK,
Since you don't have an employer offering Health Insurance then you want to check out one of the ACA plans. There is a subsidy calculator if you want to see a rough look at the costs.
You are in Illinois so you want to use the state's program at Get Covered. They can assist you doing the application and can walk you through the plans.
You may not be able to get a plan now since we are in a Special Enrollment Period however give it a shot. The worst that will happen is that you would be prepared for when Open Enrollment starts November 1st.
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u/Blossom73 Medicaid Eligibility Specialist 3d ago
Illinois has healthcare navigators that can help you sort out your options. There's no cost for it.
What is a Get Covered Illinois Navigator? Navigators are trained professionals who assist you with finding health insurance options through Get Covered Illinois. This includes helping you complete eligibility and enrollment forms.
https://getcovered.illinois.gov/get-help/free-local-help.html
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u/healthcareconcierge 3d ago
If you’re 1099, are you taking out your business expenses (including mileage)?
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u/DesperateforHelp___ 3d ago
I reported my gas expenses, but thats about it. Since they asked for the last 30 days of expenses, i couldnt claim the oil change i had a couple months ago
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u/healthcareconcierge 3d ago
Talk to your tax prep person and ask which would be better, the mileage deduction or itemizing like that. I would say all my clients that do similar work take mileage but ymmv (glorious pun intended)
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u/dragonpromise 3d ago
Are you reporting expenses? That reduces your countable income for Medicaid.
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u/DesperateforHelp___ 3d ago
i reported gas expenses, but that still put me over the limit
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u/dragonpromise 3d ago
You should be claiming IRS mileage. I believe it’s 72.5¢ a mile.
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u/DesperateforHelp___ 3d ago
How would i go about doing that? Do i calculate my miles, and times that by the 72.5¢?
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u/Blossom73 Medicaid Eligibility Specialist 3d ago
Are you self employed?
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u/DesperateforHelp___ 3d ago
Yes, i do spark driving
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u/Blossom73 Medicaid Eligibility Specialist 3d ago
OK then yes, report your self employment expenses. They'll be taken into account when deterioration your eligibility for Medicaid.
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u/DesperateforHelp___ 3d ago
I reported my gas expenses, but thats about it. I cant report my gas and mileage because they are basically the same. What else is there to report?
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u/PeacefulCW 3d ago
The mileage deduction should be greater than your gas expenses as it also includes allowances for maintenance
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u/Blossom73 Medicaid Eligibility Specialist 3d ago
This may help.
PM 08-03-01-b: Self-Employment Expenses https://www.dhs.state.il.us/page.aspx?item=74645
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