Jann in TX Posted August 31, 2020 Share Posted August 31, 2020 DD 27 is living with us-- she has an 8 month old child. She is getting a small amount of child support... DD is unemployed-- she worked part of last/this year as a PS teacher then went on a medical leave due to 'stress seizures' after the baby's birth... Her insurance benefits through the school expire TOMORROW! Anyone have any idea of where she can get insurance for her and her child? With seizure disorders you have to be documented for one year before you can start applying for disability (6 months from now!). It may be possible for baby-dad to add child to his insurance (DD's plan was much better when she had one)-- if this happens then she will have to draw up new custody agreements ($$) and time... We do not have money on hand to pay out of pocket for her medical care-- she is on several medications too! Any thoughts? Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted August 31, 2020 Share Posted August 31, 2020 It depends on state law. She might be able to get on Medicaid for being low income. Or she might have to buy ACA insurance. I would suggest calling a local independent insurance broker with a good reputation to find out what the boots on the ground laws and availability are. 1 Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted August 31, 2020 Share Posted August 31, 2020 PS. I believe that it is very important to avoid a lapse in coverage, which sometimes results in not being able to get new insurance. So do this TODAY. There might be a grace period on that, I am really not sure, but don’t risk it. Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted August 31, 2020 Share Posted August 31, 2020 (edited) Can she extend through COBRA while she looks at her private plan options? Does her old district have a benefits coordinator who could help? The 8 month old likely would qualify for CHIP or Medicaid but the paper backlog is pretty awful. You can find links at hhs.texas.gov/services/health. Edited August 31, 2020 by prairiewindmomma 3 Quote Link to comment Share on other sites More sharing options...
JustEm Posted August 31, 2020 Share Posted August 31, 2020 yes the backlog is going to be awful right now. So, if you go this route she needs them to date stamp the application and get a copy of it so she can prove that she had the application in on a specific date. Because everything gets back dated to the day you apply. If she is unemployed she may qualify for Medicaid. I do not know how household income is defined in TX but in many states your income wouldn't necessarily effect her for eligibility 1 Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted August 31, 2020 Share Posted August 31, 2020 Fwiw, Texas is known for having difficulties in filing and processing... I would recommend that in the application process that when she has to scan in paperwork that she use a phone app that keeps a digital copy of the papers so that she can easily resubmit. Quote Link to comment Share on other sites More sharing options...
QueenCat Posted August 31, 2020 Share Posted August 31, 2020 I would have her try Medicaid first. Quote Link to comment Share on other sites More sharing options...
happi duck Posted August 31, 2020 Share Posted August 31, 2020 I'm pretty sure COBRA is retroactive...goes back to the first day coverage stopped...as long as you sign up and pay before a certain time. Quote Link to comment Share on other sites More sharing options...
J-rap Posted August 31, 2020 Share Posted August 31, 2020 My dd had a state insurance low-income policy, which actually was great! She was working full-time but her employer wasn't able to offer her health insurance and her income was quite low. At least in our state, there are state health insurance numbers to call and they can help advise you depending on your circumstances. Not sure what it's like there. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted August 31, 2020 Share Posted August 31, 2020 I would try Medicaid first, then low income state insurance, and then the Marketplace. If she has lost her insurance because she lost her job then that is a qualifying life event so she can sign up for the Marketplace now. Quote Link to comment Share on other sites More sharing options...
mum Posted August 31, 2020 Share Posted August 31, 2020 We got insurance through the marketplace that was very affordable, when my husband changed jobs this year and we had 2 months where we would have had no insurance. COBRA may be a good very short term option, just so that she doesn't have a lapse in coverage. Signing up for one month of that would give her, and you, a chance to figure out alternatives. Quote Link to comment Share on other sites More sharing options...
Jann in TX Posted August 31, 2020 Author Share Posted August 31, 2020 (edited) Main issue is that she has ZERO income-- COBRA is totally out of question $$$$. She is unable to work (seizures too frequent). She had to resign her teaching job. No way to work with middle school students when you have seizures several times a day! Disability takes at least a year to get going-- and it will be VERY hard to get. People like my dd just fall through the cracks. I know baby will be able to get insurance somehow-- but I think my dd is out of luck. I want to scream! Edited August 31, 2020 by Jann in TX Quote Link to comment Share on other sites More sharing options...
Scarlett Posted August 31, 2020 Share Posted August 31, 2020 10 minutes ago, Jann in TX said: Main issue is that she has ZERO income-- COBRA is totally out of question $$$$. She is unable to work (seizures too frequent). She had to resign her teaching job. No way to work with middle school students when you have seizures several times a day! Disability takes at least a year to get going-- and it will be VERY hard to get. People like my dd just fall through the cracks. I know baby will be able to get insurance somehow-- but I think my dd is out of luck. I want to scream! https://hhs.texas.gov/services/health/medicaid-chip/programs-services/children-families/medicaid-parents-caretakers I would advise against putting the child on the dad's insurance and having to redo the custody and child support agreement. MUCH better for both parents and baby to be put on medicaid. And then it looks like she should be able to get coverage herself if her child is on medicaid. 3 1 Quote Link to comment Share on other sites More sharing options...
katilac Posted August 31, 2020 Share Posted August 31, 2020 Putting the baby on dad's insurance should not require changing custody agreements, that should not enter into it at all. All he has to do is officially acknowledge paternity, which it sounds like he may have already done if he's paying child support. She needs to at least put in a request for the Cobra paperwork. Medicaid takes a while - they have 45 days to process your application, if you do everything perfectly. Leaving out a document can mean 90 days to get a ruling. So basically she's looking at ACA coverage, hopefully being eligible to enroll because of life events. She should qualify for a subsidized plan. I don't know how long it takes; she needs to be doing this right now. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted August 31, 2020 Share Posted August 31, 2020 1 hour ago, katilac said: Putting the baby on dad's insurance should not require changing custody agreements, that should not enter into it at all. All he has to do is officially acknowledge paternity, which it sounds like he may have already done if he's paying child support. She needs to at least put in a request for the Cobra paperwork. Medicaid takes a while - they have 45 days to process your application, if you do everything perfectly. Leaving out a document can mean 90 days to get a ruling. So basically she's looking at ACA coverage, hopefully being eligible to enroll because of life events. She should qualify for a subsidized plan. I don't know how long it takes; she needs to be doing this right now. It might be harder to get on Medicaid if she is already on ACA. Even if she is uncovered for a bit I would try the Medicaid route first. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted September 1, 2020 Share Posted September 1, 2020 5 minutes ago, Dotwithaperiod said: It is very, very hard for an adult to get Medicaid in TX. That is a fact. Her baby will be able to, though. I think one of the few ways she could get it would be for her to receive social security disability benefits. I’m very sorry. It should not be this way for anyone. Did you see the link I posted? It read like a low income parent caring for a child on Medicaid would be eligible for Medicaid., but 8 know what should happen and what does happen is often very different. if not Medicaid surely ACA.? Quote Link to comment Share on other sites More sharing options...
Scarlett Posted September 1, 2020 Share Posted September 1, 2020 4 minutes ago, Dotwithaperiod said: Yes, a person with a child has to make under $196 or so a month to qualify? That is sick. I think the person also has to prove that they absolutely can not work, tho I’m not sure what that entails. I think that’s where the “very very hard to qualify in TX” comes in. To compare, a one parent home with a child under 18 in NY has to have a yearly income of around $24,000! It was one of the state’s that expanded Medicaid. It is only my opinion, but the differences are due to states deciding their obligations in helping each other. I hope she is able to receive the health care she needs. Ugh. I didn't read that far. Yes that is sick. But maybe Jann's dd will qualify since she currently cannot work at all. Hopefully child support won't count as income in this case. Quote Link to comment Share on other sites More sharing options...
katilac Posted September 1, 2020 Share Posted September 1, 2020 2 hours ago, Dotwithaperiod said: Yes, a person with a child has to make under $196 or so a month to qualify? Well, we wouldn't want to be giving Medicaid to someone who is apparently making quite a few cents per hour. 1 Quote Link to comment Share on other sites More sharing options...
Amy in NH Posted September 1, 2020 Share Posted September 1, 2020 Medicaid is made for this situation. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted September 1, 2020 Share Posted September 1, 2020 22 hours ago, katilac said: Putting the baby on dad's insurance should not require changing custody agreements, that should not enter into it at all. All he has to do is officially acknowledge paternity, which it sounds like he may have already done if he's paying child support. She needs to at least put in a request for the Cobra paperwork. Medicaid takes a while - they have 45 days to process your application, if you do everything perfectly. Leaving out a document can mean 90 days to get a ruling. So basically she's looking at ACA coverage, hopefully being eligible to enroll because of life events. She should qualify for a subsidized plan. I don't know how long it takes; she needs to be doing this right now. My guess is that the amount of the premium the dad would have to pay would alter his child support obligation. I would not mess with that in this situation. As @Amy in NH said Medicaid is made for this situation. Quote Link to comment Share on other sites More sharing options...
katilac Posted September 1, 2020 Share Posted September 1, 2020 33 minutes ago, Scarlett said: My guess is that the amount of the premium the dad would have to pay would alter his child support obligation. I would not mess with that in this situation. As @Amy in NH said Medicaid is made for this situation. Well, if she applies for benefits, the situation is likely to be messed with regardless. Applying for benefits can trigger a look at what the noncustodial parent is paying in child support, whether you want it to or not. If a person has an informal child support agreement, with the noncustodial parent paying 10% of their net, the agency can say no, 20% is the formula. And if they do already meet the formula, some of the child support can be directed to Medicaid or other benefit agencies. It's complicated, but you don't apply for benefits in a vacuum. Also, Medicaid is not a great solution in many areas, it's very dependent on how many and which doctors take it, and so on. I wouldn't put the baby on Medicaid just so the dad doesn't pay more in insurance. On the good news front, Texas no long counts child support as 'income' when calculating benefits. OP, you might try Catholic Charities, they may be able to provide emergency funds for medication while waiting on insurance to kick in. They're usually good about guiding people to the correct resources, as well. You do not have to be Catholic to use them. 2 Quote Link to comment Share on other sites More sharing options...
Scarlett Posted September 1, 2020 Share Posted September 1, 2020 9 minutes ago, katilac said: Well, if she applies for benefits, the situation is likely to be messed with regardless. Applying for benefits can trigger a look at what the noncustodial parent is paying in child support, whether you want it to or not. If a person has an informal child support agreement, with the noncustodial parent paying 10% of their net, the agency can say no, 20% is the formula. And if they do already meet the formula, some of the child support can be directed to Medicaid or other benefit agencies. It's complicated, but you don't apply for benefits in a vacuum. Also, Medicaid is not a great solution in many areas, it's very dependent on how many and which doctors take it, and so on. I wouldn't put the baby on Medicaid just so the dad doesn't pay more in insurance. On the good news front, Texas no long counts child support as 'income' when calculating benefits. OP, you might try Catholic Charities, they may be able to provide emergency funds for medication while waiting on insurance to kick in. They're usually good about guiding people to the correct resources, as well. You do not have to be Catholic to use them. I wasn't suggesting she get medicaid just so the dad doesn't have to pay more. I was thinking it would be better, but then again medicaid in this area is great, so I don't know. Since @Jann in TX said putting the baby on his insurance would require reworking the cs agreement I assumed it was over money.....If the dad has to pay $250 in premiums he will probably want lower cs. Changing up cs agreements is costly. Applying for benefits does not always trigger a look see at the non custodial. @Jann in TX I hope she finds a solution. Has she looked at the Market place yet? Quote Link to comment Share on other sites More sharing options...
katilac Posted September 1, 2020 Share Posted September 1, 2020 27 minutes ago, Scarlett said: I wasn't suggesting she get medicaid just so the dad doesn't have to pay more. I was thinking it would be better, but then again medicaid in this area is great, so I don't know. Since @Jann in TX said putting the baby on his insurance would require reworking the cs agreement I assumed it was over money.....If the dad has to pay $250 in premiums he will probably want lower cs. Changing up cs agreements is costly. Applying for benefits does not always trigger a look see at the non custodial. @Jann in TX I hope she finds a solution. Has she looked at the Market place yet? She said that it might require reworking the custody agreement, which is not the same as child support. Applying for benefits may not always trigger a look at child support, but it certainly can and OP's dd needs to know that. I mean, it's Texas, my guess is that it probably does always happen, lol. It's most assuredly not rare. It can mean that X amount of your child support goes to the state, or that the child isn't eligible for Medicaid because there is a parent who could carry them on private insurance. Every state is different. I wouldn't want the OP's dd to be caught by surprise. If they have a child support agreement that was approved by the courts, I would think he is already paying by the formula, but then I would be surprised that they didn't address health insurance. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted September 1, 2020 Share Posted September 1, 2020 On 8/31/2020 at 11:15 AM, Jann in TX said: DD 27 is living with us-- she has an 8 month old child. She is getting a small amount of child support... DD is unemployed-- she worked part of last/this year as a PS teacher then went on a medical leave due to 'stress seizures' after the baby's birth... Her insurance benefits through the school expire TOMORROW! Anyone have any idea of where she can get insurance for her and her child? With seizure disorders you have to be documented for one year before you can start applying for disability (6 months from now!). It may be possible for baby-dad to add child to his insurance (DD's plan was much better when she had one)-- if this happens then she will have to draw up new custody agreements ($$) and time... We do not have money on hand to pay out of pocket for her medical care-- she is on several medications too! Any thoughts? 11 minutes ago, katilac said: She said that it might require reworking the custody agreement, which is not the same as child support. Applying for benefits may not always trigger a look at child support, but it certainly can and OP's dd needs to know that. I mean, it's Texas, my guess is that it probably does always happen, lol. It's most assuredly not rare. It can mean that X amount of your child support goes to the state, or that the child isn't eligible for Medicaid because there is a parent who could carry them on private insurance. Every state is different. I wouldn't want the OP's dd to be caught by surprise. If they have a child support agreement that was approved by the courts, I would think he is already paying by the formula, but then I would be surprised that they didn't address health insurance. Actually see above she said it would require reworking.....and yes she did say custody but I was assuming (possibly wrongly) that she mean the child support portion of their agreement. My guess is (again I could be wrong) that since @Jann in TX dd had better insurance she insured the baby and that was part of the calculation of cs. Thus since the mom lost that coverage it is not unreasonable that she replace it as best she can in her current circumstances. I am sure they will ask questions of each option and do what is best in this time of crisis. Getting Medicaid now might buy her enough time to be able to file for disability. Quote Link to comment Share on other sites More sharing options...
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