[Jenny]

My sister just went through a nasty divorce. SAHM, autistic son. I am trying to help her learn about personal finance for the first time in her life, but I know almost nothing about the ACA healthcare marketplace.

My question is about how people are paying very little in premiums. Her alimony will be $48k annually, which I believe doesn’t even count as “income” for the purposes of ACA.

She was referred to a broker (not sure how this person gets paid?) who is quoting her $700/month. But first getting rejected by Medicaid (because alimony will count as “income” for Medicaid).

Is there a minimum required income to qualify for the subsidies?

she’s in North Carolina.

Thanks in advance for any insight.

[Rick]

I dont have specific question feedback but I would strongly encourage her to

1. Don’t sweat it year one and maybe year two. Do a best efforts but expect to get about 80% optimized at very best and likely closer to 60% optimized.

2. Over than next year or two, take the darn time to become an expert in this stuff.

Yes, it is likely boring as heck and as fun as eating sand but it may be the best return on time spent she may have available, at least for a while.

Get to that 95%+ optimized for her aca and Medicaid options for her very specific address, location, city.

It will be totally worth it. Do not ignore this and act like it’s too hard to learn as the cost of that action will be great over time.

[Amie]

Depending on the severity of the autism and the state they live in there could be an option for a Medicaid waiver based on disability rather than income.

[Regina]

She should look online. It’s fairly easy to navigate and you could do it together. I’m sure she would love the support.

Some states have generous income levels for Medicaid. The online system will automatically check if she or son are eligible.

It could be that alimony counts as income but child support does not. But she should double check!

[Moore]

You don’t need a broker. If she does want broker check to see if the city, county, or local hospital offers assistance with getting signed up.

[Chrissy]

Can she just go to the marketplace and apply herself? And what state is she in?

Her child may qualify for a Medicaid waiver for their disability.

[Heidi]

Instead of a classic “broker” who earns commissions, and typically serve clients who can afford to pay full premium, try to find a local “navigator “in her state.

Navigators are usually salaried state employees & knowledgeable about all the state & federal subsidies/discounted/free ACA plans & what are the most affordable options.

Because they do not receive commissions, there is no incentive/disincentive to steer clients to a particular plan.

Google her state and ACA Navigator to find one.

[Author]

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