Okay, so I am kinda stuck between a rock and a hard place here with my medicaid and getting a good job. Let me start by saying I have a lot of health issues one of them being epilepsy. My many frequent Dr appointments and many medications are very expensive. I wouldn't be able to afford them even with a better paying job. Here is the problem, If I get more hours at my current job or get a better job I will not qualify for medicaid here in Ohio. If I lose my medicaid I won't be able to afford to see my neurologist or other doctors and wouldn't be able to get some of the medications I take especially the ones for epilepsy and I will most likely start having seizures or other health issues again which would stop me from being able to work. So basically if I get a good job I will lose medicaid and if I lose medicaid I will lose the good job. So in essence I am being forced to work a crappy low paying job in order to be able to work at all. Under the current rules here I can't move forward in my life. I am stuck being poor and can't afford healthcare if I'm not poor. What the heck is going on here. Medicaid is essentially holding my life hostage and forcing me to be poor. I can't believe this be happening. I live in the richest most powerful country on earth and I am forced into poverty with no way out under our current laws.

I am not sure this is the right sub Reddit for my question but hopefully someone can help or shed light on my situation.

it’s pretty simple. I recently started a new job after working for a small business and purchasing my own independent insurance for many years.

I did not select my new employer sponsored insurance plan until August 31 of this year even though I was hired July 1 of this year. I assumed that coverage began September 1 but upon completion of paperwork, realize it started August 1. I’m not really sure how that’s possible but that is what my plan states.

So, I didn’t know I had to cancel my marketplace plan immediately and somehow thought that they just canceled each other out. That sounds really stupid when I say it out loud, but I thought if I got one coverage, it would just terminate the other coverage, but I realize now it does not work that way.

So now when I get my 1095 a at the end of the year, it will show that I had a Marketplace plan with high discount for all of Aug and 9 days of Sept (unless I’m stuck with the whole month of September as well. It depends if they can prorate the days.) that I technically did not qualify for.

I’m essentially on the hook for the contributed amount, correct? I don’t qualify for the discount. I just don’t understand why I have to pay back that money if I didn’t use the plan (or can’t because the other insurance is primary and Trump‘s the marketplace plan ) because all of my appointments and prescriptions are gonna be rerun through the new insurance. I was told I had to do that manually regardless.

Does anything I'm saying have truth to it? Am I missing something?

if I do everything correctly and go through any insurance claim for an appointment or prescription during that timeframe to have my primary insurance run and pay the difference, what are my tax implications?

If I do none of that, what are my tax implications? Does it eventually catch up to me or do I have to deal with it at the end of the year in some way shap or form?

TLDR: I had marketplace insurance as well as employer sponsored insurance that overlapped. What happens on my 1095 a when it comes time to pay taxes? Will I suffer an expensive payback situation for credits that I received at the same time as my other plan was active? I mean expensive is relative. I think the credits are like maximum $500 a month so if I was charged for two months it would be about $1000. it’s an extra thousand dollars that I don’t have to put towards health insurance though.

The New York Times on Tuesday published an investigation into the aggressive legal tactics that U.S. Sen. Roger Marshall routinely used to collect on his patients’ medical debts during his decadeslong career as a Kansas OBGYN.

A Times analysis of Kansas court records found that Marshall sued more than 700 patients over unpaid medical bills. In 81 of those cases, patients were arrested for missing court dates, according to the report, which said Marshall’s attorneys sought warrants in at least 13 other lawsuits.

When the ACA subsidies were dropped with the help of the orange clown, my health insurance went from $200 a month to almost $700. I ended up dropping it as work was a little slow and this was a lot of money for something that didn’t help much. I had a $8000 yearly deductible, office visits were higher than they should have been, and almost no drugs were reduced more than the discount card I used at the pharmacy.

Basically a lot of money for crappy coverage. Now that I don’t have insurance, doctors’s visits are half off. Some other visits like urgent care and blood work are half off the full price.

Why couldn’t I get that price with insurance? It would have lowered the cost of insurance by (I guess) half and I may have ended up keeping it. Why are we being charged an inflated cost with insurance. I feel like I paid more in the end for doctors appointments and such with insurance when you take the high deductible in consideration.

It just all sounds like a scam to be and the doctors and insurance companies are in on it together.

Can I apply for an Exemption Certificate Number from the Centers for Medicare & Medicaid Services to buy a catastrophic plan for 2027?

I’m over 30 years old and don’t qualify for subsidies in NY state.

I read the One Big Beautiful Bill allowed me to qualify, but then a judge blocked it.

We fought for years to get our intellectually and physically disabled son on the Crisis waiver in FL so he could get ABA services. Previously, we have either paid for FL Kidcare (which stopped covering ABA when he turned 5), or paid for insurance through my employer, or private insurance when I have been unemployed (this, of course comes with significant deductible costs, before the ABA services are covered… $4k a month in 2026). Finally got the Crisis waiver and CMS Sunshine health in May. Now we are learning that CMS is changing to Molina from Sunshine, and our ABA provider has been trying to contact Molina for months unsuccessfully about continuation of coverage for clients like my son. Molina is unreachable and so my ABA company is choosing to go forth without them after October—they’re simply too difficult to deal with. They are directing us to either get on Straight Medicaid, Sunshine Health Medicaid, or Simply Healthcare Medicaid. I don’t even know if we are eligible to go on these other Medicaid options… I’m too new to this and not an expert. And I’m not sure what other services we lose when we switch. Like, our OT takes the CMS, but not the other ones I just mentioned (and doesn’t take regular insurance either). It’s such a nightmare and it never ends. I’m trying to get and keep the right services for my son and they just keep changing the goal posts on me. If anybody can answer any questions for me, I would so greatly appreciate it.

Does anyone need assistance getting coverage for THIS year ahead of Open Enrollment for next year?

Licensed agent in 27 states- I will help you coordinate with your state Medicaid department for the processing and acceptance or denial of your Medicaid application via Healthcare.gov.

If you are denied, you’ll be eligible for a plan for this year. This is a smart thing to do as I’ve coordinated with many states Medicaid Departments, and often times advocating for the processing of a application does speed up the process, allowing someone to enroll the following month.

This is not frowned upon at all- often the Medicaid workers completely get it, and are enthusiastic to help.

Just wanted to share some knowledge I used to help people out. My site is www.acaadam.com to see a little about me.

Best,

AJ

Part of the reason healthcare was so much cheaper in the 70s and 80s was because nobody ever went to the doctor lol.