Navigating Marriage and Medicaid
My husband and I recently tied the knot at the end of 2024, and we’re working through the complexities of filing our taxes jointly and managing our insurance options.
Currently, he is enrolled in Medicaid due to his income level, but my earnings push us above the eligibility threshold. Unfortunately, my employer only allows me to add dependents during the enrollment period, which isn’t until May.
I have a couple of questions:
1. Will Medicaid allow him to maintain his coverage until May?
2. If he keeps his coverage until then, will he be required to reimburse any costs for procedures or appointments he receives during that time?
Thank you for your help, and I apologize for the lengthy message!
Navigating marriage and changes in insurance can definitely be tricky, especially with Medicaid involved. Here are some considerations regarding your questions:
Medicaid Coverage Until May: Generally, Medicaid coverage is meant to be continuous, as long as the individual remains eligible. If your husband’s income exceeds the Medicaid threshold due to your combined income, he may be notified of a change in his benefits. However, it’s important to communicate with your local Medicaid office about his specific situation. They will provide guidance on whether he can maintain his coverage until May, considering your circumstances.
Repayment for Procedures/Appointments: If he continues to use Medicaid while technically ineligible, Medicaid typically has strict rules regarding overpayments. Depending on state regulations and the specific details of his situation, he may be required to pay back claims if he receives services while above the income threshold. It’s advisable to check with your local Medicaid office. They can clarify how coverage might change and what the implications would be for any medical services received during that time.
It might also be worth exploring options for special enrollment periods that might apply to him due to marriage, as some plans might allow for that outside typical enrollment periods. Consulting with a financial advisor or an insurance navigator can also help clarify your options.
I hope that helps! Don’t hesitate to reach out for more specific information tailored to your situation.