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If you receive a subsidy on the ACA plans, is that considered "Medicaid" in that your assets will have a lien for payment upon your death?
Or does that apply only if you are on complete 100%subsidized Medicaid health plan?
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If you make >100% FPL and buy a metal level insurance plan on an Exchange, you are buying from a private carrier, you are not enrolled in Medicaid. Even if the subsidy pays 100% of your premium (a possibility depending on your age and which plan you select).
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You are referring to the Medicaid Estate Recovery provision of the Omnibus Budget Reconciliation Act of 1993. This law requires states to recover money received for Medicaid from estates. This is nothing new. It has been around for 20 years. What is new is that the ACA makes many more people eligible for Medicaid than previously.
Some things to keep in mind regarding Medicaid Estate Recovery.
1. It applies only to Medicaid benefits received after age 55.
2. Federal law applies only to long term and institutional care, but some states include all Medicaid spending.
3. Recovery cannot take place until after the death of both spouses.
4. Many states are modifying their state laws to reflect the original intent of counting only long term care, not ACA insurance premiums.
5. A plan purchased on the exchange, with or without subsidies, is not Medicaid. In states that extended Medicaid coverage, it applies to those below 138% of the federal poverty level who are directed into a Medicaid program.
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