Author Topic: jersey care  (Read 240518 times)

Offline Eliyohu

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Re: jersey care
« Reply #900 on: December 10, 2018, 11:52:40 PM »
Now I remember. Plan a (county) allows JC as a secondary. Not the other plans
Not an adult? Say an expectant women added to a childs plan that's currently at the state level can't have a different primary insurance?

How long does it take from adding someone to a state plan to get onto the HMO?

Offline Jellybelly

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Re: jersey care
« Reply #901 on: December 10, 2018, 11:58:01 PM »
Anyone knows what happens if you miss a recertification deadline?
My deadline is tomorrow, is my only option to go down
To Toms River or can I just send it in the mail and it’ll get there late?
TIA
« Last Edit: December 11, 2018, 12:04:22 AM by Jellybelly »

Offline churnbabychurn

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Re: jersey care
« Reply #902 on: December 10, 2018, 11:59:28 PM »
Not an adult? Say an expectant women added to a childs plan that's currently at the state level can't have a different primary insurance?

How long does it take from adding someone to a state plan to get onto the HMO?
Pregnant additions would be a

Offline yesitsme

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Re: jersey care
« Reply #903 on: December 11, 2018, 12:00:42 AM »
Pregnant additions would be a
?
Whats plan a b.. ?
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Offline Eliyohu

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Re: jersey care
« Reply #904 on: December 11, 2018, 12:06:20 AM »
Pregnant additions would be a
Even if the child currently on Jersey care is not on plan a?

Offline yesitsme

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Offline Jellybelly

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Re: jersey care
« Reply #906 on: December 11, 2018, 12:14:41 AM »
Anyone knows what happens if you miss a recertification deadline?
My deadline is tomorrow, is my only option to go down
To Toms River or can I just send it in the mail and it’ll get there late?
TIA

Anyone here know?

Offline shulem92

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Re: jersey care
« Reply #907 on: December 11, 2018, 02:28:36 AM »
Not an adult? Say an expectant women added to a childs plan that's currently at the state level can't have a different primary insurance?

How long does it take from adding someone to a state plan to get onto the HMO?
YMMV one time i added someone on to state it went instant. the next time took 4 months (although i did get a letter saying that my HMO was effective from the application date, not just medicaid retroactive...

Offline Eliyohu

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Re: jersey care
« Reply #908 on: December 11, 2018, 08:23:54 AM »
YMMV one time i added someone on to state it went instant. the next time took 4 months (although i did get a letter saying that my HMO was effective from the application date, not just medicaid retroactive...
Thanks, the Medicaid card came months ago.. who would I call regarding trying to get the HMO faster, the state or HMO?

Offline YesThatsMe

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Re: jersey care
« Reply #909 on: December 11, 2018, 01:47:03 PM »
Now I remember. Plan a (county) allows JC as a secondary. Not the other plans

Thanks!

Offline shulem92

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Re: jersey care
« Reply #910 on: December 11, 2018, 03:17:14 PM »
Thanks, the Medicaid card came months ago.. who would I call regarding trying to get the HMO faster, the state or HMO?
it would be the state but they will probably not be helpful. the Hmo only gets their info once your in the system and u wud have gotten a letter first from the state

Offline S209

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Re: jersey care
« Reply #911 on: December 11, 2018, 07:37:38 PM »
When the adults are ineligible because you’re above 147% of the FPL, but the children are eligible for partial/full coverage, and everyone has insurance through an employer, and they want JerseyCare for secondary coverage for the children, is that possible?
I believe yes, I think LRRC had a write up about it in the Voice a few months back. Call them to confirm.
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Online ExGingi

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Re: jersey care
« Reply #912 on: December 13, 2018, 01:02:51 PM »
A friend of mine living in Morris county just got his kids eligible for NJ Family Care based on his current income.

Which of the following has the best doctor network in NJ (and specifically Morris county and vicinity):

Aetna Better Health of NJ
Amerigroup NJ
Horizon NJ Health
UnitedHealthcare Community Plan.
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Offline yakrot

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Re: jersey care
« Reply #913 on: December 17, 2018, 04:18:16 PM »
I have a question about jersey care. I got different information from lrrc and a rep on the phone. Anyone here know if I submit a profit/loss statement to them Will a monthly profit that puts me over the threshold make me ineligible even if I am still good for the year

Offline mendy from lakewood

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Re: jersey care
« Reply #914 on: December 17, 2018, 04:23:31 PM »
I have a question about jersey care. I got different information from lrrc and a rep on the phone. Anyone here know if I submit a profit/loss statement to them Will a monthly profit that puts me over the threshold make me ineligible even if I am still good for the year
I have the same issue and went down to jersey care office and they said that it goes after yearly - I don't know whether to trust the Rep so I might just take myself off
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Re: jersey care
« Reply #915 on: December 17, 2018, 04:36:36 PM »
I have a question about jersey care. I got different information from lrrc and a rep on the phone. Anyone here know if I submit a profit/loss statement to them Will a monthly profit that puts me over the threshold make me ineligible even if I am still good for the year

I can't talk about Jersey Care specifically, but I get these kinds of questions all the time regarding the NY exchange (which I believe operates similarly in regards to income verification).

The truth of the matter is that none of these income based eligibility programs are adequately equipped to handle business income. So if you go with income that qualifies you for an ATPC on the exchange, there's recourse in the form of reconciliation of ATPC with actual Tax Credit that you're eligible for based on filed tax returns.

However, when talking about Medicaid, CHIP or Essential Plan in NY (and IINM also CSR on exchanges) there's very little that could be done. Officially one is required to report every change in income. But as any business owner knows, that's 100% ridiculous, as one often doesn't really know what the actual income is until many months later.

After the above preface, in my experience (on the NY exchange) they ask for either the prior year tax return, or most recent 3 month Profit and Loss statement, broken down month by month (they actually also give an option to submit business records such as bank statements, invoices, etc. but I have no idea what they might do with those. My best guess is that they would look at credits minus debits). They will then average out the 3 months, and count that as your monthly income. IMHO there's absolutely no-way in the world that this could be verified (unless they use costly forensic accounting), and just to be on the safe side, I always recommend that while people submit what they believe to be correct, they should also write on the P&L submitted: UNAUDITED.
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Offline yakrot

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Re: jersey care
« Reply #916 on: December 17, 2018, 05:09:54 PM »
I have the same issue and went down to jersey care office and they said that it goes after yearly - I don't know whether to trust the Rep so I might just take myself off
Lrrc said it would count as yearly ( not putting me over the monthly limit) and not put me over the threshold rep said it would

Offline mendy from lakewood

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Re: jersey care
« Reply #917 on: December 17, 2018, 05:51:10 PM »
Lrrc said it would count as yearly ( not putting me over the monthly limit) and not put me over the threshold rep said it would
i spoke to someone who needed a lawyer because of legal troubles he got into through Jersey care and his lawyer told him that technically if one month you go over the limit then you have to report the income change. Jersey care income eligibility does not realy cater towards someone in my field of real estate where you can make a lot one month a no money the rest of the year. In short there’s a lot of grey area and even if the rep in the office tells you that you are eligible  it will not help if you get into legal trouble.
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Re: jersey care
« Reply #918 on: December 17, 2018, 06:02:22 PM »
i spoke to someone who needed a lawyer because of legal troubles he got into through Jersey care and his lawyer told him that technically if one month you go over the limit then you have to report the income change. Jersey care income eligibility does not realy cater towards someone in my field of real estate where you can make a lot one month a no money the rest of the year. In short there’s a lot of grey area and even if the rep in the office tells you that you are eligible  it will not help if you get into legal trouble.

Which is exactly what I said here:

The truth of the matter is that none of these income based eligibility programs are adequately equipped to handle business income. So if you go with income that qualifies you for an ATPC on the exchange, there's recourse in the form of reconciliation of ATPC with actual Tax Credit that you're eligible for based on filed tax returns.

However, when talking about Medicaid, CHIP or Essential Plan in NY (and IINM also CSR on exchanges) there's very little that could be done. Officially one is required to report every change in income. But as any business owner knows, that's 100% ridiculous, as one often doesn't really know what the actual income is until many months later.

As for the field of real-estate, if you're talking sales, where you get paid a commission, you could technically (or theoretically) go off in a month you made a lot of money, and then go back on. If you're talking about real-estate investments, you can have positive cash-flow but very low or negative earnings due to interest and depreciation. The only thing that counts towards Medicaid eligibility is (M)AGI (with the M standing for Modified, which adds back certain items that might be excluded from AGI, such as municipal bonds interest earned).
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Offline churnbabychurn

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Re: jersey care
« Reply #919 on: December 17, 2018, 09:56:39 PM »
I don't have time now,but it's pretty easy to search and drill through to the text of the statue or regulation/guidence docs that governs Jersey care income requirements.
I've done it in the past and it should clarify the question.


Btw, Ime the people who review financial info haven't a clue about profitability or understanding of financial reports..