Qualifying for Medicare in WA?

December 11, 2013 8:39 AM

I'm trying to determine if I'm eligible for Medicare in WA state, and can't get into a social services office right now. I've read the website back and front, and still can't quite figure out if I qualify due to my "household" (read: co-parent's) income.

Here are the facts:

-40 year old non-disabled male
-I have $0 in income per year
-I live with my co-parent and child - co-parent pays for all living expenses for the three of us.
-We are not married so I can't get onto co-parent's insurance.
-Co-parent may or may not claim me as a dependent on 2012 taxes depending on whether that matters for Medicare - she never has before.
-We have cohabitated for 1.5 years in WA
-Co-parent's gross income is $70K. Believe it or not we still can't afford one of the new ACA plans.

So - everything I've read on the Medicare website indicates that I'm eligible up to where I have to list "household" income - even tho it's not my income and I don't receive income or allowance or stipends or whatever. I clean and cook and care for the kid in exchange for room and board.

Does anyone have any insight? Throwaway email [e-mail]

posted by anonymous to Law & Government (11 answers total)

Are you looking for Medicaid? Medicaid eligibility is determined by income.

Medicare is for folks who are 65 and older, plus people with disabilities, and people with end stage renal.
posted by mochapickle at 8:46 AM on December 11, 2013

Here is a link to an eligibility calculator. The Medicaid program is part of Washington State's Department of Health and Social Services.
posted by mochapickle at 8:50 AM on December 11, 2013

What you're looking for is more Medicaid than Medicare, but healthcare.gov should send you in the right direction.

Basically, what immediately comes to mind is this: if your co-parent* is claiming you as a dependent, her income is going to count towards your household income. What you can do from there is either 1) have her not claim you, in which case you two are treated as roommates, more or less or 2) get married and get on her insurance. Right now you're basically getting the worst of both possible scenarios.
posted by Oktober at 8:50 AM on December 11, 2013

*I noticed you used "co-parent" and not "partner" or "girlfriend", implying that getting married is probably not an ideal option.
posted by Oktober at 8:51 AM on December 11, 2013

Medicaid defines a "household" based on paying taxes. So long as the "co-parent" does not claim you as a dependent, you are a household of two people. If the "co-parent" claims you as a dependent, you are a household of three people.

The reason I am putting "co-parent" in quotations is that it is not a legally defined term - not out of any sense of derision. Medicaid only cares about taxes.
posted by saeculorum at 8:52 AM on December 11, 2013

The definition of household on p.9 of this document is consistent with what saeculorum said. You can also contact the Washington Medicaid folks.
posted by Mr.Know-it-some at 9:01 AM on December 11, 2013

I don't receive income or allowance or stipends or whatever. I clean and cook and care for the kid in exchange for room and board.

Also, these statements are contradictory. Receiving room and board is income, in the form of barter income, which is taxable. Of course, at the end of the year, you still might find that your income is less than your deductions and end up with no net tax due to the government, but that doesn't mean you have $0 income.

If you claim $0 income and Medicaid as a 40-year-old non-disabled person, that strikes me as almost inviting an audit, so you should probably make sure you're filing your taxes accurately.
posted by saeculorum at 9:11 AM on December 11, 2013 [1 favorite]

Medicaid has been expanded in Washington State so you should be applying through the state exchange, after following the suggestions above to not have your co-parent claim you as a dependent.
posted by PhoBWanKenobi at 9:50 AM on December 11, 2013

Oh, and just as a note, the exchange will ask you for projected 2014 income, not 2013 income. In case that makes a difference.
posted by PhoBWanKenobi at 9:54 AM on December 11, 2013

Here's (PDF) a list of organizations that have been selected as In-Person Assister Lead Organizations in Washington, in case one is close to you. Should be easier and better assistance than a social services office. They're supposed to help you determine your eligibility and navigate your options better than anyone.
posted by General Malaise at 10:46 AM on December 11, 2013

Being claimed as a dependent explains why you have no income of your own, but you need to check with the IRS about the details of doing this since you are not a relative.

If you do have to apply for DSHS assistance (welfare) to get the Medicare, make sure that you are not on co-parent's bank accounts or credit accounts. You cannot have access to their money directly. (I had to do this back in 2004. Didn't care about the cash, but needed to get onto Medicaid. But I also had to apply for Disability since I was eligible, and they wouldn't put me on State aid without doing that in my circumstances.) My mother claims me as a dependent on her taxes and it doesn't matter to DSHS, but did explain to them how I'd survived for the past 3 years without any job. You also have to be without assets. We even had to take my name off of the car title just to be sure.

But going through the healthcare exchange is probably your best way to go about this if all you want is medical coverage.
posted by monopas at 12:17 PM on December 11, 2013