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Jeremiah Brown

Does unemployment affect medicaid eligibility in Washington?

I'm currently receiving Washington ESD unemployment benefits and I'm worried about how this might impact my medicaid coverage. My UI benefits are around $600 per week which puts me at about $31,200 annually if this continues. Does anyone know if unemployment income counts toward medicaid income limits? I really can't afford to lose my health coverage while I'm job searching. Has anyone dealt with this situation before?

Yes, unemployment benefits do count as income for medicaid eligibility purposes. However, the good news is that Washington expanded medicaid so the income limits are higher than many other states. For a single person, you can make up to about $20,120 annually and still qualify for full medicaid coverage.

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Wait, so at $31,200 annually I'd be over the limit? That's really concerning because I need my medications.

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Actually there are different programs within medicaid and some have higher income limits. You might qualify for subsidized coverage through the health insurance exchange instead.

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I went through this exact situation last year. Your UI benefits absolutely count as income, but Washington has Apple Health (medicaid) programs with different income thresholds. Even if you don't qualify for traditional medicaid, you might be eligible for premium assistance or sliding scale coverage through the Washington Health Benefit Exchange.

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How did you handle the transition? Did you have a gap in coverage?

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I had to reapply and provide documentation of my UI benefits. There was about a 2 week processing period but no actual gap in coverage since I applied before my renewal date.

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This is so confusing and stressful! I've been trying to call the medicaid office for weeks to ask about this but can never get through. The phone system just hangs up on you after being on hold forever. Has anyone found a way to actually talk to someone about medicaid eligibility while on unemployment?

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I had the same problem trying to reach them. What worked for me was using Claimyr (claimyr.com) - they have a service that can get you connected to state agency representatives. I used it to reach Washington ESD about my unemployment claim, but they also help with other state agencies. There's a demo video at https://youtu.be/7DieNd3C7zQ that shows how it works.

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Thanks! I'll check that out. I really need to talk to someone who can explain my options clearly.

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Just want to point out that unemployment is temporary income, so your medicaid eligibility should be based on your current situation, not your previous employment income. Make sure you're reporting your UI benefits correctly when you apply or renew.

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That's a good point. Should I report my weekly UI amount or try to estimate what I'll receive for the whole year?

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Report your current monthly UI income. They'll use that to project your annual income for eligibility purposes.

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I'm in a similar boat. Been on unemployment for 8 weeks now and my medicaid renewal is coming up next month. Really worried about losing coverage right when I need it most for job search stress and everything.

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Don't wait until your renewal date! Apply for a change in circumstances review now since your income situation changed when you started receiving UI benefits.

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How do I do that? Is there a specific form or do I just call them?

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The Washington Health Benefit Exchange website has an income calculator that can help you figure out what programs you might qualify for based on your UI benefits. It's way easier than trying to call and wait on hold for hours.

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That sounds helpful. Do you remember what the website is called?

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It's wahbexchange.org - they have tools to estimate your eligibility and you can apply online too.

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I used that site and it was pretty straightforward. Just make sure you have your most recent UI benefit statement when you use the calculator.

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One thing to keep in mind is that if you do lose medicaid eligibility due to UI income, you have special enrollment rights for marketplace insurance because losing medicaid counts as a qualifying life event. So you wouldn't have to wait for open enrollment.

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That's reassuring to know there are options. How long do you have to enroll after losing medicaid?

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Usually 60 days from when your medicaid coverage ends. But don't let it lapse - apply for new coverage before your medicaid ends if possible.

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Been there! What helped me was getting all my UI documentation together first - your weekly claim confirmations, benefit payment history, anything showing your exact UI income. Medicaid needs specific numbers, not estimates.

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Good advice. I can get that from my Washington ESD online account. Should I include my job search log too or just the payment info?

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Just the payment info for medicaid purposes. The job search log is for maintaining your UI eligibility, not related to medicaid.

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Also worth mentioning - if you're doing any part-time work while on UI, that income counts too for medicaid eligibility. Make sure you're reporting all income sources, not just your unemployment benefits.

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This is important! I forgot to report some freelance work I was doing and it caused problems with my medicaid renewal.

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I'm not doing any side work right now, just focusing on finding full-time employment. But good to know for the future.

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The whole system is frustrating. You lose your job, need health coverage the most, but then the unemployment benefits that are supposed to help you might disqualify you from medicaid. Makes no sense.

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I totally agree. It's like being punished for accepting the help you're entitled to.

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At least Washington expanded medicaid though. Could be worse in other states where the income limits are much lower.

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Quick question - does anyone know if the medicaid office can see your UI payments automatically or do you have to report them? I'm wondering if they cross-reference with Washington ESD data.

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You're supposed to report changes in income within 10 days. Whether they automatically check or not, it's your responsibility to keep them updated.

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Fair enough. Better to be upfront about it anyway.

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I actually had luck getting through to the medicaid customer service line by calling right at 8am when they open. Took a few tries but eventually got connected to someone who could review my case.

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What number did you call? I've been trying the main medicaid line with no luck.

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I called the Washington Apple Health customer service line at 1-855-923-4633. Early morning definitely seems to be the best time.

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That's the same experience I had before I found Claimyr. Now I just use their service when I need to reach state agencies - saves so much time and frustration.

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Don't forget that even if your UI benefits put you over the medicaid income limit, you might still qualify for reduced-cost coverage through the health exchange. It's not free like medicaid but it's way cheaper than regular insurance.

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That's something I hadn't considered. Do you know roughly what the costs might be?

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Depends on your exact income and the plan you choose, but for someone making around $31k, you'd probably qualify for significant premium tax credits. Could end up paying $50-150/month instead of $400-500.

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This thread has been super helpful! I'm in a similar situation and was panicking about losing my health coverage. Sounds like there are more options than I realized.

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Same here! I feel much better knowing there are pathways to keep coverage even if I don't qualify for traditional medicaid anymore.

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The key is being proactive about it. Don't wait until your coverage lapses to figure out your options.

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One last tip - if you do need to switch from medicaid to marketplace insurance, make sure your doctors accept the new plan before you enroll. Not all providers take all insurance plans.

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Great point! I have a few specialists I need to keep seeing. I'll make sure to check that when looking at plan options.

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You can usually find provider directories on the insurance company websites or call them directly to verify coverage.

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I'm going through this same situation right now and wanted to share what I learned from speaking with a Washington Apple Health representative. Your UI benefits of $600/week ($31,200 annually) would put you over the standard Apple Health income limit, but you may still qualify for Apple Health coverage with a small premium or subsidized marketplace coverage. The rep told me that many people on unemployment end up in what's called the "coverage gap" - too much income for free medicaid but still qualifying for significant help with marketplace premiums. I'd definitely recommend using the income calculator on wahbexchange.org that someone mentioned earlier, and don't forget that your UI benefits won't last forever, so your eligibility could change again when they end. The most important thing is to report the income change promptly so there are no issues later.

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Thank you for sharing that detailed information! The "coverage gap" concept is really helpful to understand. I didn't realize that UI benefits being temporary could actually work in my favor for future eligibility changes. When you spoke with the Apple Health rep, did they mention anything about how to handle the transition if I do need to switch to marketplace coverage? I'm worried about timing it right so I don't have a gap in coverage while switching between programs.

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This is exactly the kind of detailed info I was hoping to find! @Fatima Al-Maktoum, when you spoke with the Apple Health rep, did they give you any guidance on the timeline for reporting income changes? I want to make sure I handle this correctly and avoid any potential issues with overpayments or coverage gaps. Also, did they mention whether there's a specific form I need to fill out when reporting UI benefits, or can I just update my information online through the Washington Healthplanfinder portal?

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@Fatima Al-Maktoum This is incredibly helpful information, thank you! I m'the original poster and your explanation about the coverage "gap really" clarifies my situation. When you mentioned that many people on unemployment still qualify for subsidized marketplace coverage, do you know approximately what income range qualifies for the most help with premiums? I m'trying to figure out if my $31,200 UI income would still get significant assistance or if I d'be looking at much higher monthly costs than my current free Apple Health coverage. Also, did the rep mention anything about prescription drug coverage differences between Apple Health and marketplace plans?

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I've been following this thread closely since I'm in almost the exact same situation - receiving about $580/week in UI benefits and worried about my Apple Health coverage. After reading everyone's experiences, I decided to be proactive and called the Washington Apple Health line this morning right at 8am (thanks @Brianna Schmidt for that tip!). I actually got through after about 20 minutes on hold. The representative confirmed that my UI benefits would put me over the standard Apple Health income limit, but she walked me through the online portal to update my income information and check my options. What I learned is that even though I won't qualify for free Apple Health anymore, I'm eligible for a subsidized marketplace plan that would cost me around $75/month with my current UI income level. The rep also mentioned that I should report my income change within 10 days to avoid any overpayment issues later. She emphasized that it's better to be upfront about the UI benefits now rather than deal with potential payback requirements down the road. For anyone else in this situation, I'd really recommend calling early in the morning - the wait times are much shorter and the representatives seem to have more time to explain your options thoroughly.

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@Luca Romano Thank you so much for taking the initiative to call and sharing what you learned! Your experience gives me a lot of hope that this situation is manageable. The $75/month cost for subsidized marketplace coverage actually sounds very reasonable compared to what I was fearing. I m'curious - when you spoke with the rep about reporting your UI income change within 10 days, did they mention whether you need to provide specific documentation like your weekly UI payment stubs, or is it sufficient to just report the weekly benefit amount? Also, did they give you any guidance on what happens to your coverage during the transition period between Apple Health and the marketplace plan? I want to make sure I time everything correctly so there s'no gap in my prescription coverage.

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@Luca Romano This is incredibly helpful! I m'dealing with a similar UI income level and was really stressed about losing my Apple Health coverage. The $75/month marketplace cost you mentioned actually sounds much more manageable than I expected. I m'curious about the timeline - when you updated your income information through the online portal, did the system immediately show you the new coverage options, or was there a processing delay? Also, I m'wondering if the representative mentioned anything about whether your current providers would be covered under the subsidized marketplace plans. I have a couple of specialists I really need to keep seeing during my job search period. Thanks again for sharing your experience - it s'made me feel much more confident about handling this transition!

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@Luca Romano This is exactly what I needed to hear! I ve'been putting off calling because I was dreading the phone maze, but your success story gives me the motivation to try the 8am approach. The $75/month cost is actually much better than I expected - I was imagining I d'be looking at $300+ monthly premiums. Quick question: when you updated your income information in the online portal, were you able to see the subsidized plan options immediately, or did you need to complete an application process first? I m'trying to plan out the timing so I can get everything sorted before my current Apple Health coverage period ends. Also really appreciate you mentioning the 10-day reporting requirement - I had no idea about that timeline and definitely don t'want to deal with overpayment issues later!

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@Luca Romano This is such valuable information - thank you for sharing your experience! I ve'been avoiding making the call because I was worried about long hold times, but knowing that 8am works gives me a concrete plan. The $75/month cost is honestly a relief compared to what I was expecting. I m'curious about one thing - when you were talking to the rep about the subsidized marketplace plan, did they mention anything about the deductibles or out-of-pocket costs compared to Apple Health? I m'mainly concerned about my monthly prescription costs and whether there might be a significant difference in what I d'pay for medications under the new plan versus my current Apple Health coverage. Also, did the rep give you any sense of how long the transition process typically takes once you submit the updated income information?

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@Luca Romano Thank you so much for calling and sharing such detailed information! Your experience really helps put things in perspective. I m'the original poster and have been really anxious about this whole situation, but hearing that you got through and found viable options makes me feel much more optimistic. The $75/month cost is honestly much better than I was expecting - I was imagining I d'be looking at several hundred dollars a month. I m'definitely going to try calling at 8am tomorrow following your approach. One question - when you spoke with the rep about the 10-day reporting requirement, did they clarify whether that s'10 days from when you first received UI benefits, or 10 days from when you realized it might affect your Apple Health eligibility? I ve'been receiving UI for about 6 weeks now and just learned about this potential impact, so I m'hoping I m'not already in trouble for not reporting sooner.

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@Luca Romano This is incredibly helpful, thank you for sharing your experience! I m'in a very similar situation with UI benefits around $600/week and was really worried about losing my Apple Health coverage. The $75/month cost for subsidized marketplace coverage is actually much more reasonable than I expected - I was thinking I d'be looking at $300+ per month. Your tip about calling at 8am is gold - I ve'been dreading trying to get through to them but knowing it worked for you gives me confidence to try. Quick question: when you updated your income information online, did you need to upload any documentation of your UI benefits right away, or were you able to just enter the amounts and provide documentation later if requested? I want to be prepared with the right paperwork when I call tomorrow morning. Also really appreciate the heads up about the 10-day reporting window - better to handle this proactively than deal with overpayment issues down the road!

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@Luca Romano This is such helpful information! I ve'been really stressed about this situation since I started receiving UI benefits about 3 weeks ago at $590/week. The $75/month cost you mentioned is actually a huge relief - I was expecting to pay much more for marketplace coverage. I m'definitely going to try calling at 8am tomorrow using your approach. One question about the timing: when you reported your UI income change, did your Apple Health coverage continue until the marketplace plan started, or was there any gap? I m'worried about losing coverage in the middle of switching between programs. Also, did the rep mention whether you could keep the same pharmacy for prescription refills under the new subsidized plan? I have a couple of medications I need to stay on during my job search. Thanks again for taking the time to call and share what you learned - it s'made this whole situation feel much more manageable!

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@Luca Romano Thank you so much for sharing your experience with calling this morning! This gives me hope that I can actually get through and get real answers. I m'the original poster Jeremiah (and) have been really anxious about this whole situation. The $75/month cost is honestly much more reasonable than I was expecting - I was imagining I d'be looking at $400+ per month. I m'definitely going to try the 8am calling strategy tomorrow. One question about the documentation - when you updated your income information, did you need to have your UI payment statements ready, or could you just provide the weekly benefit amount? I want to make sure I have everything prepared before I call. Also, did the rep mention anything about how this affects prescription coverage compared to Apple Health? I have a couple of medications I need to keep taking during my job search. Really appreciate you taking the initiative to call and sharing what you learned!

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@Luca Romano This is incredibly helpful information! I m'dealing with a similar situation - UI benefits around $620/week - and was really panicking about potentially losing my health coverage. The $75/month cost you mentioned is actually much more manageable than I expected. I was imagining marketplace plans would be $300+ monthly. Your 8am calling strategy sounds like a game-changer - I ve'avoided calling because I assumed I d'be on hold for hours. Quick question: when you updated your income in the portal, did the system walk you through the marketplace options right away, or did you need to complete a separate application? I want to understand the process before I call tomorrow. Also really appreciate the reminder about the 10-day reporting window - I had no idea that was a requirement and definitely want to stay compliant. Thanks for being proactive and sharing your experience with all of us!

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