Assistance eligibility hinges on income

Robert Field, a Drexel University professor of law and public health.
Robert Field, a Drexel University professor of law and public health.

For graduate student, Medicaid is a possibility in N.J., but Pa. has not expanded its program.

Posted: July 08, 2013

The biggest health insurance changes in a generation are starting this fall with the opening of online insurance exchanges for individuals and small business employees. Robert I. Field, a law and public health professor at Drexel University, answers reader questions and writes the Field Clinic, a blog on and

Question: I am a full-time graduate student with no income.

I applied for Medicaid several years ago, but was turned down because I had too much money in savings. I have spent some of my savings, but I believe it is still more than what is required to qualify for Medicaid based on the reason I was rejected several years ago.

It sounds like I will not qualify for any financial support for the health-care exchange because I have no income, and with no income I should be applying for Medicaid. So unless Medicaid in Pennsylvania changes its rules on savings, I will not qualify for that either.

Does this sound about right? Does the amount of savings one has also get calculated in for the health-care exchange?

Answer: Your eligibility for financial assistance will depend on whether you have any income at all.

If you earn between 100 percent and 400 percent of the federal poverty level, which is between $11,490 and $45,960 in 2013, you will qualify for a subsidy that reduces the cost of insurance you buy on an exchange.

The amount you have in savings will not matter. At 100 percent of the poverty level, the subsidy will bring the cost to near zero.

If you earn less than that, you will not qualify for a subsidy on an exchange.

But you would qualify for Medicaid, if you live in a state that has chosen to expand its program. Those include New Jersey but, unfortunately, not yet Pennsylvania.

If you live in a state, like Pennsylvania, that has not expanded Medicaid, you may have one other option for affordable coverage.

If you are younger than 30, you will be able to purchase an inexpensive catastrophic-only policy on an exchange.

The coverage will be limited to major medical expenses, but the premiums will be quite low. Also, if one of your parents has coverage through an employer, they can include you under it as a dependent, if you are younger than 26.


Robert I. Field can be reached at

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