Will my partner lose Medicaid when we get married?

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Q. I am planning a wedding with my partner, who is on Medicaid. She is 35, has a 5-year-old, and I believe makes less than $20,000 a year. I made $74,000 a year, so I imagine that after we are married, she will no longer be eligible for Medicaid. When would she become ineligible and be dropped from Medicaid?
— Planning ahead

A. Congratulations on your upcoming wedding.

You are correct in your assumption that your partner will no longer be eligible for Medicaid once you are married because of your family’s income level.

But New Jersey has other programs in addition to Medicaid to help families with their healthcare costs, said Dawn Brown, a certified financial planner with Peapack Private Wealth Management in Summit.

She said under normal circumstances, Medicaid participants receive annual eligibility reviews.

The question of when her coverage would end has been complicated by special rules related to the COVID pandemic, Brown said.

“Since March 2020, Medicaid coverage has continued for all participants regardless of whether they were still eligible,” she said. “Starting April 2023, New Jersey will resume eligibility reviews. Depending on when you get married and New Jersey’s rollout of the review process, it is unclear when her coverage might end.”

In either case, loss of coverage and marriage both count as qualifying life events which trigger a 60-day special enrollment period, allowing both of you to change your coverage, Brown said.

If you receive your coverage from an employer, you can notify your benefits coordinator of your life event and add your partner and her child to a plan your employer offers, she said.

If you receive coverage from the open market, you can visit Get Covered NJ. There you will find the resources to find the best coverage for your family’s needs and various programs to assist with the cost of healthcare, Brown said.

Two programs to be aware of are New Jersey Health Plan Savings (NJHPS) and NJ FamilyCare Children’s Health Insurance Program (CHIP).

“The NJHPS program allows individuals earning up to $81,540 and families of four earning up to $166,500 to receive state subsidies, lowering their monthly premium payments,” she said. “CHIP provides children under the age of 19 free or low-cost coverage depending on income and family size.”

In addition to these programs, you might also qualify for premium tax credits and cost-sharing reductions, she said.

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This story was originally published on March 16, 2023.

NJMoneyHelp.com presents certain general financial planning principles and advice, but should never be viewed as a substitute for obtaining advice from a personal professional advisor who understands your unique individual circumstances.

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