r/Insurance • u/After_Berry7937 • Aug 15 '26
Health Insurance Need Help Finding Health Insurance for 59 Year Old Family Friend with $0 Income
My family friend is an immigrant to the U.S. who arrived over 15 years ago, and has spent the subsequent years living with her extended family. She is practically my grandmother and helped take care of in the past. As the years have gone by, her health issues have progressed, and Medicaid has not been sufficient for her. Unfortunately, her current income is nearly $0 and she doesn't count as an insurance claimant for the household she lives with, so access to insurance that way is null. I am 18 and I don't have much experience finding insurance yet, but is there any way for me to find insurance plans that will fit her? I plan on paying in full for any insurance I can find her. Does anyone have advice for where I can look?
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u/jorge0246 Aug 15 '26
Ok so…where are the critical thinking skills here?
“She keeps going to doctors who refuse to treat her” - Search for a highly rated doctor who accepts her Medicaid and tell her to go there. That’s it.
In a comment you mention she’s not a native English speaker…is she articulating her needs properly? Some doctors and clinics have interpreter services available.
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u/After_Berry7937 Aug 15 '26
I’m sorry for asking publicly, I just didn’t know how to navigate this because her family isn’t so forthcoming to her about medical stuff and I’ve never navigated this on my own, but I’ll keep this in mind thank you!
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Aug 15 '26
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u/After_Berry7937 Aug 15 '26
She keeps on going to doctors who refuse to treat her or just ghost her, which is an issue that is getting more worrisome as she ages. I'm fully willing to cover all her insurance costs because I'm that concerned about her and I have a job that pays me decently okay. She's also a not a native English speaker so I worry about her medical care on that end as well. We're in Pennsylvania if that helps!
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Aug 15 '26
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u/After_Berry7937 Aug 15 '26
Thank you so much for the advice, I'll look for supplemental insurance for her. I didn't think it was the nature of her issues just because they seemed very everyday, but I'll keep that in mind.
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u/Moist-Meringue-1913 Aug 15 '26
You are not going to like the cost and terms on an ACA policy even if you are in a state that still gives subsidies. Why do you think that Drs won't see her? Are they legit complaints?
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u/Comfortable_Two6272 Aug 15 '26
Subsidies are federal law not state but she wont qualify with $0 magi.
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u/Moist-Meringue-1913 Aug 15 '26
Here you go and you are right.
https://www.healthinsurance.org/faqs/which-states-offer-their-own-health-insurance-subsidies/
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u/Comfortable_Two6272 Aug 15 '26
Yes those are additional on top of federal. But still need to make a min amount of income. In these expanded states you get medicaid if dont make enough. In non expanded states you get nothing (unless meet very strict criteria)
https://www.healthinsurance.org/obamacare/subsidy-calculator/
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u/After_Berry7937 Aug 15 '26
From the doctors or from her?
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u/Moist-Meringue-1913 Aug 15 '26
From her?
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u/After_Berry7937 Aug 15 '26
Yes, plus she needs to see them for pretty necessary medication and mobility issues.
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u/Moist-Meringue-1913 Aug 15 '26
A Dr can write open ended prescriptions after an Annual Wellness visit. She needs a referral to a specialist to treat mobility issues.
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u/Internal_Health7812 Aug 15 '26
What are you say medicaid dosent work??? I received it while raising my daughter. Its excellent insurance. You shouldn't be having a problem unless this is a AI post?
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u/Comfortable_Two6272 Aug 15 '26 edited Aug 15 '26
Does not qualify for ACA subsidy if $0 MAGI and full price would be over $1k a month Healthcare.gov. Not sure if can pay full price if qualify for medicaid.
Medicaid is what poor people use if they qualify. Thats it.
As a 50 year old female I find most drs are dismissive. This might not be an insurance issue. I had to fly out of state to see a specialist for example.
With her age and health issues dont bother with non aca plans - they dont cover pre existing issues.
Probably better posting in a local fb group asking for dr recommendations for her specific issues.
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u/abouttodiethistime Aug 15 '26
Why did you fly out of state? I’m curious how your age played any role in this
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u/Comfortable_Two6272 Aug 15 '26
Because local drs were unable to help me. Went and saw 1 of 2 known experts in the US.
Age? Women are often ignored more as they become older. Why? Idk.
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u/Stunning_Avocado5633 Aug 15 '26
Former county worker here. Which state are you in? She most likely qualifies for Medicaid
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u/Stunning_Avocado5633 Aug 15 '26
I just saw where you said it isn’t “working” for her—how so? You may need to push a bit more to find providers but…id kill to have Medicaid. It covers everything and is totally free
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u/Jujulabee Aug 15 '26
You indicate that she has Medicaid.
She needs help to use Medicaid by finding providers that accept Medicaid. If you can't help her with this there are probably organizations that offer this kind of guidance to people. There might be groups that are from her country who can act as interpreters and explain the system.
The reality is that any insurance you can purchase would be unaffordable unless you are an exceptionally rich 18 year old and the care itself would be costly because of deductibles and co-payments.
Medicaid is free and the care that is provided is "free" because specific providers have agreed to accept Medicaid in full. You just need to find those providers and use them.
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u/Hot-Bid-9129 Aug 15 '26
You're going to want to look up community clinics. Medicaid pays very little so most regular clinics seem to make it harder for those on it. Also if she will let you go with her you may help her get a better explanation of what she has/needs to get healthy. Good luck.
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u/SecretButterfly199 Medical Administration Grad Aug 15 '26 edited Aug 15 '26
I hold a degree in Medical Administration. Under the circumstances you described, insurance is going to be very difficult to find. While insurance is ideal, there are a few more options if she does not find insurance to fit her needs.
- Concierge medicine or fee-based care. This is a monthly or a yearly fee that you pay to a doctors' office. In some cases, it can be cheaper than insurance. Usually you get communication access to a doctor. Sometimes this fee will cover so many visits a year (well visits or even sick ones). It all depends on the provider and office terms. Of course, you still have to pay for medications out of pocket.
- Some hospitals have patient assistance programs that sometimes individuals can qualify for. This may help cover tests/labs in-hospital.
I know that neither of these options should replace health insurance, but when someone is in need of medical care any type of care is better than none. I wish your loved one the absolute best.
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u/After_Berry7937 Aug 15 '26
Thank you so much!
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u/thrwaway75132 Aug 15 '26
Also once she is 60 she might qualify for assistance via the states Agency on Aging. Over a certain age there are social workers that can help find facilities and providers for healthcare, including in home care. Their goal is generally to help you help them as long as you can so they don’t end up in Medicaid paid long term care beds.
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u/Zestyclose-Soil9524 Aug 15 '26
Tell her to GET a JOB. That's what MOST people have to do. No training then get trained in something.
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u/KittyC217 Aug 15 '26
Why isn’t Medicaid working?