AGI for Healthcare Marketplace?

[trippypea]

We are going to have to look for healthcare in the marketplace since DH lost his job. It says it goes by AGI, but is based on expected 2020 income, not previous years' income. I don't know how long he will be out of a job, but in a worse case scenario, he'd be unemployed for the year. I can only base 2020's income on what I know for sure he'd get which is severance and unemployment, and assuming he makes the same amount in side work as he did last year (some years it's $0, but we'll be optimistic), I can add that in.

But how to figure AGI? If I figure that half of the side work would occur at the same time as he'd be eligible for unemployment, he wouldn't be able to collect unemployment for the weeks he'd be earning, so the unemployment amount would have to be reduced by 6 weeks. Federal taxes are crazy on the severance (several thousand more taken out for 6 months than taken out for 12 when employed).

We would normally have some deductions to offset the freelance (home office, travel, etc). And 2020 will be an expensive year for college because we will have two kids going.

And when determining income for 2020, do they take into consideration college expenses? I haven't gotten a 1098-T from DD1's school yet for this year, so have no idea what having a kid in school does to your taxes, and she only has one semester in 2019 and we paid roughly $4500 in tuition/books. For 2020, I would estimate she'll have around $9000-$10,000 in tuition/books. DD2 will have 1 semester of 2020 we'd have to take into consideration, and is she goes where she wants to go, we'd probably have $8-10K for that semester.

Any idea how I can get a working number to use for the marketplace?

[bean29]

Hopefully there are a few people here who have experience buying policies in the marketplace. I just enrolled my DS, he turned 26 in October, so he is off my insurance, and he works for my DH. His income would only give him a $600 annual subsidy. All I know is that at the end of 2020, you have to go back and report your actual income and then they will adjust the subsidy. If your subsidy was too much $$ they will take it back (on your tax return?), so I opted for DS to take no monthly subsidy.

When I was on severance from a large employer, my health insurance was paid.  Could your DH get health insurance as part of his severance? 

[alabamagal]

Also can you do COBRA? It is usually very expensive, but much better coverage than marketplace.

[NastyWoman]

Jan 16, 2020 12:48:39 GMT -5 alabamagal said:

Also can you do COBRA? It is usually very expensive, but much better coverage than marketplace.

Since I don't know when your DH lost his job, it is good to know this little nugget of information in case he would be eligible (it might give you a little POM while looking for insurance on the exchange):

"Can I sign up for Cobra after an accident?
This can be a really big deal, and may scare you into signing up for expensive COBRA benefits right away. But there's a final wrinkle. You have 60 days after you lose your benefits to elect to pay for COBRA coverage. However, even if you enroll on Day 60, your coverage is retroactive to Day 1"

[trippypea]

DH lost his job last week. His employers' chart for COBRA, but I think the cost is $1750/month for the COBRA version of our current plan. We currently pay $440/month, so COBRA is going to be out of the question.

[oped]

If you base it on your income, and you get a subsidy and take the full subsidy, and then he gets a job that puts you in an entirely different place for the year, then you might end up owing back subsidy payments.  

I would suggest not taking the full subsidy if possible, so that if he gets a job there is less of an adjustment at the end of the year. 

[bean29]

I think JelloShots4all has some experience buying a policy in the marketplace too. and I do believe you have 60 days from your event/change in status date to pick up a policy in the marketplace. I did not cover DS for Nov/Dec, just started him up on Jan 1st.

If you have a small group employer/depending on the state you are in, you may not have COBRA coverage. We do not have Cobra coverage for my employer in WI.

[NastyWoman]

Jan 16, 2020 14:40:36 GMT -5 trippypea said:

DH lost his job last week. His employers' chart for COBRA, but I think the cost is $1750/month for the COBRA version of our current plan. We currently pay $440/month, so COBRA is going to be out of the question.

You are correct that COBRA is way out of line/reach $$$-wise but the law allows for 60 days to sign up for it even retroactively, so you can use those 60 days to find the best plan for you.  It can work kind of like an emergency fund for healthcare. If you find something that works for your family quickly, that is even better

[buystoys]

You may find that COBRA cost to be better than the Marketplace.  Your subsidy depends on your MAGI.  You can make the best case estimate and then the worst case estimate and select somewhere in between.  You will reconcile when you file your 2020 taxes.  You can always go in and change your subsidy amount, i.e. if you are receiving $500 you can elect to only receive $250 without any kind of penalty.

[Deleted]

Now that my house closed, I have to buy health insurance.

Not sure how it will go since my AGI is going to be <10K this year, but my bank account disqualifies me from Medicaid. 

[oped]

Jan 16, 2020 21:11:15 GMT -5 @shastasnewlife said:

Now that my house closed, I have to buy health insurance.

Not sure how it will go since my AGI is going to be <10K this year, but my bank account disqualifies me from Medicaid. 

Healthcare.gov looks at income not assets.

[teen persuasion]

There are 2 calculations going on at the same time when you give them your AGI. First they try to see if you are income eligible for Medicaid. Medicaid looks at monthly income, right now. When DH was between jobs, and I worked part time, I'd figured out our annual AGI, and thought we'd be eligible for ACA coverage/subsidies, because DH had already earned 6 months of income, and I expected him to get another job soon. But looking at current monthly income, we were Medicaid eligible, which means you are not ACA subsidy eligible. Only after they rule out Medicaid do they look at annual AGI.

Other big thing I learned is that if you apply before the 15th of the month, you could get coverage set up to begin on the first of the next month. Wait until the 15th, and coverage can't begin until the first of the month after the next month. So don't wait to begin signing up, it takes time to get coverage.

Use a navigator - they know all the weird quirks and gotchas. I thought I could do it myself online; I mean, I have a computer science degree and work in a library looking things up all day, I know my way around online sign-up, right? Most frustrating thing ever, didn't follow the rules I thought I knew (like the annual AGI limits for ACA), couldn't go backwards to fix info in previous screens (you got locked out). Switched to phone to get help - each rep had different info, they said they'd walk me thru it screen by screen but we saw different screens...

[Deleted]

I can't apply for coverage in a state I don't have an address for yet. 

By income I qualify for Medicaid but by savings account I am disqualified. I'm sure it will be a cluster.

[oped]

Jan 17, 2020 21:44:25 GMT -5 @shastasnewlife said:

I can't apply for coverage in a state I don't have an address for yet. 

By income I qualify for Medicaid but by savings account I am disqualified. I'm sure it will be a cluster.

New rules in some states don’t look at assets anymore. And if you are disqualified for medi you would most likely qualify for free or low cost premiums under .gov ... but deductibles might be high.

[tallguy]

Jan 17, 2020 21:44:25 GMT -5 @shastasnewlife said:

I can't apply for coverage in a state I don't have an address for yet. 

By income I qualify for Medicaid but by savings account I am disqualified. I'm sure it will be a cluster.

Both California and Oregon are expanded Medicaid states.  There is no asset test in those states.  Their Medicaid eligibility is income-based only.  You will not be disqualified for having the house sale proceeds in a savings account.  I believe that there is open enrollment for Medicaid at all times, so you should not be limited to certain periods to apply.  You should check that out in your state to be sure though.

You just emerged from a long and tortuous ordeal.  Don't screw up your future with a bad attitude now.  Figure out what is accurate and go from there.   

[trippypea]

Jan 16, 2020 14:59:45 GMT -5 oped said:

If you base it on your income, and you get a subsidy and take the full subsidy, and then he gets a job that puts you in an entirely different place for the year, then you might end up owing back subsidy payments.  

I would suggest not taking the full subsidy if possible, so that if he gets a job there is less of an adjustment at the end of the year. 

Let's say we sign up for the marketplace and qualify for a subsidy. How does that work if DH gets a new job in a few months?

1) Are we stuck in the marketplace plan for the entire year, collecting a subsidy we don't qualify for anymore, and then end up having to pay back come 2020 tax time?

2) Or are we able to join the new employer's insurance and quit the marketplace plan?

If you are only on the marketplace plan for the months you really didn't have the money to front insurance premiums, do they make you pay that back, or only on months you collected the subsidy but had more income coming in?

[oped]

No. Actually you MUST tell them that your situation has changed and if you have health care available you must use that. 

BUT, the subsidy is based on annual income, it will be calculated based on your husband not making money for those months and it might require a reconciliation on your end of year tax forms. So again, I'd take the subsidy you need, but not all of it if at all possible...  If he doesn't find work, you will get the rest of the subsidy 'back' at tax time... but this is one time i'd take the refund because the whole thing is just so unpredictable.