Thank you so much so this great information, my question is whet is considered income? would it be based on your previous tax return? do you have a specific video about that subject? Sometimes I don't understand if your 401K contributions are deducted from your income.
Modified Adjusted Gross Income is your Estimated Adjusted Gross Income for the next year. The modification is the addition of Social Security, tax-exempt interest, and foreign earned income. 401k contributions lower your taxable income that is used to calculate the subsidies. I need to update this video, but the information is pretty accurate. ua-cam.com/video/Z9N6S-PVqgw/v-deo.html
Great information. We are at over 400 % FPL (retired) but we still worry about not claiming the exact household income due to the business income reported as a loss on a Schedule C….
For 2025 your income can be over 400% FPL and you can still get subsidies. Don’t worry about claiming the exact dollar amount. Estimate as best you can and hedge it a little highe.
Great video, thank you. Couple of questions. If we have a 23 yr still living at home part time student and works part time job. Is her income supposed to be considered in the household income? We are retired and only have investment income/ira distribution/conversion as our income so I don't think having her on our tax return as a dependent offers much benefit to us. Is the deciding factor if we list her on our tax return or not? Secondly, if we want to make sure we are not on medi-cal, do we just make sure to either do a distribution or roth conversion so that our total income stays above 138%? Just want to make sure we take enough income this year and trying to understand if our daughters income factors into this equation or not. Thank you for your help.
If a dependent earns enough income to owe federal income tax, then the income is included in the household. If the dependent does not earn enough to owe taxes, and only files to get the withholding tax refunded to them, then the income is not counted in the household. You can estimate that you will have a taxable event from converting a retirement account on the Covered California application. Of course, that does not guarantee that it will happen. Sometimes there is other income into the household such as a part-time job that must be included. If that arises, maybe you don’t convert the retirement funds, but your income still meets the estimate because of the employment income.
Hi Kevin, Thanks for sharing the information. If I understand correctly, if I am filling out the application for the first time for 2025 Covered CA Health Insurance then I have to enter the projected taxable income for 2025. Is this correct? Also, I am unemployed with minimal taxable income so I may qualify for the Silver 94. Suppose I cancel the Covered CA plan on March 31st because I got a job with an annual income above the limit. Will CA consider the total annual income for 2025 to determine if I have to repay the Medical Financial Assistance -even though I did not have income during January-March 2025?
You are estimating your income for the next year. If your income increases dramatically, either because of new employment or you win the lottery, you will most likely have to repay some if not all of the Advance Premium Tax Credit subsidy you received during the year. You will repay the excess subsidy to the IRS when you file your federal income tax return for 2025.
So if I still live with my parents and I obviously don’t include them in my taxes and they don’t include me. I report a household of 1, correct? And I’m supposed to do my student teaching which I won’t get paid for in the fall of 2025 so should I adjust my estimated income accordingly now for open enrollment? I will have to leave my substitute teaching job to complete my student teaching or do I estimate like if I will work all year and adjust it when the time comes. What do you recommend?
Covered California would like you to report any changes to your income within 30 days. If you lose income from student teaching, and your income is $0, you would be eligible for no cost MAGI Medi-Cal coverage. Some people have fluctuating income during the year. They use an average monthly income. Some months their income is $0, other months it is $10,000. These individuals don't report an income change because they are using an average monthly income. What they are shooting for is that the estimated annual income (averaged over the months) will be very close to what they anticipate reporting on their federal tax return. If you are determined eligible for Medi-Cal, remember that you need to report your increased income and any employer sponsored health insurance, so that Medi-Cal can properly terminate your enrollment.
@@KevinKnauss Is it based on the previous year's income or on current year projected income? For instance, what happens if my 2023 income does not meet the guidelines due to income being above the threshold of a program, but I lose my job this year around August and will not have income that is above a program limits?
@@KvOG22 It is based on your current tax year estimated income. Prior year’s taxable income is not considered. Jan 1 - Dec 31 estimate. If the income changes in the middle of the year, no problem, you can update the income, lower or higher.
Thank you for your helpful videos. I m wondering what the income year of (2024 or 2025) is used for renewing the 2025 insurance plan on covered ca? Thanks
The income table for Open Enrollment will state 2025 in the title. In the lower right hand corner the date of 10/2024 will be shown. Another income table will be issued in February for 2025. The only change will be the income for Medi-Cal programs that are increased by the 2025 federal poverty level increase. That table will have a date of 02/2025 or maybe 03/2025, depending when CC issues it.
Hi Kevin. How can I find out if my doctor PCP takes a new HMO Silver 94 plan (I'm switching from BlueShield to Anthem B-Cross HMO S 94)?? I'm getting vague answers from the front desk at his office. Thank you very much in advance!- Alex
The easiest check is through the Covered California Shop and Compare Tool where you can enter the physician's name and select the address you visit the doctor at. The best source is to directly to the carriers website. For Blue Cross, www.anthem.com/ca/find-care/, then follow links to search for California, medical networks on exchange, HMO, doctor's name. It will give the most accurate results. The doctor's office information is notoriously unreliable.
Should the "attestation of income" form be submitted every year even if there is no income change? I think mine is older than 10 months. But no change. Thank you Kevin!
You only need to submit the attestation if CC requests income verification. That might happen if you renew for 2025 or are auto-renewed. Some people must submit the attestation every year, even though the income has not change. But you should wait to see if CC requests it first.
My accountant told us we would not qualify for any subsidy since we estimate to be over 400% of the FPL in 2025. But I see a very substantial subsidy when putting that estimated income into the CC cost estimators. I'm in the SFBay area and best I can tell the SLCSP is over $36,000 annually for two of us. (Maybe I should send my accountant this video!). If that's correct than people earning over $300K would still get some subsidy (and you can see that in the online estimator). It seems unbelievable. This is making me nervous since if we didn't get any subsidy we'd more strongly consider sticking with our cobra coverage since it would be much less expensive than even the *least* expensive CC option at full cost and has better coverage. Any advice?
Any Silver 94 plan is great. Of course, a health plan without your chosen providers is not worth much. If there is a Silver 94 that is both reasonably priced and has your doctors, that is great! There are some Silver 94 plans that are still expensive even with large subsidies. These are usually PPO plans.
Nice video! You explained a complicated subject very well
Terrific. I’m glad it made sense.
Thank you so much so this great information, my question is whet is considered income? would it be based on your previous tax return? do you have a specific video about that subject? Sometimes I don't understand if your 401K contributions are deducted from your income.
Modified Adjusted Gross Income is your Estimated Adjusted Gross Income for the next year. The modification is the addition of Social Security, tax-exempt interest, and foreign earned income. 401k contributions lower your taxable income that is used to calculate the subsidies. I need to update this video, but the information is pretty accurate. ua-cam.com/video/Z9N6S-PVqgw/v-deo.html
@ thank you so much
Great video as always! Thanks for the info.
Great information. We are at over 400 % FPL (retired) but we still worry about not claiming the exact household income due to the business income reported as a loss on a Schedule C….
For 2025 your income can be over 400% FPL and you can still get subsidies. Don’t worry about claiming the exact dollar amount. Estimate as best you can and hedge it a little highe.
Great video, thank you. Couple of questions. If we have a 23 yr still living at home part time student and works part time job. Is her income supposed to be considered in the household income? We are retired and only have investment income/ira distribution/conversion as our income so I don't think having her on our tax return as a dependent offers much benefit to us. Is the deciding factor if we list her on our tax return or not? Secondly, if we want to make sure we are not on medi-cal, do we just make sure to either do a distribution or roth conversion so that our total income stays above 138%? Just want to make sure we take enough income this year and trying to understand if our daughters income factors into this equation or not. Thank you for your help.
If a dependent earns enough income to owe federal income tax, then the income is included in the household. If the dependent does not earn enough to owe taxes, and only files to get the withholding tax refunded to them, then the income is not counted in the household.
You can estimate that you will have a taxable event from converting a retirement account on the Covered California application. Of course, that does not guarantee that it will happen. Sometimes there is other income into the household such as a part-time job that must be included. If that arises, maybe you don’t convert the retirement funds, but your income still meets the estimate because of the employment income.
Hi Kevin, Thanks for sharing the information. If I understand correctly, if I am filling out the application for the first time for 2025 Covered CA Health Insurance then I have to enter the projected taxable income for 2025. Is this correct? Also, I am unemployed with minimal taxable income so I may qualify for the Silver 94. Suppose I cancel the Covered CA plan on March 31st because I got a job with an annual income above the limit. Will CA consider the total annual income for 2025 to determine if I have to repay the Medical Financial Assistance -even though I did not have income during January-March 2025?
You are estimating your income for the next year. If your income increases dramatically, either because of new employment or you win the lottery, you will most likely have to repay some if not all of the Advance Premium Tax Credit subsidy you received during the year. You will repay the excess subsidy to the IRS when you file your federal income tax return for 2025.
So if I still live with my parents and I obviously don’t include them in my taxes and they don’t include me. I report a household of 1, correct?
And I’m supposed to do my student teaching which I won’t get paid for in the fall of 2025 so should I adjust my estimated income accordingly now for open enrollment? I will have to leave my substitute teaching job to complete my student teaching or do I estimate like if I will work all year and adjust it when the time comes. What do you recommend?
Covered California would like you to report any changes to your income within 30 days. If you lose income from student teaching, and your income is $0, you would be eligible for no cost MAGI Medi-Cal coverage. Some people have fluctuating income during the year. They use an average monthly income. Some months their income is $0, other months it is $10,000. These individuals don't report an income change because they are using an average monthly income. What they are shooting for is that the estimated annual income (averaged over the months) will be very close to what they anticipate reporting on their federal tax return.
If you are determined eligible for Medi-Cal, remember that you need to report your increased income and any employer sponsored health insurance, so that Medi-Cal can properly terminate your enrollment.
Are assets counted towards eligibility for any of these programs? Or is it just based off income?
Only income that is taxable, plus Social Security, tax exempt interest, and foreign earned income.
@@KevinKnauss Is it based on the previous year's income or on current year projected income? For instance, what happens if my 2023 income does not meet the guidelines due to income being above the threshold of a program, but I lose my job this year around August and will not have income that is above a program limits?
@@KvOG22 It is based on your current tax year estimated income. Prior year’s taxable income is not considered. Jan 1 - Dec 31 estimate. If the income changes in the middle of the year, no problem, you can update the income, lower or higher.
Thank you for your helpful videos. I m wondering what the income year of (2024 or 2025) is used for renewing the 2025 insurance plan on covered ca? Thanks
The income table for Open Enrollment will state 2025 in the title. In the lower right hand corner the date of 10/2024 will be shown. Another income table will be issued in February for 2025. The only change will be the income for Medi-Cal programs that are increased by the 2025 federal poverty level increase. That table will have a date of 02/2025 or maybe 03/2025, depending when CC issues it.
Hi Kevin. How can I find out if my doctor PCP takes a new HMO Silver 94 plan (I'm switching from BlueShield to Anthem B-Cross HMO S 94)?? I'm getting vague answers from the front desk at his office. Thank you very much in advance!- Alex
The easiest check is through the Covered California Shop and Compare Tool where you can enter the physician's name and select the address you visit the doctor at. The best source is to directly to the carriers website. For Blue Cross, www.anthem.com/ca/find-care/, then follow links to search for California, medical networks on exchange, HMO, doctor's name. It will give the most accurate results. The doctor's office information is notoriously unreliable.
Should the "attestation of income" form be submitted every year even if there is no income change? I think mine is older than 10 months. But no change.
Thank you Kevin!
You only need to submit the attestation if CC requests income verification. That might happen if you renew for 2025 or are auto-renewed. Some people must submit the attestation every year, even though the income has not change. But you should wait to see if CC requests it first.
My accountant told us we would not qualify for any subsidy since we estimate to be over 400% of the FPL in 2025.
But I see a very substantial subsidy when putting that estimated income into the CC cost estimators. I'm in the SFBay area and best I can tell the SLCSP is over $36,000 annually for two of us. (Maybe I should send my accountant this video!). If that's correct than people earning over $300K would still get some subsidy (and you can see that in the online estimator). It seems unbelievable.
This is making me nervous since if we didn't get any subsidy we'd more strongly consider sticking with our cobra coverage since it would be much less expensive than even the *least* expensive CC option at full cost and has better coverage.
Any advice?
Subsidy is based on making the SLCSP no more than 8.5% of your income. Many 6 figure income households receive subsidies.
@@KevinKnauss Thanks!
I did send to my accountant!!!!! with the Note - "Inflation Reduction Act - Min 6"..........
Great info, Kevin as usual!!! I qualified for Silver 94 Trio HMO based on the FPL table. What are your thoughts on this plan?
Any Silver 94 plan is great. Of course, a health plan without your chosen providers is not worth much. If there is a Silver 94 that is both reasonably priced and has your doctors, that is great! There are some Silver 94 plans that are still expensive even with large subsidies. These are usually PPO plans.
@@KevinKnauss Thank you Kevin for the prompt answer! Yes, I noticed the PPO Silver 94 is very expensive. I'll stay with HMO this year.