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.
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?
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.
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.
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.
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.
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.
@@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?
@@Vangfamilyjourney 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.
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 as always! Thanks for the info.
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!
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.
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.
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.
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.
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.
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?
@@Vangfamilyjourney 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.