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#Line8b Adjusted Gross income then add line 2a, 5a & 7a (Foreign Income)
to get Covered CA MAGI Income
2019 1040 Form *** 2019 Schedule 1 Additional Income & Adjustments to Income
Modified Adjusted Gross Income (MAGI) (2) … means adjusted gross income – Line 37* & 7 for earlier years or 8b of the new 2019 1040 Form * Health Care.Gov * 26 USC §62 *
*Plus +
(i) Amounts excluded from gross income under IRC §911 Foreign Exempted * IRS Form 2555 * CFR 1.36 B – 1 *
(ii) Tax-exempt interest (Line 8b – 2a) [IRS Coursework] [Form 8815 * Interest Income * Investing Answers.com] the taxpayer receives or accrues during the taxable year; and
(iii) some Social Security Benefits (Line 20a & b – 5 a & b) Western Poverty & Law Explanation of MAGI ♦ (UC Berkely One Page Summary) ♦ CFR 1.36 B 1 * IRS Publication 974 ♦ George Town.edu
IMPORTANT!!!
The time frame is the future for what you tell Covered CA!
Sure, many people think it’s the past as Covered CA may ask for last years paperwork, but that’s BS! You might have to give back all the subsidies when you file Subsidy Reconciliation form #8962!
Adjustments to Income – Schedule 1
IRS Website Explanation of
Foreign Earned Income Instructions for # 2555
Official Publications on MAGI
It’s important to read the all material & links as one can’t rely on Covered CA to give you the correct answer.
UC Berkeley explains MAGI Modified Adjusted Gross Income –
Click on image to enlarge and for a more clear picture
Western Poverty & Law Explanation of MAGI – IMHO one of the most authoritative publications I’ve ever seen!
Covered CA’s
What Counts for MAGI Income
Cares Act Relief $600/week unemployment – $1,200 Stimulus FAQ’s
Get more detail on how each type of income counts under the IRS code for MAGI Income.
See our child & subpages for MAGI Income
#Form8962 Premium Tax Credit
Reconciliation Form attaches to 1040
Subsidy is IMHO hocus pocus - smoke & mirrors
it all comes out when you file taxes!
Details…
Household income means Code of FEDERAL Regulations – IRS Income Taxes – 1.36B 1 – (e) …(1) … the sum of—
(i) A taxpayer’s modified adjusted gross income; (Line 37 NEW Line 7 1040) plus
(ii) The aggregate modified adjusted gross income of all other individuals who—
(A) Are included in the taxpayer’s family under paragraph (d) [below] of this section; and
(B) Are required to file a return of tax imposed by section 1 for the taxable year (determined without regard to the exception under section (1)(g)(7) to the requirement to file a return). [26 USC §6012 ♦ IRS tool to see if you must file a return ♦ Medi-Cal Household Size Flow Chart ♦ Blog – Insure Me Kevin.com]
(f) Dependent has the same meaning as in section §152. * IRS Interactive Assistant *
(d) … A taxpayer’s family means the individuals for whom a taxpayer properly claims a deduction for a personal exemption under section 151 for the taxable year.
Family size [Medi-Cal Household Size Flow Chart ♦ Blog – Insure Me Kevin.com] means the number of individuals in the family. Family and family size may include individuals who are not subject to or are exempt from the penalty [mandate] under §5000 A (f) (1) for failing to maintain minimum essential coverage. Health Care.gov explanation *
26 USC § 151 – Allowance of deductions for personal exemptions pdf
(a) Allowance of deductions
In the case of an individual, the exemptions provided by this section shall be allowed as deductions in computing taxable income.
To be more clear — (2) Married taxpayers must file joint return. A taxpayer who is married (within the meaning of section 7703) at the close of the taxable year is an applicable taxpayer only if the taxpayer and the taxpayer’s spouse file a joint return for the taxable year. GPO.Gov Final Regulations Page 11 * Turbo Tax Calculator * Tax Policy Center….. Joint or separate? * Estranged Spouse?
Premium Tax Credit Form 8962 & Instructions
Get a Free No Obligation Calculation of your Tax Credit, Premiums and see the benefit brochures.
View other pages & resources in this section…
Getting MAGI Right – 23 page primer by GeorgeTown University on differences that apply to Medicaid (Medi-Cal) and CHIP Children’s Health Insurance Program Insure Kids now CA
Power Point presentation CMS Income Counting MAGI
Health Care.Gov – What income to count
See also this article on Kevin’s site
If you would like to talk to a professional tax adviser about this try Bruce Bialosky [email protected] 310.273.8250
- Covered CA 9.5.2014
- View Recorded Webinar
- PowerPoint Presentation
VIDEO What is APTC Advance Premium Tax Credit
Interactive Tax Assistant (ITA)
Am I eligible to claim the Premium Tax Credit?
Tax #Estimators
- turbotax.com
- H & R Block
- Efile.com
- Estimate the Subsidy for Health Insurance, benefits, premiums, etc.
- 8962 ONLINE Calculator
- TaxFormCalculator.com
- etax.com
ACA What You Need To Know #5187
Health Net VIDEO
How to get subsidies – pay less for coverage
How do the types of Income Below, count for MAGI Income?
Child, Related Pages & Site Map
- Income Chart – Line 8b 1040 Covered CA MAGI
- Table of Contents – Details of Income, Deductions & Expenses for MAGI
- Alimony – From a Divorce Settlement
- Annuity Income? IRA, Pension # 1040 Line 4
- Calif. Earned Income Tax Credit
- Capital Gains – Line 6
- Caregiver Income?
- Clergy – Housing Allowance?
- Debt Cancellation? Foreclosure?
- Educational Credits
- Foreign Income IRC §911
- Gambling Income & Losses – Other Income Line 21
- Gift Income?
- Itemize or use Standard Deduction?
- Medical Expense Deduction – Line 40 Individual
- Schedule C – Self-Employment Income – Line 12
- SDI State Disability Benefits Taxable?
Is MAGI Adjusted Gross Income before or after taxes?
Please see above, it’s line 8b, + Social Security, Foreign Income & Tax Exempt Interest. = Modified Adjusted GROSS Income
The lines below 8b don’t count!
Line 9 -11

Lines 12 – 19

My husband is losing his (relatively well paid) job this week, and I earn around 10 to $20k per year.
I am worried about health care coverage, since we will not have any and I am pregnant, and we already have 2 very young children
We have a ton of $$$ in various bank account savings — does this count against us for Medi-Cal or Covered California coverage?
Please advise, thank you!
Worried Pregnant Mom
There is NO ASSET TEST for MAGI based subsidies in Covered CA or MAGI Medi Cal Qualification.
See the VIDEO https://youtu.be/56DSWSQcu-A we just produced for more details and possible solutions. See also the links below to the various webpages so that you can get the best coverage for your budget and to fit your needs.
https://medi-cal.healthreformquotes.com/eligibility/
Western Poverty Law https://wclp.org/wp-content/uploads/2016/06/Western_Center_2016_Health_Care_Eligibility_Guide_Full_rev.1.pdf#page=166
Income Questions https://individuals.healthreformquotes.com/subsidies/magi/#comment-102934
https://individuals.healthreformquotes.com/subsidies/magi/categories/sdi-disability/unemployment-compensation/
https://individuals.healthreformquotes.com/subsidies/magi/income-chart/
https://medi-cal.healthreformquotes.com/eligibility/faq-magi/notification-make-much-medi-cal/
https://medi-cal.healthreformquotes.com/eligibility/pregnancy/
Get a Quote http://www.quotit.net/eproIFP/webPages/infoEntry/InfoEntryZip.asp?license_no=0596610
https://medi-cal.healthreformquotes.com/eligibility/faq-magi/monthly-vs-annual/
https://individuals.healthreformquotes.com/subsidies/report-a-change/
https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/
My spouse lost his job and our health benefits due to Covid-19.
I applied for Covered CA and it asks for the adjusted gross income also it asks for
itemized deductions we have not asked you about…I called Covered CA and a non-reassuring man told me my
mortgage real estate/property taxes from Schedule A, line 5B and mortgage interest on line 8A would qualify as itemized deductions. Line 8A also consists of property held for investment.
Our actual itemized deduction was the standard 24,400. However, I added $11,296 for just line 5B and 8A from schedule A.
Is it true that these are itemized deductions that I can enter onto the Covered CA application?
Thank you
How about appointing us as your Covered CA broker, being as here is where you come for reliable answers with a citation? https://steveshorr.com/intro/15-reasons/covered-ca-agent-appointment-instructions/ No extra charge!
I don’t believe in calling anyone.
See below about NOT answering all the “stupid” questions that the Covered CA application asks for https://individuals.healthreformquotes.com/subsidies/magi/#comment-102936
The only thing that matters is line 8b of the 1040 form https://individuals.healthreformquotes.com/subsidies/magi/#line8b above! Unless you have Tax Exempt Interest, Social Security or foreign income.
Note that Line 9 of 1040 comes AFTER line 8b. Thus it doesn’t count for MAGI Income.
So, you can enter your mortgage, interest & property taxes, BUT the Covered CA worksheet should do nothing with them, as your getting more from the standard deduction. In reviewing the list of deductions in the Covered CA worksheet below https://individuals.healthreformquotes.com/subsidies/magi/#comment-102936 I don’t see a spot to list these deductions. Do you have a screen shot of where they would be?
IMHO use an official tax estimator https://individuals.healthreformquotes.com/subsidies/magi/#estimators and just put in your MAGI Income, see above and don’t get caught in the trap of filling out everything with Covered CA. You could easily make a mistake and wind up in Medi Cal.
Don’t forget the mandate to report changes of income within 30 days. https://individuals.healthreformquotes.com/subsidies/magi/#report
Please note too, that Covered CA nor I are permitted to give you tax advice! Covered CA recommends VITA https://individuals.healthreformquotes.com/subsidies/intro/premium-tax-credit-8962/must-file-tax-return-free-help-vita/
https://www.irs.gov/pub/irs-pdf/f1040.pdf
https://www.irs.gov/pub/irs-pdf/f1040sa.pdf
Other Deductions?

This is a comment from a “culled” webpage.
What happens if I overstated my income.
I’m self employed and my month to month income is not consistent.
I’ve been covered with a PPO using APTC Advance Premium Tax Credit – subsidy for 2014-16.
The first two years I made less than $5K and in 2016 I had no income at all. I’ve been borrowing to pay premiums.
Each year I’ve “projected” approx $18K income partially to prevent falling into the Medi-Cal zone and I also naturally expected to do much better financially.
CoveredCA has extended my coverage but they need to see evidence by March when checking with the IRS that all years have been filed. I’m just now filing my returns.
Will I be able to keep my PPO the APTC for this year (2017) and how will the IRS and CoveredCA interpret all this?
One might argue that you’ve committed tax fraud & perjury.
You might also have to pay back the subsidies! See our page on Form 8962 about reconciling the APTC.
Our page on what if your income drops to Medi-Cal level and do you have to pay back subsidies. Note the requirement to report income changes within 30 days. Citation on duty to report from Western Poverty
I doubt that you can keep your subsidies.
I retired from my company on Jan 1, 2020. I have received a severance pay which will end shortly.
I also enrolled in [Federal] COBRA until June, 2021. https://employers.healthreformquotes.com/cobra/cal-cobra/
I plan to enroll in ACA after COBRA ends.
Starting November of this year, I will have very low income.
MAGI uses the tax return from previous year (2020) which is way over 600% of Federal Poverty Level $76k for a single
https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/magi/income-chart/ but does not reflect next year income which is very low.
How do I modify MAGI form to reflect actual 2021 income?
First off, MAGI is NOT and never was based on last years income!!!
See above, MAGI is what you estimate your income to be at the end of the year when you file taxes.
Asking for last years taxes or other documents is just to verify what you are saying. It’s hocus pocus!
If you get too much in subsidies or too little, the IRS either makes you give back the subsidies or gives you additional credit when you file your taxes, including form 8962 https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/intro/premium-tax-credit-8962/
Right in the Covered CA ONLINE Application, it says “Projected Income.”
Jump to the rest of the Covered CA questions on estimating your projected MAGI income for the upcoming or remainder of the year
https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/magi/#comment-102936
When you do apply, how about appointing us as your broker, no extra charge. That way we get compensated for helping you. https://steveshorr.com/intro/15-reasons/covered-ca-agent-appointment-instructions/
I retired from my company which was not located in CA nor did I live in CA so I don’t think I can get Cal COBRA
Other States might have an extension to COBRA like CA does for Cal COBRA but I’m not familiar with that.
Here’s a chart from an “non-official” website https://www.insure.com/health-insurance/cobra-by-state.html
http://www.hrknowledge.com/wp-content/uploads/2018/02/Federal_and_State_Mini_COBRA_Chart.pdf
As far as switching to ACA immediately, I am concerned that Supreme Court invalidate the ACA and I end up with no coverage.
At least with COBRA, I have another 8 months to come up with alternative to ACA.
We are following the Supreme Court case here – Texas vs USA https://individuals.healthreformquotes.com/aca/heath-reform-upheld-tax/texas-vs-usa-federal-case-to-declare-pre-x-clause-of-aca-unconstitutional/
Here’s our webpage on Pre-Existing Conditions https://individuals.healthreformquotes.com/aca/pre-existing-conditions/
Here’s another agent’s thoughts on what might happen in CA if the Court rules ACA/Obamacare unconstitutional. https://insuremekevin.com/what-if-obamacare-is-repealed-by-the-supreme-court/
People were concerned the ACA would end immediately when Trump took office.
I did go to Washington DC as a tourist in January 2017….
Check this out – Picture with President Trump https://www.facebook.com/steve.shorr/posts/10208323062780431
Here’s a picture with my Congresswoman https://www.facebook.com/steve.shorr/posts/10208393581183347

Justice Scalia who taught be the word Jiggery Pokery https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/intro/calculation/36-b-tax-credit-calculation-technical-stuff/subsidies-upheld/
https://www.facebook.com/photo?fbid=10208344566838019&set=pcb.10208344250350107
My son and I in front of the White House
https://www.facebook.com/photo?fbid=10208335815419239&set=a.10204806938759528
I’m not sure about the rest of the Country, but CA Open Enrollment lasts till January 31st. https://individuals.healthreformquotes.com/aca/enrollment/
Nationally, Health Care.gov says deadline is December 15th https://www.healthcare.gov/quick-guide/dates-and-deadlines/
It’s my understanding the Supreme Court will hear the case on November 10th. So, we’ll watch and see what happens. ACA has gone through SEVERAL challenges!
Cost Sharing Reductions… Covered CA simply raised the Silver Level rates and one barely notices any change
https://individuals.healthreformquotes.com/aca/metal-levels/enhanced-silver-cost-sharing-reductions/%c2%a7156-410-cost-sharing-reductions-enhanced-silver/constitutional-extra-costs/
Subsidies in Health Care . Gov Upheld King v Burwell
https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/intro/calculation/36-b-tax-credit-calculation-technical-stuff/subsidies-upheld/
Health Mandate Penalty Upheld as a tax NFIP vs Sebelius
https://individuals.healthreformquotes.com/aca/heath-reform-upheld-tax/
I didn’t know I signed up as a Constitutional Lawyer to do Covered CA at minimum wage and Medi Cal for free. Keeping track of these cases has been interesting.
Watch our webpage on Texas vs USA… https://individuals.healthreformquotes.com/aca/heath-reform-upheld-tax/texas-vs-usa-federal-case-to-declare-pre-x-clause-of-aca-unconstitutional/
Health Care Reform changed WAY MORE than just giving guaranteed issue and subsidies in Covered CA or Health Care . Gov
https://individuals.healthreformquotes.com/aca/
CA passed AB 1083 to make Employer Plans up to 100 lives conform to ACA
https://employers.healthreformquotes.com/ab-1083/
I’d love to, but I’m not in California
Covered CA asks way too many questions to try to help you come up with your estimated income for the end of the CURRENT year. Not last year!!!
IMHO don’t get caught in the trap of trying to use their system to do that. Things just get messed up, beyond repair!!!
IMHO just estimate your income yourself and put in ONE number!!! If it changes, you’re mandated to report the change within 30 days. It’s not say a once a year thing. https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/report-a-change/
How about using professional tax estimation software. Then you have something to show your accountant and/or actually file your taxes! https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/magi/#estimators
If you expect your income to be below 138% of Federal Poverty Level https://individuals.healthreformquotes.com/covered-ca-tax-credits-subsidies-aptc/magi/income-chart/ or around $18k for a single, there is Medi Cal at no charge. We don’t get paid to help you with Medi Cal. You can enroll here. https://medi-cal.healthreformquotes.com/contact-info/
Here’s screen shots of various income questions Covered CA asks to hopefully figure your income at the end of the current year, NOT last year!
Employment

Retirement

Investment

Retirement

Scholarships

Other Taxable Income

Deductions

See our Cal COBRA page for Q & A on that.
https://employers.healthreformquotes.com/cobra/cal-cobra/#comment-52371
I lost my job due to COVID 19, I reported that to Covered CA and I was transferred to Medi-Cal.
I don’t really want to be on Medi-Cal.
I have a new job starting in June.
What about the $600/week from the Feds? Does that count as Income for Covered CA? Medi-Cal? I reported the $600 but I heard from Covered CA that that income doesn’t count toward MAGI.
How much $$$ does one need to earn, to qualify for Covered CA rather than Medi-Cal?
Here’s the income chart for Medi-Cal vs Covered CA and Enhanced Silver Levels
So, for a single, as of March 2020 it would be around $18k. Please use an accurate estimate and be sure to update any changes within 30 days. 10 days for Medi Cal.
Here’s guidance that is quite confusing about getting back into Covered CA if you reported the incorrect income.
https://medi-cal.healthreformquotes.com/eligibility/faq-magi/drop-medi-cal/
We have a VERY confusing situation here on the $600/week PUC Pandemic Unemployment Compensation!
4. Will the extra $600 per week Pandemic Unemployment Compensation (PUC) payments be considered countable income for purposes of determining eligibility for financial help and premium assistance available through Covered California?
Yes, all unemployment benefits (including the extra $600 per week PUC payment) are included in the recipient’s income for purposes of eligibility for financial help available through Covered California (APTC, CSR, and state subsidy).
5. Will the extra $600 per week Pandemic Unemployment Compensation (PUC) payments be considered countable income for purposes of determining Medi-Cal and CHIP eligibility?
No, the extra weekly $600 PUC payments are not included in the recipient’s income for purposes of eligibility determination for Medi-Cal and CHIP (C-CHIP and MCAP). However, traditional ununemployment benefits are still considered income for Medi-Cal and CHIP purposes. source
So, what do you expect your Annual MAGI income to be for 2020?
PUC counts for Covered CA.
How much will you be making at your new job?
How much PUC will you get?
How much did you earn on your old job?
Please let us enter the numbers for you, AFTER you provide them in WRITING!
Covered CA’s income, expense & deduction questions are very confusing!
Here’s our scheduler, if you want to set a Skype or Zoom meeting to go over this.
My divorce agreement provides that my X Spouse must provide lifetime housing in one of their rental units or bedroom. More specifically – My ex-wife is providing me one room for my living space which values around $450 per month. She also allows me to use her car. Does that count as alimony even though it’s non cash? Does that count as income for Covered CA subsidies?
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Our Reply
In the example on page 14 of IRS Publication 504 https://www.irs.gov/pub/irs-pdf/p504.pdf it says that it wouldn’t be alimony as it’s a home you own and the debts are yours. If you owned the home jointly with your spouse see page 15 table 4
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More clarification
Publication 504 is a 30 page document and refers one to other documents, including your actual separation agreement. Be sure to seek competent tax and legal counsel. Covered CA basically just goes by the definition of MAGI line 37 of your 1040 and not how your AGI is calculated.
Kevin cows it’s all about line 7 and not how you got there
https://insuremekevin.com/covered-california-crazy-income-section/
I do not have a line 37 on my 1040 – however I do have a Schedule A (Agriculture business) amount on my line 8 that is subtracted from my line 7 (gross income) to get My line 10 taxable income – from which 12% is calculated and became the amount I paid in taxes.
Do I use my taxable income for 2018?
Line 37 is on the old 1040. AGI is on line 7 of the 2018 1040 and going forward. So, you use Line 7 AGI and then add in Social Security, Tax exempt interest and Foreign Income if any.
Schedule A Itemized Deductions isn’t relevant for Covered CA subsidies. It’s MAGI income, see beginning of this page.
Hi,
My mom has been told that she is no longer eligible for Medi-Cal because of her Alimony. She’s been on Medi-Cal for close to 3 years with this alimony and is just now being told that she doesn’t qualify.
My mom is self employed and reported a loss of $6000 on her federal taxes as part of her schedule C. Her alimony is $20,0000 annually. Her AGI based on line 37 is around $14,000. She has been repeatedly told that her loss of $6000 and the fact that her AGI based on line 37 of her 1040 is under the income limit for Medi-Cal do not matter, and that her alimony is higher than the income limit and that is all that matters.
Based on everything that I’ve found online, including what is on your website, it seems like she should be eligible for Medi-Cal. She has been told on the phone and in person at the Medi-Cal office that she is not eligible and will not have Medi-Cal as of the end of August.
Is there any advice you can give us?
Thank you!
Here’s our page on Alimony.
Near as I can tell and I’m not allowed to give tax advice, if the divorce settlement was done before 12.31.2018, alimony counts as income.
But you are right, Medi Cal is based on MAGI income as defined above. Line 37 – now 7 + …
$14k qualifies one for Medi Cal see chart.
Here’s our page on MAGI income qualification for Medi Cal.
Here’s our contact page for Medi Cal Try emailing your question and my research to this address [email protected]
B. Counting Income
MAGI Medi-Cal and MCAP use largely the same MAGI methodology that is used by Covered California for counting income. Taxable income, Social Security benefits, tax-exempt interest and foreign earned income are all included.
2. Income Threshold for Financial Assistance
Most adults with household incomes up to 138% FPL in California are eligible for Medi-Cal (for children, the income standard is set at 266% FPL), and as described above, eligibility for Medi-Cal precludes eligibility for Covered California. In the vast majority of cases, an individual must have household income above 138% FPL to qualify for premium tax credits – and most children must be in families with incomes above 266% FPL in order to obtain premium tax credits. Western Poverty Law *
What is your Mother’s expected income for 2019? 2020? When income gets too high, then you can get subsidized coverage with Covered CA. Get quotes here. No charge to have us as your broker.
the IRS does often rely on what is known as the “3-of-5 test.” This means that a successful small business should typically earn a profit three of every five years. If you have attempted to turn your hobby into a profitable business for seven years with no success, it may become difficult to claim profit as your true motivation. biz fluent.com
Our webpage on hobby or business
when calculating MAGI when the client has W2 wages plus a Schedule F Farming —
please tell me how the MAGI would be figured when applying for health insurance.
The bottom line is, what do you expect the MAGI income to be when you file the current years or the next years taxes? What do you expect on Line 7?
W 2 Wage income counts, so does net profit from Farming. It’s countable income. If things change, just comply with the law and notify Covered CA or the Exchange within 30 days.
Do you expect the farming income to be income or a loss?
Schedule 1 see line 18
1040 Instructions
Farming & Fishing Income
We are having technical difficulties with replies being indented.
Here’s the question, I’m answering:
Anonymous Asks:
I called Covered CA and told them my income was the following:
To date Jan thru Feb 25, 2018 for Bxx Hxxx I have received 4 paychecks. YTD gross for them is $3838.00.
Txxx On Rxxx less than $500.00 this year.
Just started with CxxC on Feb 26, 2018 and so far received a check for approximately $274.02 from them.
My premium just took a drastic jump, Why?
*************************************************************
Our Reply
First of all, while Covered CA did add all the entry pages for ones income and deductions, IMHO (In my Humble Opinion) it’s best to just figure out what you are going to have as MAGI income at the end of the year on your tax return. It’s basically line 37. Scroll to the top of this page for more detail.
If you are going to fill out the entire form, then again IMHO it’s best to log into your Covered CA account and complete the form yourself. Here’s our webpage on how to update, change your income.
I do not recommend just calling and having someone else enter information for you. This is also why, we prefer that you email us rather than call. This is how someone whose income went from $15/hour to $15.20/hour gets hit with $40k in income, when it should be closer to $25k, being as she’s a teacher and doesn’t work summers.
Here’s our free quote engine to figure your subsidy based on the income you project for the current year. The PAST is not relevant, unless your projected income is in question and Covered CA wants some kind of proof.
Excerpt of Covered CA Income Entry Page
i am head of household (IRS and CA FTB – CA Taxes) for my daughter and grandson who are both adults and grandaughter who is 2 yo.
The three live full time with me, they have no income, and are all on medi-cal (no special circumstances).
my AGI in 2016 will be approximately $78,000.
can i claim them as dependents for tax purposes and still keep them on medi-cal?
I don’t think so. According to the income chart, you are at 322% of FPL-Federal Poverty Level. This is too high, even for the granddaughter to qualify as a child under 18 at 266% or less of FPL.
Please get a complementary quote here and with subsidies your premium might be very low.
The adult children might consider applying direct to Medi-Cal and seeing if they qualify.
I don’t get paid to help you with Medi-Cal so contact your local office. See Western Poverty Law Center 375 page booklet for more details, namely page 45 – 2.32
thank you Steve.
unfortunately our experience with medi-Cal over the last 2 years has been more than frustrating–no one knows anything but they think maybe they do!
with that history of innumerable dead-end contacts, we are reluctant to call for reliable info.
The most reliable information that I’ve found is the 375 page booklet from Western Poverty Law Center. See links above.
I still cringe when I reflect back when my local Congresswoman put on a introduction to ACA around September 2013 and when her speakers gave WRONG information about the current system, information for which I could lose my license, if I said it, her aides told me I was never allowed to interupt a well – respected member of congress.
See our contact page, I do have some email addresses there.
What are the ages of everyone in the household? What county are you in? How did they get Medi-Cal in the first place? I wouldn’t expect anyone to know the answer to your question over the phone. When you look at the Western Poverty Law Center booklet, do you expect a telephone employee in India to understand the tax code? Here’s a flow chart for calculating household size, this might be simpler.
Don’t you think it’s a shame, that Medi-Cal won’t pay agents to help you enroll?
Read everything VERY carefully, it looks like the adults over 21 could still qualify for Medi-Cal.
When does your redetermination come up?
https://www.chabad.org/parshah/article_cdo/aid/4091059/jewish/Listen-Really-Listen.htm
1. Yes, it’s line 11 of your 1040. See our page on spousal support for more detail
2. No. See our Gift page for more detail
3. It’s what you expect that your 2016 1040 return will show for line 37 AGI Adjusted Gross Income, then add in, Social Security Line 20…, Foreign Income and Exempt Interest line 8b. Review this page…
Get free quote, subsidy calculation, Enhanced Silver Level here, once you have your estimated MAGI Income. You can easily change the income amount and see if you get Medi-Cal, Enhance Silver, etc. There is no extra charge for our help. We get paid, when you appoint us as your agent.
I am in the process of applying, [for Covered CA] I do long form taxes, [1040] can I deduct car registrations, home property taxes, amortization from rental and expenses on rental to lower my income.
MAGI income is defined at the top of this page. MAGI is line 37 of your 1040 plus foreign income, tax exempt interest and some Social Security benefits. For details of what goes on line 17 Rental Income, please see our rental income page. We are happy to be your agent for Covered CA and there is no additional charge. Click here for instructions to appoint us if you already have an account with them.
Know how adjusted gross income affects taxes
• A taxpayer’s AGI and tax rate are important factors in figuring their taxes. AGI is their income from all sources minus any adjustments or deductions to their income.
Generally, the higher the AGI, the higher their tax rate, and the more tax they pay.
• Tax planning can include making changes during the year that can lower a taxpayer’s AGI. The taxpayer could:
o Contribute to a Health Savings Account
o Claim educator expenses if they’re a qualifying educator
o Pay student loan interest
A full list is on Schedule 1 of Form 1040.https://www.irs.gov/pub/irs-pdf/f1040s1.pdf
Save for retirement
• Retirement savings can also lower AGI. https://www.irs.gov/retirement-plans
o Contributing money to a retirement plan at work like a 401(k) plan can reduce a taxpayer’s AGI.
o Investing in a traditional IRA plan is another way to save for retirement and lower AGI.
o Self-employed SEP, SIMPLE, and qualified plans are also retirement options that can lower AGI.
Hi,
I have a couple of questions for you:
I am currently receiving Medi-Cal and have had an increase in wages which has brought me to $16,938 in annual income. I desperately want to be enrolled in the Kaiser silver 94 HMO benefits through covered California.
Will the increase in wages be considered a qualifying event?
If I were to have you assist me would that remove the DHCS caseworker from determining approval or speed up the process?
Thank you
$16,938 is barely over 138% of Federal Poverty Level as you can see on the income chart. Please get a complementary quote and subsidy calculation here so we can double check.
Yes, an increase in income is a qualifying event CFR 156.425.
I would suggest that you get the complementary quote above, send us the proofs that you expect your MAGI Income line 37* on your tax return to be over 138% of FPL then we can either start your Covered CA account or appoint us and we should be able to get you going for July 1.
I am moving and am using special enrollment to change my healthcare coverage. According to the rules, if I apply before the 15th of a month, coverage begins on the 1st of the following month. If I apply after the 15th, then coverage begins on the 1st of the second month after I apply. Thus coverage can start up to a maximum of 45 days or so after I apply.
In applying, I was declared as conditionally eligible” due to them requiring that I “verify income” by 90 days after my application date.
My question is:
Will I be uninsured for the period after my coverage is suppose to start up until the day the approve my attempt to verify income? This could be a 45 day period in which I need medical care. Or will I be covered for those 45 days and if they reject my verification of income – then will they drop me from my new plan?
Thanks for all the help on your website!
You will be covered when the coverage says it will start, given the 15th of the month rule… 155.420 (d) (b)
If you don’t verify income, then you might get a cancellation notice, as the sample notice says on page 2. If you do get cancelled the policy EOC Evidence of Coverage requires at least 30 days notice. It’s a CA law too, let me know if you need that citation.
If you’re income is below 138% of Federal Poverty Level – Free Quote, FPL & Subsidy calculator, then you can get Medi-Cal, which has year around enrollment. If your income at the end of the year is too low or too high for subsidies (chart) you might have to pay them back when you do your taxes.
The rule about when coverage starts and if you apply before or after the 15th has nothing to do with subsidies or verifying income. That period is there partly because a lot of people have other coverage, like COBRA or their prior individual plan to carry them through the end of the month. Take a look at our Temporary Plan Page
Instructions on how to appoint us as your Covered CA Certified Agent – No Extra Charge. We only get compensated when you appoint us.
If a person owns property and is on Covered California will all the medical expenses have to be payed paid back after the death of the person on Covered California?
Yes, if over age 55 – see §14009.5 for details. Capitation Rates – Premium Costs for Medi-Cal.
Hi Steve,
I’m enrolled in anthem blue cross viA California Covered Care.
I get letters that contradict each other routinely. One letter says I’m covered , the other says I’m not.
I’ve spent hours on phone with California covered care with people who have questionable English literacy.
I need a professional to deal with California Covered as they are too disorganized for a non insurance specialist to deal with all their idiosyncratic behavior.
Can you help me ?
Thanks,
Martin
Yes, we would be glad to help you. Two things that you need to do to transfer your case to us.
1. Change your Covered CA agent delegation to use. Here are the instructions. If you have trouble, just send us your user name and password and we can do it.
2. Email us for the Blue Cross Change of Broker Form Blue Cross though has tricky rules and if you are a “house account” they might not pay us.
Once we have access to your Covered CA account, we can view all the letters they send you. If Blue Cross won’t recognize us as your agent, then:
3. Get an ONLINE Member Account and give us the user name and password for that.
Then we should be fully able to help you. If you were to get additional coverage, like Life Insurance, Long Term Care or Disability that would be a way to compensate us for our time, if you are a “House Account” or you had coverage with Blue Cross prior to 1.2014.
Steve
I am currently receiving Medi-Cal due to low income (my MAGI is less than 138% FPL).
On my 65th birthday, I will get to keep Medi-Cal just by being 65 years old, even if my MAGI is greater than 138% FPL. Is this assumption correct ?
Regards,
Tom N
I don’t think you will be eligible for MAGI based Medi-Cal, once you qualify for Medicare, definitely not if your income is over 138% of FPL, Federal Poverty Level.
Medi-Cal requires annual re-determination – proof of income or checking through the Federal Hub. I will check. Look for updates on our Medi-Cal Eligibility Page. If you remain eligible for Medi-Cal, there will probably be an asset test.
Do you qualify for Medicare? How long have you lived in the USA? How many years/quarters did you pay into Medicare? If long enough, you can buy into Medicare. If not long enough to qualify or buy into Medicare, then you can stay on Covered CA, with subsidies.
We can help you with Medicare Advantage plans, if you qualify or purchase Medicare.