Covered California and ACA related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the ACA and Covered California knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Medi-Cal Renewal Form?

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Question: The Medi-Cal renewal form says "every member of your household who is living with you or is listed on your tax return". I am married filing separately (for a few years now) and qualified for medi-cal for myself and 2 kids last year through Covered California. At that time i was not living with my husband. My questions is should i list my husband or not? We live with him now, but file taxes separately and do not have medi-cal with him.

Answer: Yes. His income is now a factor in your mutual eligibility, so if your household income is above $33k for 4-person household you and your spouse are no longer eligible for Medi-Cal and now eligible for Covered California coverage. But since you file taxes as "married filing separately", you are not eligible for premium assistance.

Question: We are a family of 4 however my daughter, age 23,who I covered under the Covered California family plan. She files her own taxes. Do I have to claim her and her income on my taxes?

Answer: No. If your 23 yr-old daughter files her own federal income taxes in 2015, she cannot be included as part of your household for CC eligibility. If she files fed income taxes for 2014 and you included her in your 2014 Covered California coverage, there is no penalty. However, you probably received excess advanced premium tax credits in 2014 which will be reconciled when you file your 2014 return. As for 2015, you have to remove her from your Covered California account and she needs to create a CC account of her own. She will be eligible for either Covered California coverage or MediCal based on her own income.

Replace COBRA Now or Later?

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Question: If my COBRA coverage ends in July, do I have to enroll now or may I enroll in July?

Answer: You can enroll in Covered California by 2/15/15 and drop your COBRA effective 3/1/15 if it is advantageous for you. Otherwise, you can keep your COBRA coverage until it expires and apply for Covered California coverage then as you will be eligible for a special enrollment period at that time..

Kids in Medi-Cal Automatically?

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Question: I was told that if I have Covered CA health plan, my child is automatically enrolled in Medi-Cal. Is that true?

Answer: Not necessarily. It depends on the family income. If the household income is over 138% Federal Poverty Level (FPL) (approx. $33K for family of 4), but below 265% FPL (approx. $63K for family of 4), the children age 18 and younger are automatically enrolled in Medi-Cal. If the income is below 139% FPL, the parents are eligible for Medi-Cal as well. With income above 265% (and less than 400%) FPL, both the adults and children are eligible for Covered California coverage with premium assistance. If you or your children are eligible for Medi-Cal you can choose not to enroll, but you will not receive premium assistance.

Question: When I initially applied for Obamacare through Covered California is was found eligible for Medi-Cal. Three weeks passed before I could correct the income figures in my application. At that time I was approved for Anthem coverage with premium assistance through Covered California which I recently removed. Now, over a year later, Medi-Cal started sending me enrollment questions. They still think I’m enrolling in MediCal! How do I put a stop to this?

Answer: According to, Cathy Senderling-McDonald, Deputy Executive Director of the County Welfare Directors Association of California, county eligibility workers are unable to delete duplicate applications or remove applications upon a consumer’s request. Senderling-McDonald said, “Our county eligibility workers need to be able to tell the system, ‘This person is not eligible,’ or, ‘We need to withdraw this application,’” adding, “The computer can start that process, but our workers can’t and that was a huge oversight in the programming.” So I suggest trying to get your Medi-Cal enrollment cancelled by calling Covered California at 800-300-1506 and ask them to cancel the enrollment from their end.

Question: Hi, I want to download my 1095-A as a PDF. I don't want to have to chase down the paper copy. Is it available online? Please make it easy and obvious to find once I log in.

Answer: The Form 1095-A's have already been posted online. You will have to login to your Covered California online account. You may find the form in your Secure Mailbox (iffy) or more reliably on your Documents and Correspondence page. To get there, click on the Summary checkbox on the home screen and next click the Documents and Correspondence link, select and download the 1095-A document as PDF.

Question: Will an immigration sponsor be responsible for Medi-Cal bills of the immigrant who is holding a permanent green card?

Answer: No. There is no direct liability for the sponsor to repay the Medi-Cal expenses of the sponsored persons. However, if the sponsored immigrant secures means-tested benefits like Medi-Cal fraudulently the sponsor can be held liable.

Debt Cancellation Distorts AGI?

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Question: In 2013 and 2014 we had a debt cancellation (credit card settlements) since we were in financial hardship and weren't able to pay the credit card payments. We settled with creditors and paid off our debt but creditors have sent us 1099C forms and the amounts of cancelled debts were added to our income in 2013 and will be added in 2014 as well. This has raised our AGI tremendously for both years. Based on our actual income ,we are qualified but considering this phantom income (cancelled debt) seems like we won't be able to qualify. What do you suggest we should do? we need to send the 2013 tax return as proof of income. Can we to deduct the amount of 1099Cs from our AGI and report that amount? Please advise.

Answer: In addition to submitting a copy of your 2013 federal income tax return, you will want to explain to Covered California that your 2013 Income Tax form includes an exceptional one-time lump-sum credit which distorts your adjusted gross income (AGI). Download a free online affidavit form and use it to explain your debt cancellation issue. Otherwise, I would leave your Covered California account as it is for now.

Final Version of Form 8962?

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Question: Phil, you posted a draft version of the IRS Form 8962 a while back. Do you have a download for the final version?

Answer: Yes. Download IRS Form 8962.

When you file your federal taxes, you or your tax preparer will use the information on Form 1095-A to complete IRS Form 8962. You will use Form 8962 to tell the IRS how much premium assistance was paid to your health plan on your behalf in 2014. Using the form you will:

  1. Calculate the total amount of premium tax credit that you are allowed to claim based on your coverage, income and family size.
  2. Compare the amount of premium assistance that was paid in advance on your behalf to the premium tax credit.
  3. ´┐╝´┐╝´┐╝Determine the amount by which the premium tax credit exceeds the amount of premium assistance received, if any. And, claim it as the net premium tax credit on your federal income tax return.
  4. Determine the amount by which your premium assistance received exceeds your premium tax credit, if any, and report it on your federal income tax return. You will have to repay some or all of this excess amount.

How to Get IRS Form 1095-A?

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Question: How do I get my 1095A form?

Answer: You don’t need to do anything. Covered California will mail the IRS Form 1095-A to all consumers who got insurance through Covered California in 2014. They also send a copy to the IRS. The Form 1095-A has the information you or your tax preparer will need to file your tax returns. This form has information you gave about your family. The form also tells you:

  • How many months you had health insurance
  • How much you paid in monthly premiums
  • How much premium assistance was paid to your health plan on your behalf (if any)
  • Who was enrolled in your health plan

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