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Covered California Q&A

Covered California and Obamacare 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 Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Domestic Partnership Eligibility?

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Question: I now quality for health insurance assistance. If I enter into a domestic partnership with someone who is over 62 (opposite sex) who does not qualify for assistance, would I have to include his income to determine if I still quality for assistance?

Answer: In general, California now affords the same rights and responsibilities to registered domestic partnerships (RDP) as married individuals. However, because the IRS does not recognize RDPs as married individuals for federal tax purposes, domestic partners will continue to been seen as unmarried individuals by Covered California. Your eligibility for premium assistance is based on your income alone.


Question: My child is a full time dependant that lives at home and works part-time. This year she earned over the limit of nonreportable income and had to file taxes. My question is this, do I report the income earned through the part- time job that is over the threshold or the entire 9k? Secondly, is it okay to include under entire household income (my income, self employed) estimate, or should I list the income for my dependant alongside the dependant name?

Answer: This is the easy part of your question: all of your adult child's $9,000 income must be reported, not just the amount over the threshold. Part two: If you wish to continue claiming her as a dependent, you must add the $9,000 to your household income. In that case, your dependent must opt out of her personal deduction when filing her income tax return. Otherwise, she can apply for coverage as a one-person household. The income of $9,000 makes her eligible for Medi-Cal, no cost insurance, but you would give up the dependent deduction on your taxes.


Question: My spouse & I are renewing our health plan coverage for 2019, but he will be going on Medicare in April. When he cancels his Covered California plan, how will that affect my rate?

Answer: You and your spouse have individual rates which are now combined. When your husband goes on Medicare, you will pay only your individual rate.


Question: My wife and I sold our primary residence in 2018 with a capital gain of $100,000. We meet the certain conditions to exclude the first $500,000 of gain from the sale of our home from our income and thus don't have to pay taxes on it to the IRS. Because of this fact, is this $100,000 capital gain not counted as income from Covered CA stand point and not affecting the Advance Tax Credits we receive? Thanks

Answer: Covered California considers only taxable income in establishing your eligibility for premium assistance under the Affordable Care Act. Your taxable income is your adjusted gross income (AGI) which can be found on Line 37 of IRS Form 1040. AGI includes capital gains, but since the capital gain from selling your home is excluded from tax in your case, it will not affect your taxable income.


Question: If I divorce before the end of the year I understand I have to file my taxes separately but my annual income to determine coverage was based on both of our incomes as a married couple. My coverage was based on household income of 40K with 2 people, married. If we divorce and I have to file taxes separately as a single person my reported income would only be about 18,000. How does that impact my covered California? My email is below

Answer: In your case, your individual income of $18,000 will qualify you for more premium assistance than you qualified for as a couple. You will receive the added premium assistance as a tax credit when you file your 1040 for 2018 as a single taxpayer.


What is Considered Income?

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Question: What is considered "income" Is savings or proceeds from retirement investments "income"?

Answer: In determining eligibility for premium assistance and cost sharing benefits, Covered California considers only taxable income. A quick way to check your "income" is to look at line 37 of your Form 1040 tax return. This is your Adjusted Gross Income or AGI. It includes interest earned on your savings account and withdrawals from your retirement account.


Question: When is open enrollment this year?

Answer: The Covered California 2019 Individual Health Insurance Open Enrollment Period starts on October 15, 2018 and runs through January 15, 2019. To purchase new coverage effective January 1st 2019, you must apply by December 15, 2018. During Open Enrollment you can apply without a Qualifying Life Event.


Ending COBRA Now?

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Question: We have been continuing coverage through COBRA since August, but our premiums are so high we want to switch to Covered California. Does canceling the coverage count as a qualifying event if it's accompanied by spouse being pregnant? What are our options if we are unable to enroll in Covered California but still wish to cancel COBRA?

Answer: You can be eligible for Covered California premium assistance if your COBRA coverage is cancelled during the open enrollment period or when the COBRA coverage expires usually after 18 months. If you drop it now, you can probably find an individual plan plan with lower premiums than your COBRA, albeit with less coverage.

Also check Health Coverage Options for Pregnant Women under Medi-Cal.


Question: I have Blue Shield silver 87 but it turns out very few doctors in my aria accept Blue shield, and the few that do take forever to get an appointment too see, So I'm was wondering if I could change my plan I was thinking of Kaiser Permanente gold hmo, even though my monthly payments would be considerable more at least when I had Kyser I could see a doctor in a timely fashion when I needed one!

Answer: No. You can't change your health insurance plan until the next open enrollment period which is November-December 2018. You can switch to Kaiser then and the new coverage will be effective on January 1, 2019.


Question: If my child is offered an insurance at his college, will he no longer be eligible for subsidized Covered California insurance? He is a high school senior now and is planning to attend a college in California this fall.

Answer: Your son can remain on your Covered California health plan and the household will remain eligible for premium assistance even if student health insurance is offered.

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