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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.


Question: I had more income than I estimated in 2020, and I owe the IRS $6,000 for excess tax credits. That sucks big time.

Answer: Lucky you! The American Rescue Plan suspends repayment of excess advance premium tax credit (APTC) owed to the IRS for the 2020 tax year.


Question: I was on unemployment insurance until April 2021. How do I estimate my income for Covered California health for this year.

Answer: For households in which the primary tax filer or their spouse receives or is approved to receive unemployment insurance benefits (UIB) for one or more week in 2021, your household income is locked at 138.1% of the Federal Poverty level. What that means to you, is that your health insurance costs you nothing in 2021. The FPL lock will apply to all members of the household that are not otherwise determined eligible for Medi-Cal or CHIP programs.


Question: Our family income is just above the income level to qualify for a health insurance subsidy. We pay almost $1,500 a month for health insurance. That’s too much.

Answer: The American Rescue Plan makes health care coverage more affordable by limiting a family’s required contribution for coverage to no more than 8.5% of household income. In your case — a family of four with an annual income of $105,000 — the monthly premium for the second-lowest silver plan would drop from $1,326 to $743.


Covered California Deadline Today?

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Question: I saw on TV that today is the deadline for signing up with Covered California. Is that right? I also read that Open enrollment in CA goes to January 31.

Answer: Today is the deadline for enrolling for coverage effective 1/1/2020. The Open Enrollment Period remains open until 1/31/2020 for coverage starting February 1st.


Question: I've read through the archives, but I need clarification regarding a dependent and what to include in the household income in the application. I am 20 and going to school full-time. My mother's group plan is not covered in the county that I am in, but I am working part-time. Would I be able to apply for just myself as a household of 1? or do I need to include them in my application? I am still being claimed as dependent, but will be filing my own taxes.

Answer: Yes. You can enroll as a single-person household based on your own income. You must file a tax return and claim your personal deduction. Your mother can no longer claim you as a dependent starting in 2020. If your projected income is less than $17,000 in 2020, you will be enrolled in Medi-Cal.


Untaxed Social Security Income?

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Question: Are Social Security income benefits included in the income total? I ask because only a portion of my wife's SS is considered taxable.

Answer: Covered California's income calculation includes non-taxable Social Security benefits. However, if your income is less than less than $32,000 for joint income tax filers, you pay no tax on your Social Security benefits.


Did I Make the Sign-up Deadline?

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Question: I started the application on the Saturday the 14th deadline, but couldn't finish it. I tried to upload a form but could't get it done. Did i do everything already on my part for the deadline.

Answer: Covered California extended the Open Enrollment deadline for coverage starting on January 1, 2020 coverage to Friday December 20th, but as long as you start your application by the deadline, you'll have coverage on January 1st even though your application may have some unresolved issues.


Need Form 8962 for Tax return?

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Question: I filed my 2018 federal income tax return late and didn’t realize I needed to include Form 8962. I received subsidies in 2018 and 2019 and will need premium subsidies in order to afford coverage next year. Can I still receive premium subsidies in 2020?

Answer: If you received advance premium tax credits in 2019, they will continue in 2020. The IRS requires a you to submit IRS Form-8962. Click to download 2018 form 8962 here. Keep in mind that later during the year, Covered California will check with the IRS to verify your return was filed.


Son Off Medi-Cal at Age 19?

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Question: My son is turning 19 in January and lose MediCal coverage. He will need to be added to our Covered California coverage? What do we need to do?

Answer: Notify Medi-Cal to terminate your son’s eligibility. This will trigger a qualifying event and your Covered California account will be updated by your county Medi-Cal staff. Once the update to the account has been made then you, your agent, or a Covered California call center representative can complete the plan enrollment within the Covered California account.


Subsidy for Separated Couple?

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Question: We are a separated couple with two different households, is each spouse eligible for a subsidy?

Answer: Your federal income tax filing status is key. If you file as "married filing jointly", you may be eligible for premium assistance depending on your joint income. You and your husband and any dependents would be considered one household even if you live apart. If you file as "married filing separately, neither you or your husband will be eligible for premium assistance.

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