Speak with a Covered California certified agent! Call (888) 413-3164 or Shop Online Now

Shop and Compare

California Health Insurance Plans and Rates

It's easy. Just enter your zip code.

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.


Subsidy for Separated Couple?

By on | 2 Comments

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.


Estimate S-Corp Income?

By on | No Comments

Question: My wife and I draw a salary as employees of the small S-Corp company we own. There are additional business profits that reside in the business bank account and are not drawn as salary or as owner distribution. What do we consider when estimated our yearly income?.

Answer: S corporations and partnerships pass through the reporting of the company's entire profit to the owners. You and your spouse are liable for taxes on the corporation's profit whether or not it was distributed. Those profits are included in your 1040 AGI upon which Covered California eligibility is based.


Overpayment of Subsidy?

By on | No Comments

Question: I took out $20,000 from my IRA. It raised my income to $55,000 which normally be around $35,000. This was a one time deal, 2020 income will be closer to $35,000. How do I handle this with Covered California?

Answer: If you don’t plan to make an IRA withdrawal in 2020, I suggest you do not change your stated income in your Covered California account. The IRS will recover some or all of the subsidy overpayment in 2019 on your next tax return.


QuestionMy husband and I are enrolled in Covered California. We claimed my mother in-law as dependent on tax return. Can my mother in-law still apply for Medi-Cal while my wife and i have Covered California?

Answer: Your mother-in-law is not eligible for Medi-Cal unless you remove her as a dependent for federal income tax and change your Covered California account to a two-person household.


Question: My income exceeded my estimate for the year. I’ll have to pay some of the subsidy back. How do they handle that?

Answer: The IRS will recover some of the excess tax credits you received to help pay your health insurance through your tax return. The repayment is added to your taxes due.


Adult Child Dependent Status?

By on | No Comments

Question: I was told that my 25 year-old daughter had to be a dependent on my taxes. I thought she could stay under my Covered California plan until she is 26 years old.

Answer: Your adult child can file their own tax return and still be included on your family coverage to age 26. If your family is eligible for premium assistance through Covered California and you wish to include your daughter as part of your household, she must be a dependent on your income tax return. She will still file a tax return, but opt out of her personal exemption.


Question: My husband 1s currently on my insurance at work, but it has gotten too expensive. He makes less than $20,000 a year. Can he apply for covered California on his income alone?

Answer: No. Your spouse is not eligible for premium assistance (subsidy) through Covered California, because he has access to your employer’s health plan. He can apply off exchange for insurance coverage without a subsidy. Compare off-exchange rates with your employer based plan.


Will I Have to Repay the Subsidy?

By on | No Comments

Question: If I am on Covered California or even Medi-Cal for part of the year and then I get hired for a full time position with income that exceeds the income limit for Covered California will I need to pay back the benefits I received during the first part of the year or pay a penalty?

Answer: You will have to repay some or all of the premium assistance you drew when you file your tax return for that year. If your income remains within the subsidized range, the amount of the federal tax clawback is limited to a maximum of $2,600. If your income exceeds $49,500 individual $100,500 family), the tax credits you received must be repaid in full. If you are covered by Medi-Cal, no repayment will be required regardless of subsequent income.


How to Report IRA Withdrawal?

By on | No Comments

Question: I withdrew $10,000 from my IRA which raised our income to $45,000 which normally be around $35,000. I’m confused on what is Income, if I do not noemally count on that money yearly, nor do I plan to again.

Answer: Since you are collecting monthly premium assistance in the form of tax credits based on an estimated annual income of $35,000, your excess tax credits for actual 2019 income of $45,000 will have to be repaid when you file your taxes for 2019. Since you do not plan to make an IRA withdrawal in 2020, I suggest you do not change your stated income in your Covered California account, because your 2020 income will return to to about $35,000 and you’ll be back on track with a minimum of complications.


Moving to California?

By on | No Comments

Question: I am moving to CA this month. (1) When should I apply for health insurance in CA? My family may qualify for Medicaid or other subsidized programs. Would the effective date be the exact date of the move or would I be covered by my Texas plan until I start my CA coverage.

Answer: You must be a California resident to apply, so apply as soon as you have a California address. Apply through Covered California to determine your eligibility for premium assistance or Medi-Cal. Your CA coverage will start on the first of the month following your application.

Do You Have California Health Insurance Questions?

Ask An Expert

View Previous Questions
Call Us at (888) 413-3164


© 2019 California Health Benefit Advisers, LLC
Home / About / Start Shopping / Ask a Question

“Covered California,” “California Health Benefit Exchange”, and the Covered California Logo are registered trademarks or service marks of Covered California, in the United States. This web site is owned and maintained by California Health Benefit Advisers, LLC, which is solely responsible for its content.