Question: I can’t find this anywhere! My brother will be in China this school year, including the first half of 2014, which is what the financial assistance for premiums will be based on. He didn’t have any other income in 2013. His income in 2013 will all be excluded because he pays taxes to the Chinese government as a teacher and he is under the $90k or so foreign income exclusion limit. Yet, he’ll be low income, probably fitting in the less than 200% of the FPL. We can’t figure out if he qualifies for the financial ACA premium assistance. Most people drop insurance when they go work overseas, but since he is returning and wants to remain with the HMO and his doctors, he wants to pay while he is teaching this school year in China. Thanks.
Answer: Your brother is exempt from the mandate to purchase health insurance while he lives out of the country. He couldn’t enroll in Covered California while out of the state anyway. When he returns, he will qualify for a special enrollment period and can enroll in the exchange. His eligibility for a premium assistance at that time will be determined on his projected income. He can probably find a plan that will include his current providers if not the same carrier he has now.