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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.


Applying with 0$ Current Income?

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Question: My son is going to be 26 on 1-3-2014. He is covered on my insurance until 1-31-2014. He is living at home and is between jobs and does not have income. Covered California does not allow him to enter information without showing an income. Also, askes for number of people in household. My husband and I have our own insurance so we would not be applying. How does he fill in this information. He does not need his insurance until 2-1-2014, however, he needs to be covered. We have both tried calling but to no avail as the system is super busy. Please explain how my son proceeds.

Answer: Your son should apply for coverage through Covered California anytime after December 23rd and before January 15th for his coverage effective 2/1/2014. He is a one-person household and since he is estimating his income for 2014, he must enter in income figure even though he is earning $0 today. A number under $16,000 will make him eligible for Medi-Cal. He must promise to file a tax return for the 2014 tax year. (I am assuming that his parents no longer claim him as a dependent.)

34 Comments

My daughter who is 26 included me on her paperwork with the household however put down that she is not claimed by myself. Can I simply just remove my information from her application? When I called they said yes and it won’t make any changes to hers

Hi Dawne - No. You daughter applies by herself as a household of one.

When filling out the application. My daughter is 26 and has 0 income. She lives with me and her brother. Do I need to be included on her application under household?

You have your governor and legislators to thank for that and all the people who voted for them. In California your health insurance would be free under Medi-Cal (Medicaid in other states).

Max, thanks for the correction of my comment to Tom in NJ. Of course, if his income is $0, he is eligible for Medicaid in any state.

If Tom actually has $0 income in NJ, he would still be eligible for Medicaid since his income is below 133% FPL — expansion or not. However, if he wants commercial health insurance, then, yes, he must pay 100% of the premium BECAUSE he is eligible for Medicaid, which is precisely what makes him ineligible for APTCs.

Obamacare was never intended to give people “free insurance”, although many persons receive enough APTCs to cover most of their premiums thanks to competition in the marketplace (which existed pre-Obamacare).

Tom, in California you would automatically be enrolled in Medicaid and receive free public health insurance. But because New Jersey did not approve Medicaid expansion under the ACA, you are apparently forced to pay $707 for private coverage - a case of geopolitical bad luck for you.

Are you still having this issue? I am making zero dollars a month here in NJ and it let me put zero in, I believe.

since I have no income the marketplace can go by I have to pay the full premium with no tax credit, 707.00 !! so anyone who thinks obamacare is free think again

DeAngelo …

If you have been requested by CoveredCA to upload documents — this will appear on the ELIGIBILItY page of your online application, then there should be a “Manage Verifications” link on the home page of your application (near the bottom right corner of the screen — in blue). You can click on that, or you can go to your Eligibility page and click on the “Upload Documents” link.

There you would choose the type of document you are uploading and select the file. Be sure to scan your document at a JPG or PDF for upload. After clicking the “Upload” button, a few seconds later you should see the success message which is in hard to see green.

Wow Maxx Herr u have answered all my questions! Okay accept where would i send this written affidavit? Do i scan it and upload it on the online application? Im thinking that would help avoid and fax and snail-mail trafficing delays.

Bobby …

You need to CHANGE your income from $0 — which is probably what you entered — to $3000/month to reflect $36,000 in income for 2014.

If that change does not update the system, then you will have to call CoveredCA (800-300-1506) and have a CSR make that change for you. Certain changes to income cause the system to lock up an account and only a CSR can undo that.

Hi Max,

I quit my job in July and made $36xxx from Jan to July. However, coveredca denied my app and told me that I am eligible for medi-cal since I have no current income. Is this correct? I have 3 people in my household, me, wife and 4 yo daughter. I thought any income made in any time of the year would count towards medi-cal’s max limit for eligibility and I am over their $27xxx for 3 ppl in household max limit for eligibility.

Thanks.

Sheen …

If you are going to claim your adult child as a dependent, then all income reported by that child, even if he/she files an individual tax return (with income of $18,000+ in 2014, that will be a requirement) must be included in the calculation of your “household modified adjusted gross income” for determination of the Premium Tax Credits for which you are qualified (or not). The adult child’s income is not included as part of your own taxable income.

Your professional tax adviser will be able to tell you how this complex mechanism works. Because this is the first year for this nonsense, there will be many people who make mistakes, some of which may be very costly down the road.

My son is 21 year old, a full time student and I claime him as a dependent, has a summer intern income 18000. Does his income have to be included in my household income under covered California regulation?

To expand on my previous comment, while the PPACA demands that employers offer coverage to the dependent “children” of an employee, that privilege does not extend to grandchildren of the employee, which is the situation described by Lettie. The grandchild, based on “household income” could be Medi-Cal eligible. If not, the child needed to have been enrolled in an individual health plan by 3-31-2014.

Now, if the 20-year-old has applied for health insurance through CoveredCA, and her income is <138% of FPL, she is eligible for Medi-Cal, but is not eligible for premium tax credits because she has an offer of health insurance through her parent. The 20-year-old child may be Medi-Cal eligible if her “household income: is <266% of FPL, but the PPACA does not require them to be enrolled in Medi-Cal when they have an offer of employer-sponsored health insurance, and I do not believe the employer has a unilateral right to terminate such a child.

HOWEVER … it is also possible that the parent’s health plan is a grandfathered plan and not entirely subject to the PPACA. If that is the case, then it may be possible to terminate a child eligible for public health coverage.

There simply are not enough details provided. Situations such as this are relatively uncommon and are very much fact-dependent.

CalWORKS is a program which provides certain benefits for the following children:

The eligible children are deprived of parental support or care due to … Death Incapacity Unemployment/underemployment or Continued absence of one or both parents

It does not sound like this applies to the situation as you have described it.

Have a question but cannot find the answer. Parent has 20 year old child covered on their insurace through their job. Child has baby and applies for CalWorks(fancy name for cash welfare benefits) and is approved. Whatever name your state choses to give cash welfare benefits it also comes with Medi-Cal(Medicaid for the rest of America, wonder how much money California wastes coming up with these names). Now the law is very specific regarding what happens if say both parents have separate job insurances, neither insurance can turn down the adult child. It very very specific in the wording and specifies repetidly that this applies to job based insurance. Everything from what I can find is silent towards medicaid. Now I have heard that at least one insurance company is trying to end coverage for adult children with medicaid. Can this be dome with new HCR rules.Before you would use both with medicaid paying what the insurance does not pay for such as co-pays. Any links to where I can find this answer would be great

Oanh Trinh … If you were denied Medi-Cal prior to 1-1-2014 on the basis of assets, it is because you and/or your husband are over 55 years of age and in need of assistance with Long Term Care expenses.

After 1-1-2014, the only eligibility factor is income in relation to the Federal Poverty Level. There is still a “share of cost” test of assets and income in relation to LTC expenses, but anyone with a household income of 138% of the FPL or less is Medi-Cal eligible.

If you were wrongfully denied Medi-Cal there is an appeals process that must be started within 90 days of denial. You may have already passed that point, but that does not prevent you from reapplying for Medi-Cal by filing a new application through Covered California.

We applied for Covered California last November. But, since we don’t have income because my husband has been out of work for 2 years. They said we were qualified for Medi-Cal. But, Medi-Cal in Orange County denied us since we have money in the bank! Now, are in the hole that we can’t get any help? Is it my husband’s fault that he worked hard for 31 years, paid tax and saved some money for later that we can’t get help now? Is there a solution for people like us?

Diana S wrote: “It would NOT let me put zero income!” Yes, that’s correct, because $0 is what is already programmed into each of the three income and one deductions sections.

When you have $0 income/deductions in any of the four sections, just skip the section by clicking the “Continue” button at the bottom of each page. This is obviously something CoveredCA did not think to mention in it’s limited instructions for the D-I-Y applicants. And, come to think of it, they did not expressly say this in agent training online or in person.

I guess they think everyone knows to do this. And it goes hand-in-hand with some of the suubsequent documentation requests to provide “Proof of Income” — how do you prove $0 income? Check stubs, bank account statements? This is what happens when government does not fully think through its processes. They could have simply stated on the form “IF YOU HAVE NO INCOME IN THIS SECTION, CLICK ON THE CONTINUE BUTTON” and accepted that as “proof of income” — notice they never request “PROOF OF NO SELF-EMPLOYMENT INCOME” or “PROOF OF NO OTHER INCOME” or “PROOF OF NO DEDUCTIONS FROM INCOME” … only PROOF OF INCOME.

Blank = $0 — Employment Income, Self-Employment Income, Other Income, or Deductions From Income. Entering $0.01 is not going to be a problem, and you can always go into your application and change the income — but I would simply say to leave it alone. With little or no income, you are qualified for Medi-Cal.

But here’s what I’m being told by many of my Medi-Cal applicants … “It’s been (two or three) months and I haven’t heard anything about my Medi-Cal. I even have several applicants from November and December 2013 who have called me in the last ten days with this same complaint.

Because there is no transparency or accountability on the part of CoveredCA or DHCS as to whose applications have been received/forwarded to the local county Medi-Cal agencies (DPSS in most counties, but CalWORKS in some), there is no way to know if someone’s application has fallen through a crack somewhere.

I have one family (H-W-C-C) in LA County with $0 income that one child age 19 and another age 22. The 19-year-old received a State Benefits ID card within two weeks, but the rest of the family has heard nothing since the end of January — more than 8 weeks. DPSS only tells them, “You application is pending.”

Well, that means my $58 is also “pending” — I have no way of tracking 100+ Medi-Cal applicants without contacting all of them individually to see if they were enrolled at the county level. Am I going to spend hours doing that? I doubt it.

None of this bodes well for CoveredCA in October 2014. All these layers of bureaucracy — CoveredCA on top of DHCS on top of local Medi-Cal agencoies — is an utter waste of money. CoveredCA has no trouble taking $2 million in “administrative expenses” out of the funding pie for its part in forwarding applications to DHCS which were submitted by agents, CECs, Navigators, and the individuals who submitted applications with no effort on the part of CoveredCA.

What about MY (and other agents’ administrative expenses for spending hours on hold with CoveredCA (and being forced to listen to that ungodly music) which failed to create a system that could handle the “we are experiencing higher than expected call volume” that begins precisely at 8am every day?

It would NOT let me put zero income! To continue with the application I had to input .01 as my income. Is that going to mess up my app? I only get minimal child support and was injured in car accident and haven’t applied for disability yet. I have custody of my daughter but her medical insurance is through her Dad’s employer. I hope I did my application correctly 🙏

Dylan …

Withdraw your application and submit a new application with $0 income. If asked to provide “Proof of Income” write a statement that documents why your income is now $0 and upload that (use the “Affidavit” choice from the list of documents — it is the only one that comes close).

With $0 income, you will be enrolled in Medi-Cal.

I am a 28 year old student, I made 30,000 last year and began graduate school last fall. I have no income this year, how do I verify that I do not have any income this year and qualify for assistance? As of right now I have entered my income from last year and do not qualify based on the expected income.

KC …

Student — not a student — doesn’t really matter. What does matter to a certain extent is your status as a dependent. Technically, under the IRC, past age 24 you cannot be claimed as a dependent on your parents’ tax return. Up to age 26, you were eligible to remain on your parents’ health insurance plan.

Now that you are 27, you are supposed to be on your own, have your own health insurance, file your own income tax returns. If your income from all sources is less than $15,856 (2013 numbers), then you are eligible for Medi-Cal, and should apply through CoveredCA.

I am 27 y.o. full-time online student. I do not work at all, and the only income I have is a student grant of $2,500 a year — which I do not see because it goes towards school. I am claimed as a dependent on 2013 income tax return. Do I have to use his income when applying for Covered CA? Or do I use mine of $0-2,500?

Marty …

With $0 income, you will be enrolled in Medi-Cal through CoveredCA. Bariatric surgery must be approved on the basis of physician recommendation and a combination of factors, including Body Mass Index (BMI), and two or more associated chronic health coditions such as hypertension, coronary artery disease, hypercholesterol, diabetes, etc.

HMOs generally do not cover the procedure unless determined to be “medically necessary”(as described above). Some PPOs will cover bariatric surgery if performed in a Center of Excellence within their network.

If you are a Medi-Cal enrollee, you can probably have the procedure performed courtesy of state and federal taxpayers.

I am a student with 0 income. I am wondering will covered cal accept me and do they cover batiactric surgeries for a patient with hypertension?

Angela wrote: “7. Guess what? I don’t qualify for Medi-Cal because of my age, …”

Angela, beginning 1-1-2014, your age is not the disqualifier. The disqualifier is MAGI in excess of 138% of the Federal Poverty Level.

If you are being reported as a dependent on someone else’s 2014 income tax return, however, your eligibility for both Medi-Cal and premium tax credits could be adversely affected.

You may apply at any time through CoveredCA for Medi-Cal eligibility — Medi-Cal is a continuous eligibility process.

See this is what gets me…these bureaucrats don’t get why things are different in California. If you are 26 or older and for whatever reason go back to school and go “home”, you are by law over 26 and therefore cannot be a “medical insurance dependant” however by federal tax law if your family or anyone else is providing the roof over your head, they CAN BY LAW take you as a dependant. One has nothing to do with the other and this is where people fall through the cracks. AND…if you are over 26 then you qualify for your grants with $0 income all by yourself and are classified as an “independent” student because of age. Grants= income. Obama really needs to see the between the lines info as to how people are falling through these cracks.

Here’s my problem:

  1. 29 yr old returned to college
  2. 9 yr old daughter
  3. moved back with family
  4. for grant purposes im over 26 and therefore an independent student and as such don’t have to file any taxes if my personal income is $0 even if I can be claimed as a dependent on someone else’s taxes. Age with a child causes this exception.
  5. Child support ordered but not received, and any $ received you do NOT as the recipient put that on your taxes- ever!
  6. Govt. grants for school = $ that I don’t ever see but it pays for school. They want income NOT AGI. my AGI would be $0 after all expenses and deductions which puts me in the Medi-Cal Category.

  7. Guess what? I don’t qualify for Medi-Cal because of my age, my grant $, and because I’m attending online classes instead of in-class hours. So…When I apply on Covered Ca- I am told to seek my local office, and local office says to sign up for myself on covered CA. so, they want me to lie to push through the process? what is that!!!

  8. My daughter doesn’t need coverage because I have it for her. her coverage isn’t getting cheaper- it’s actually more expensive now so that isn’t helping me.

  9. Can’t get past the application and eligibility area, so I can’t sign up for a plan

  10. neither will issue me a letter of exemption because I fit between the cracks and not in the “fixable grey areas”.

So how am I to fix this? I’m not required to file taxes and yes I can legally be claimed as a dependant if someone else provides a free roof over my head while I finish school. Tax law, School Grant Laws, and this ObamaCare junk has me screwed either way. Either I am forced to pay a penalty, or if someone claims me, I have to figure out how to pay them what penalty amount they would get for me no being able to sign up. Either way, that isn’t right.

Audrie …

Unfortunately, you will not be able to obtain health insurance through CoveredCA, which is controlled by federal law. The only reason to apply for insurance through CoveredCA is to be eligible for the premium tax credits, which are refundable or payable in advance to persons whose income is between 100% and 400% of the Federal Poverty Level (FPL). However, advance premium tax credits are not available to persons who have employer-sponsored health insurance or who are “eligible” for any government-sponsored form of minimum essential coverage — Medi-Cal, VA health system, TRICARE, etc. There are additional special provisions for Native American Indians and Alaskan Native Americans who have access to tribal health system resources.

In California, which has chosen to “expand” Medi-Cal eligibility to persons whose income is up to 138% FPL, a person applying for health insurance through CoveredCA who is eligible for Medi-Cal will be determined “ineligible” for premium tax credits, and their application will automatically be referred to the local Medi-Cal agency for followup.

You are free to obtain health insurance through any of the commercial insurers or HMOs operating in California. But even these companies and their agents are supposed to refer eligible individuals to Medi-Cal rather than collect premiums from them for health insurance. They cannot prevent you from applying amd paying for health insurance if that is your preference — but you will not be eligible for premium tax credits in 2014.

If your income will exceed 138% FPL in 2015, and you will not have employer-sponsored health insurance, then you will be able to apply through CoveredCA during open enrollment from October 15 through December 7, 2014, for coverage beginning January 1, 2015.

I am a part time student, work part time, and I live with my parents. I will be 26 next year and will no longer be covered under my parents. With my current income I qualify for Medi-cal. Is this the ONLY type of insurance that I can enroll in? If I have enough money saved to pay for another type, can I do so through Covered CA?

Bartholomew …

Your friend’s “proof of [no] income” can take several different forms. The one that will work the easiest is to simply write a statement, titled “Affidavit”, that says he lost his job on a certain date, that he has no other source of current income, and that his YTD gross income is $XX,XXXX.

In combination with his loss of employment, however, he must also experience a loss of “minimum esential coverage” (such as group health insurance). He is not required to continue his group insurance under COBRA, but has only 60 days from the last day of the month in which the qualifying event occurs to enroll in a new plan.

In a broader question. How does one proof income for the future when asked for income verification? I have a friend that is quitting his job in february and I’m pretty sure is going to have a rough time finding a new one at the same level of pay, he´s making around 100K. He’s going to make no money from february to december but he´ll have made enough already that will be over medicaid limits. How does he prove his income when he will have none?

It is absolutely possible to complete an application with $0 income. I have some 40 Medi-Cal enrollees the majority of which have been entered with $0 income.

As Phil has stated, your son should apply as a household of 1, even if he resides in your home. He should not be listed on anyone’s 2014 income tax return.

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