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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.


Husband on Medicare, Wife on Covered California?

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Question: Retired couple on Covered CA has husband turning 65. Husband is the only income in the household and they are APTC eligible. Now that husband is going to be eligible for Medicare and ineligible for Covered CA how is the income counted for the wife in Covered CA. Will his income be used to determine what her premiums will be in Covered CA? Will she now be eligible for Magi Medical since she has no income? Thanks

Answer: The husband's income is still counted even though he will not be enrolled in Covered California. Since the premium assistance (subsidy) is based on a 2-person household, the wife in this scenario will continue to pay less net premium they were paying as a couple.

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“the wife in this scenario will continue to pay the same net premium they were paying as a couple”

This is a misstatement. The wife will pay a premium for one person, not two. The advance premium tax credit amount will remain the same, since it is based on a two-person household, but only one person will be paying premiums, and that will be a smaller amount of out-of-pocket expense than the couple was paying prior to the husband’s age 65 eligibility for Medicare.

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