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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.

Affects of Overestimating 2016 Income?

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Question: I lost my job in Nov 2015. I projected our 2016 income to be $33,000 which includes my husband's annual social security of $13,000. My unemployment ran out in July in which I collected a total of $10,800 making our gross 2016 income of $24,000. I have yet to get another job and have not had an interview. With tax exemptions our adjusted gross income will be below 138% of FPL. We have Silver PPO. How will this affect the ACA subsidies I've received to date and premiums I paid?

Answer: In 2017, you will be eligible for Medi-Cal. You will not have to pay back any of the advanced premium tax credits you received in 2016.



No. You won’t owe any money but you need to notify Covered California about your income change. You daughter will be on MediCal next year.

I have a 24 yr old daughter on my plan. Silver 70, I estimated more than we have actually been making. I realize now I should put my daughter on medical. However my income threshold keeps me on Silver 97. Will I owe money back for subsidies if she should have been on medical?

Your question was not fully answered. Tax exemptions may reduce your taxable income below 138% of FPL but not necessarily your Modified Adjusted Gross Income, which is the determiner of premium tax credits. As long as your MAGI exceeds 100% of FPL you are entitled to premium tax credits. If anything, it will increase the amount of tax credits you are eligible to receive, and the excess not already paid will be refunded to you when you file your tax return. You will need to wait for the APTC statement from Covered CA (which should come in January) before you file in order to “reconcile” what you received and what you were eilgible to receive.

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