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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.

Separated Couple Eligible for Subsidy?

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Question: When a married couple is separated but not divorced, maintaining two households instead of one and having 2x the housing expenses, is that a factor that can be taken into account in determining whether each of them is eligible for a subsidy for the purchase of insurance?

Answer: No. Your living expenses are not considered in determining your eligibility for premium assistance under ACA rules. Your tax filing status and adjusted gross income (AGI) are the only considerations. As a married couple living separately, 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.


Ann, hopefully your income makes you eligible for Medi-Cal. Your tax filing status doesn’t matter for Medi-Cal eligibiliuty.

As a woman who was married to a foreign man not residing in the US, no resin to file taxes here, I am stuck in “married filing separately” as I am not divorced and won’t likely be.. working sometimes, not making enough to pay fir healthcare myself, not eligible for Medicare fir 5? More years. Thus rule leaves me uncovered.

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