Can my husband and I apply separately or do we have to apply together? If I don’t qualify for cost subsidies, is it possible that my husband will?


Answer

The ACA prohibits married couples from filing as two individuals and bases all cost subsidization on the combined MAGI income of the household.

Special rules apply for those who are married during a calendar year. Getting married can also affect how you file for ACA related taxes.

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J C on


Answer Rating:

This is horrible – I don’t need the same type of coverage that my husband does – we could save money by having two different types of plans… We had separate plans until now – the system caught up and says we have to have a couple plan now – this “affordable” insurance is a joke…

ObamaCareFacts.com on

If you file together and get cost assistance you need to have a family plan. A family plan can be a burn for two people because of the way deductibles / maximums / subsidies are capped by the law. If you don’t get cost assistance you can get individual coverage though. We strongly feel the maximum should have a more generous cap for a two person family and then slide up based on family members. It’s mathematically sensical as the current algorithm rewards large families and individuals, but can disincentivize couples.

In 2015, your out-of-pocket maximum can be no more than $6,600 for an individual plan and $13,200 for a family plan before marketplace subsidies. $6,600 x 2 IS $13,200… but this implies that each family member will be equally sick and both pay in a respective $6,600 (assuming bronze HDHP). In reality two people would rarely need to max out in a given calendar year. It’s hard to justify $13,200 as affordable to any American anywhere on the bell curve.

Citizen on

So, if a couple get the bronze plan and the maximum out of pocket jumps to 14,000 versus 7,000? Lets assume they have a baby and labor cost 10,000. Now, they will have to fork out the full 10,000 instead of the 7,000 since they have joint insurance? Am I correct?

ObamaCareFacts.com on

Yes. That is the big downside to a family plan shared by two people (or I guess two and a newborn).

The more people in the family, the better deal it is.

Tasha on

No. It is $7000 per person. It is just saying for example you are a family of three each individual would have a max out of pocket of $7000 or family max of $14000 vs $21000 it would be for all three members to max out.

Jodee Dixon on

exactly!

WrongedMiddleClass on

My husband makes more money than I do and falls into a different tax bracket, so we were going to file our taxes separately, but if we do then we can’t receive any assistance in the Marketplace (health insurance). Trump will fix this crap if he gets in.

ObamaCareFacts.com on

That is a frustrating situation for sure, as you are right filing together is the only way to make marketplace assistance work correctly in this situation.

Not to be political, but I don’t think Trump will fix this. I don’t recall anything in his plan that would at least. https://www.donaldjtrump.com/positions/healthcare-reform

That said, I do hope whoever moves forward with the next step of reform will address this and other sticking points. We put a lot of burden on people, we need to do a little more to offer security in finance and health.

dana on

Except now that he’s in…ofcourse he’s changing his tune and plan on keeping it. I think you have been played

Joe on

Can a wife qualify for Medicaid while a husband does not?

Dawn mcconnell on

I think this is ridiculous !
I think u should be able to apply separately as my husband doesn’t need as much coverage as me. Also it comes out to $200 cheaper a month.
Affordable health insurance ! !!! What a joke !!
Once again the MIDDLE class people , actually WORKING people, trying to do the right thing..get xxxxxx again !!

This system just isn’t working !!!!!!!!!!!!!!!

Erin on

I absolutely agree. My fiancé and I fall into that same category. We would love to get married, but because of my chronic health problems and inability to work, I am currently unable to contribute financially to our household. While he makes enough to pay all the bills, including a very modest mortgage, we have zero money left for anything else, never buy anything frivolous, and to avoid the chance of future debt, neither of us have credit cards. If we were to get married, as two people who have made responsible choices and thus don’t have any children, we would be paying astronomical prices for health insurance.

As it stands, I qualify for free health insurance, which doesn’t cover much, but is better than nothing. I have had to stop seeing all of the specialists who were quite essential, however, and because of that, it’s unlikely that I’ll ever be well enough to work again. Though I have applied for disability, because of my age and level of education earned before becoming disabled (I have a masters degree), they feel there are some jobs that I can still do on a part-time basis. Considering that my skull is crushing my brain stem (Chiari malformation), the insurance plan I was paying for before the ACA is now way out of my price range, and my free plan won’t pay for me to see a Chiari specialist, even working a part-time job is currently impossible.

Before the ACA, my fiancé and I could have gotten married and both had coverage under the excellent plan his employer used to offer, free of charge, to his employees. After the ACA went into effect, however, his employer could no longer afford to provide health insurance with the increased premiums that the ACA required, and he opted to drop the company health insurance plan.

We are now left with the choice to not get married or get married and give up my insurance plan. Unfortunately, because of my medical complications which required a spine surgery last year and will require another fairly soon, I absolutely have to have insurance. We’re thinking of having a small vow ceremony without getting legally married, but it’s rather heartbreaking to see all of my friends getting married now that we’re in our 30s, and to truly want to marry the man I have chosen to spend my life with, but not be able to solely because of the ACA.

Once again, the plan favors those who can work hard but won’t, or those who are irresponsible and have 5 kids that they can’t afford to properly care for, and those of us who work very hard and have made responsible decisions are penalized. If my fiancé makes enough to support us both but can only afford the bare essentials on a single income, I fail to see how that puts us so above the poverty line that we won’t qualify for any subsidies or assistance. I’m essentially being rewarded with free insurance by not working, which is ridiculous. Believe me, I miss working; I worked full time to pay for living expenses while attending college with a full academic scholarship, and I am devastated that I cannot currently contribute to society. Meanwhile, my fiancé can’t afford insurance despite working very hard to climb his way up the ladder with 25 years of employment under his belt. The system makes zero sense, aides the lazy, and yet because people mistakenly think this is government-supplied healthcare, it’s totally acceptable and looked at as some kind of miracle.

Patti on

People…a married couple can select 2 different plans. My husband and I have 2 separate plans and we are on one application. He has a florida blue plan and I have a coventry plan. You do a regular application but when it asks you if you want to group people, you just need to “group” each individual as a separate group. Then each group/individual can select a separate plan. The tax credit is divided between the two but not necessarily equally but the total applied will equal the total you are eligible for. For us, my plan was totally free and my husband had to pay a premium, but the total tax credit equaled what we were eligible for. It worked perfectly. You just need to know what you are doing.

Kathleen Miller on

earlier this year I left a Job of 20 years with all benefits including Health insurance and retirement benefits to accepted a Job that I am sure God wants me to be in, with a non profit organization that does not provide Health insurance, working in a Christ Centered Home to Restore women from Trafficking. At the time I knew that my health insurance was going to cost me 2/3 of my income, but I had faith that God would take care of it somehow. I got my 2017 rate increase for the insurance and it will now be over 1/2 my income. My husband is 65 and receives unemployment (his job closed the doors), Medicare and pays for a supplement, I only need a single plan but I qualify for no credits due to being over because of our “household” income. How is this fair.

erin.georgen@gmail.com Erin on

It’s not necessarily fair and you’re not alone in being frustrated by raising premium costs. There are a few options though. If your coverage is half your income than you can apply for an exemption at healthcare.gov and then you will not owe the fee for not having insurance and will be able to shop for other types of insurance.

You can be exempt from having minimal essential coverage if you are part of a Healthcare Sharing Ministry (HCSM). This is not a good option for everyone, but from your comment, it may be something that would meet your needs. There are not many Healthcare Sharing Ministries available to choose from and they are not minimal essential coverage or health insurance, so they aren’t obligated to meet the regulations or provide the same type of coverage as traditional healthcare insurances. But I have friends who are happy with their faith based coverage. Ultimately you have to chose the coverage that you feel is right your you and your family though and choosing a HCSM means reading the fine print, ensuring that you understand the coverage limitations, and agree with the philosophy.

This may not be a complete list, but these are the HCSMs available: Liberty Health Share, Medishare, and Samaritan Ministries.

Nobody on

Kathleen, I don’t know where you’re from, but apply for individual insurance off-marketplace!! It is so much cheaper and based on your income, but it may be an answer for you and others on here. GO OFF MARKETPLACE.

Erin on

Thank you for your input. I should have mentioned that in my comment as well. Some people, like yourself, have reported finding more affordable options off the marketplace that still counts as minimal essential coverage. If you shop off the Marketplaces, make sure that you ask the insurer is the insurance counts as minimal essential coverage unless you have an exemption from the mandate, but even then you’ll want to make sure the plan has the coverage you need.

Teresa Edwards on

My husband likes Kaiser Permanente and I hate them. I want my original doctor back and she now accepts Obamacare. According to this…my husband and I have to use the same insurance plan? That is soo stupid.

Emily Jackson on

Obama care discriminates against married people. Cohabiting families don’t have the fathers income included in the application and the stay at home mom can file as a single parent. So their family could be making unlimited amounts of money and still receive free health care for pregnancy, the mother and children. meanwhile a family were the mother and father are married who is barely over the income limit and struggling who makes half what the other family makes, is denied these services, forced to pay a whole family plan that they can’t afford and is pay for the other more well of family’s healthcare with their taxes. Every family I know on washington state health insurance make at least double the income limit yet still is on free just because they are unmarried. meanwhile our family was denied my pregnancy care even though I lost my job and our income is just 200 over the income limit and our family make half of what these other family’s make. F#!?+ Obama care it is blatantly unfair and discriminatory

roxannn on

This seems so unfair! We are separated and haven’t lived together in several years. My income is at the poverty level and his is in the top tax bracket.

ObamaCareFacts.com on

I agree, it can be unfair in this situation. It benefits other situations, such as where the spouse’s income is needed to qualify for tax credits in the first place. That said, it certainly can work against those who are separated, but not divorced for tax filing purposes.

Tom Czarnowski on

One plan we’re looking at has an individual deductible of $1,700 – but an individual deductible 3,400 for an individual on the family plan. Why would the individual deductible be higher on the same plan for married couples?

Jennifer Pope on

My partner and I are considered getting married, BUT, I am self employed and she works for a small company that does not offer insurance. Her income didn’t qualify for subsidies last year, but mine did. She makes twice as much as I do and is a W2 employee…. if we do get married, we have to file joint return and be on the same plan and it would cost triple what I pay now, plus I am healthy and don’t need much. I also don’t want to file jointly because I itemize my deductions and also have student loan debt that I have and IBR payments which would sky rocket if we file joint return. This sucks, we can finally legally marry, but this ACA makes it financially impossible!

J R on

People are misunderstanding the answer. Spouses CAN have different health PLANS under Obamacare. That has always been the case!

To get advance subsidies, however, spouses must are treated as on unit when determining income. That’s it. Don’t make this into something it isn’t. There are lots of real problems out there, this is not one of them.

Samantha segars on

I have a question I am married, but I do the obama care through an agent. The agent sign me up with my father again this year because I do not have an income, and my husbands income is not high enough for him and I to get our own plan. Now when taxes come around who the heck claims me on the taxes? My husband has it at work that I am a dependent of him which I am. But the agent said my father had to claim me on his taxes since she put me with his policy. I do not live with my father nor am I dependent of him so I am confused. I don’t want to screw my dads taxes up when he files because of the obama care, but I also do not want to mess my husband and me up because he has it at his job that I am a dependent of him HELP please cause my agent does not know anything.

Erin on

The agent is correct. You must be a part of your fathers tax household for him to be eligible for any cost assistance he received for Premiums in advanced. That means he must to be able to claim you as a dependent at tax time if he received Advanced Premium Tax Credits to cover your premiums will likely have to be repaid.

nadia on

Hi – my parents are married, file together, but my mom makes way more than my father, and my father is basically unemployed now due to health issues. I live with them/work with my mom and am 26. Do you think it’s a good idea to apply together with my parents — if eligible — or should I get my own?

Erin on

That depends on a lot of factors. If you can be considered a tax dependent of your parents you can apply together and it may make your family eligible for more or less cost assistance depending on how much income you are bringing in to the tax family. That being said, there are a number of other tax benefits for financially dependent adult children who file together with their parents. So, there may be other tax credits or deductions unrelated to health insurance your mother will be able to take by claiming you as her dependent. An accountant or tax preparer is going to be able to give you more specific and detailed information to help you and your parents make the best choice regarding this. You can also compare options on the marketplace by simply looking at the different insurance options and cost assistance for different family sizes and incomes by updating your profile on the marketplace (though some marketplaces make that a little more difficult than others).

Kathy Smith on

Need insurance have a broken twist husband got laid off he has no insuance why can’t I get insuance for myself

Erin on

You can apply for health insurance through the marketplaces during open enrollment every year on the individual marketplace if you aren’t offered an employer coverage (or a federally funded health insurance like Medicare). If you lose coverage, you are also given a 60 day special enrollment period to sign up for insurance. Married couple can get separate coverage if they are filing as separate because of divorce or seperation.

Kat Anderson on

I’m in shock over the cost of premiums due to Obamacare!! My husband is retiring and I have 10 years before I’m eligible for Medicare. My premiums will be huge with an unbelievable deductible!! I’m never sick so I will be paying a fortune to have healthcare that I will only get to use if I get really ill! I’ll be paying out of pocket plus premiums! Disgusting!!!!! Obamacare is trying to destroy the middle class!!!

Peggy on

My husband had ACA insurance all year in 2016. I signed up in August 2016. I was not told that I had to have a joint application. I got a separate policy. Now the tax preparer said I have to pay back all the premium
Assistance ($3500) because our combined household income was reported twice I called IRS but I only get hung up on. I don’t know how to fix this mess.

Peggy w on

Need advice. My husband had Obamacare all year in 2016. I signed up in Aug. was not told I needed to go on same application as my husband. Now the total family income is combined from the 2 applications and they want me to payback all insurance subsidy. Irs hangs up on me Marketplace won’t help. I don’t know what to do

B S on

This is RIDICULOUS! Before the “affordable cara act,” my husband and I paid 450/month for GOOD insurance. Thanks to OBABACARE, we pay over 800/month for higher deductible, HMO plan. We file taxes separately for specific reasons that we cannot change, and therefore don’t qualify for any help…….so much for “affordability!”

Don Forcash on

Another darn marriage penalty compliments of our Government. I make slightly over the income needed for a subsidy and my wife does not have income. We are paying $1309 per month for the cheapest ACA plan in CT. What can we do do to reduce this rediculous $15000 annual expense. As it turns, this plan has not covered any medical expenses to date. Get divorced?……kidding

Jen on

Why? We do not qualify for subsidies and I want a less expensive plan than my husband. Having to have the same expensive Silver plan at our age is cost prohibitve. I want a Bronze HSA plan. I am 59 and it will save me over $4000 per year. Both of us in Silver Choice will be $2500 per month!! Can someone tell me to do it correctly. The ACA here in CT says we have to have the same plan.

ObamaCareFacts.com on

You can’t get cost sharing reduction subsidies unless you are on a silver plan, but you CAN get premium cost assistance on ANY marketplace plan.

As for both spouses having a different plan with cost assistance, I’m not sure if that is possible or how that would work. Potentially you can use the married filing separately section of form 8962… but I would have to research this.

You can call healthcare.gov directly for guidance on the issue. I’ll look into this.

Khairy Beshara on

How I update my insurance because I and my spouse will live in different states next month ?

ObamaCareFacts.com on

Start by calling healthcare.gov. The steps can be complex, so that is your best first move.