Is $11,770 income required in all states to get coverage?


Answer

You must project to claim at least 100% of the Federal Poverty Level in household income to qualify for tax credits through ObamaCare. This was true in all states.

In 2015 the minimum income for ObamaCare cost assistance was $11,770. It raises by about $100 a year. Meanwhile, on 2018 plans bought during 2018 open enrollment (Nov 1 - Dec 15, 2017) the minimum income for the marketplace is $12,060.

If you project your income to be below 138% of the poverty level ($16,643 for 2017 for example), and your state expanded Medicaid, you can enroll in Medicaid instead. Children have even more options for CHIP.

A few tips that will help you understand your options:

  • Only 30 states as of July 2015 have agreed to expand Medicaid. In the other 20 states, Medicaid may be available only in select situations.
  • CHIP generally has higher eligibility limits, so children and parents can sometimes get free or low-cost coverage in states that didn't expand Medicaid.
  • Tax credits are offered based on your projected household income as compared to the Federal Poverty Level. If your income ends up being lower at the end of the year, you won't have to pay back tax credits.
  • If you take tax credits you'll have to file taxes for the year you take them. You'll need to file form 8962 to adjust your premium tax credits. If you make more than expected, you may owe back tax credits.
  • You can take deductions that lower your household income and help you qualify for more cost assistance, just make sure you don't go below the 100% line.
  • We suggest a silver plan if your income is below 250% of the poverty level. These plans will qualify for cost-sharing reduction subsidies to lower out-of-pocket costs.
  • Household income is the head of households MAGI, spouses MAGI, and tax dependents AGI. Learn more about MAGI here.

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lawrence gladsden on


Answer Rating:

Confusing. From this, I see that If I earn less than 138% of poverty level I have to get medicaid and not obamacare, (and medicaid is not available in florida)…but I also see that I qualify for obamacare with just 100% of poverty level income? 100%….138%…which is the amount that qualifies for obamacare rather than (the non-existant in florida) medicaid?

ObamaCareFacts.com on

So 138% is the line if your state expanded, 100% is the line if your state didn’t. Technically anyone over 100% qualifies for tax credits, but if you qualify for Medicaid then you should take that and not Medicaid.

Teresa on

11800

sharon on

before tax or after tax?

HM on

I is very confusing for PART TIME people.!!! (am 54)

How can I estimate the amount I will be making?
if i estimate 11775 $, but end up making 11665 $, so for 10$ difference, i will have to return 491×12=5892 $ basically HALF

i will not qualify for medicaid. then applying for catastrophic is debatable.

I am trying to do Uber, but it is a lot of pressure on me to make sure I will go above the 11770. in addition that those new type of “self employment”, make you lie to insurance companies, who do not insure people for share rides, and if in an accident you may easily be dropped by not declaring you are doing share rides. so I am more under pressure.

IT SHOULD CLEARLY allow people to get insurance for under 11770.
what if you get sick or an accident and cannot work few months? then you for sure dont make the 11770 and then you are under pressure to return the tax credit !!!

on this website it shows:
“Tax credits are offered based on your projected household income as compared to the Federal Poverty Level. If your income ends up being lower at the end of the year, you won’t have to pay back tax credits.”.
CAN THIS BE VERIFIED ON THE OBAMACARE Law????? I would like to see the exact article please

which is probably not true.

Also, it is very complicated this new tax form, where you have to detail every month if you were insured or not , and make more calculation. (it is like going back to the 80ies, when tax forms where complicated).

Now:
Also if you make more than 4000 , and you took health insurance, you must file taxes.
and if you made more than 10300 and have no insurance, you will pay 695$ !! but if you make 10299 you dont !!!!! how ridiculous. so 1$ cost you 695$
what happened to progressive taxing….
here is the link if interested: http://obamacarefee.com/2017-calculator/

which mean that i have to watch out to be under 10299 dollars.

and of course you need to enroll before jan 31… why????

continuing putting pressure on part time people because someone, somewhere did NOT improved the work growth in this country, is too much !!

Hope new administration will address those issues.

ObamaCareFacts.com on

So you are right, when you face a tax or subsidy “cliff” things get complicated. A $1 can lose you a number of tax credits, not just in healthcare. This can be complicated. I would not use third party calculators as a final decision making tool, they are neat for first looks and quotes, but for the nitty gritty you want to use the IRS forms, professional advice, or at least the marketplace.

Medicaid is supposed to be the thing that comes in to help those who make too little, but not all states expanded. Even then, being near that cliff is a real pain. My suggestion would be to remember that you can use small deductions and odd jobs to gain or lose a few dollars here or there. Need to lose money, find a way to tax deduction that affects MAGI (see an article like this, https://www.thebalance.com/tax-planning-basics-3193487 , but do get professional assistance), need to gain a few bucks, see if you can do some work for a friend and claim a few extra. Yes it is a pain, but there are some things you can do about it.

Lastly, a projection is a projection. You’ll always owe based on your real year end MAGI.

L Moser on

Donating to Goodwill will not change your AGI so that part is simply bad advice. (Adjusted Gross Income). I think the rest is a good summary.

In this case, when UBERing you probably have the right toat least partially deduct milage. The IRS allows deduction for milage only if you have documentation. So if you need to gain income, then “lose” some or all of your milage deduction documentation. If you aren’t deducting milage then keep records to decrease your income if desired. Also, a commercial policy might be required to deduct insurance. Check with a professional.

ObamaCareFacts.com on

100% agree, always consult a professional (or at least use official resources like the IRS website). You are right, I double checked, I had the Goodwill tax implications wrong. Going to edit that to avoid confusion. Thanks!

Gab on

The Republican Govenors rejected expanding Medicaid – so in your case, you should have been covered for medicaid in your state. But yes, the $10 difference would be an issue, but I doubt you you have to pay anything back if you earned $10 less than the minimum. Get the insurance while you still cal!

Mike on

Yeah. The new administration is defunding it to the point of collapse. Intentionally. The only problem the Republicans ever had with the ACA is that you qualified for any sort of break at all. Looks like you got duped.

ObamaCareFacts.com on

You are right, this is exactly what they are doing. They went on a “break everything we can by court cases and obstruction” tangent under Obama’s eight years. Sure, they started this scheme in the Reagan years, but they really doubled down under Obama. Now they are doing it and they are in power. I don’t think that is going to work out well for them. Well, liberals will see it and I think the pendulum will swing again, the GOP base, I won’t kid myself, they will find a way to blame TrumpCare on Obama if it doesn’t work.

Wish they would stop playing politics without everyone. These are real people being manipulated on the left and right. Pretty dark stuff really.

America way on

Just work your ass off and produce more $. Stop been lazy and relying on the system!

ObamaCareFacts.com on

The main purpose of the safety net is to help the working poor, many people are both “working their buns off” and “poor”. Those ones should be helped, we certainly help the rich out, why not help the working poor too?

http://factmyth.com/the-purpose-of-the-social-safety-net/

Thomas and Tami Moore on

people are manipulating there income just enough to get free public aid.. And we (people with jobs). are also footing the bill for immigrants, illegals,and people that refuse to work for minimum wage.They play the game to receive free bees… Im sick of paying your bills and having a inflated premium of over 800 a month because of the system.. GO TRUMP!!!

ObamaCareFacts.com on

We all know that sometimes people cheat the system, that is poor people, rich people, short people, tall people, officials, citizens, etc.

This isn’t the majority of any class, but a minority of every class.

Not every price hike is the result of a poor person cheating the system or an immigrant with no money choosing an emergency room over certain death.

Instead it is a very complex problem. I won’t ask someone paying $800 a month not to be angry, you should be!

I will ask however that you consider the reality of what is happening here. Trump’s plan so far does very little to fix your situation, it would lower your premium and likely raise your out-of-pocket costs and reduce your benefits.

If we can’t band together and demand real reform I don’t really see much of a way out for people in a situation like yours.

Still though, thanks for sharing, but let’s try not the use the poor as a scapegoat, even when we are rightly upset!

Maria on

What is the exact minimum income amt. one must receive to qualify for Obamacare in the state of Florida for 2016? I was told by a healthcare.gov rep that the amt. increased to $47,000.??!!! Is that the amt. for Florida? And, if so, to say the least that’s outrageous!

ObamaCareFacts.com on

It’s all based on the Federal Poverty Level. You can find all the details here: https://obamacarefacts.com/federal-poverty-level/

Kim on

47,080 is the most. Can’t get an answer on the least amount ?!

tj on

No. When I googled the minimum amt it stated that in 2015 it was $11,770 and that was for ALL STATES. However, each year this amt goes up a $100. So I believe for the 2017 year the minimum amt would be $13,770 to qualify for subsidy

Erin on

That just isn’t factual. The minimum amount a person must make to use the Marketplace and receive cost assistance is 100% the Federal Poverty Level (what most people mean when they ask this very vague question). This level is always different for Hawaii and Alaska, it depends on your household size, and it also changes every year. You can find out whether your family falls under the Federal Poverty Level (or fell under for previous years) here.

CHERYL MASSEY on

U say goes up $100 each year but then your calculation added a thousand each year. What’s the 100 a mistake and you meant to say 1000?

MB on

Actually if it’s an additional $100/year, the minimum qualifying income would be $11,780 in 2016 and $11,790 in 2017.

Nance Brown on

I am a single person, age 55, with an annual income of 8,000. I do not meet the criteria for Medicaid in Florida. It is not just based on income. I wish to sign up for AFFORDABLE health insurance. I just go round and round in circles being referred to the Insurance Marketplace. I seem to NOT be eligible for any subsidiaries because I earn less than $11,770. So I would have to pay a high price for health insurance I can not afford. I really want health insurance and would pay something, but something would be $100 or less a month so I can still pay my bills. Is there anything out there for me? I am feeling frustrated as it seems not.

ObamaCareFacts.com on

You can apply to Medicaid, then take the rejection letter to healthcare.gov (by showing them a virtual copy or faxing or such if necessary), then you can qualify for catastrophic coverage. This is the best path for those who need coverage in your position. However, at $8,000 annual income I can’t see this having much value UNLESS you know you’ll need it. Remember you can always use a public hospital for emergency situations and you can always pay for basic care out of pocket.

Going from $8,000 to $11,770 is not easy. However, it may be something you could work towards. Once you hit that $11,770 mark (in projected income) you can use the Marketplace. This is true even if your actual income falls short.

Leslie Carrere on

Please help! I am a 41 yo single mom of 3. I currently make $17000 a year. I don’t qualify for Medicaid (Georgia) and I am below the income bracket for marketplace. I have been looking for another job for 11 months. I finally got hired with the county that I live in for a school bus driver. This job provides good health benefits and decent pay. I was training for 2 weeks when I had a seizure in the grocery store. The insurance wasn’t going to be active till October 1st. So here I am, no insurance, was forced to resign from this job and told that I can come back if I get a full release from a neurologist. HOW am I supposed to see a neurologist with no insurance and now no job!!! Can anyone help me please??!! I really needed this job. And to the person that said get off our butts and work, how dare you??!! Ppl like myself are trying to work but have health issues preventing them from being able to work and no way to get medical care!

ObamaCareFacts.com on

That is a nightmare. Your story helps illustrate how Medicaid rules in states that didn’t expand Medicaid hurt normal people who want to work.

If you would like, you can submit that story here: https://obamacarefacts.com/obamacare-stories/

As for advice, there is no simple advice here. However, you can try contacting the Medicaid stat department to see if CHIP is an option at this point (and to inquire further) and you can buy short term coverage or a full priced marketplace plan even if you don’t qualify for assistance.

You also seem like you make enough to qualify based on what you said. Family of two starts at $16,240, so you should qualify for low cost marketplace insurance…. the problem is your life circumstances might not qualify for you it under the new special enrollment rules Trump’s administration implemented.

In short, you aren’t in an easy situation, but you may have some ways out of it.

gwendolyn Key on

I understand where you are coming from, I’m in the same situation in Ga. This is the craziest thing I have ever seen, they want over half of what I get which is only $672.00 a month, this is crazy, the only way I’m making it now is because my small mobile home is paid for. I love alone, now I understand why there are so many homeless, our Goverment need to take care of American before anyone else.

Peggy on

Go to the local state health department and fill out form every year by Nov. By dead line can not do this online. Get stamped copy of file you turned in and call about every 2 weeks on your status. If they lose form you have copy to lock in by dead line.

Mercedes kuilan on

Muy triste pues tengo 61 año y no cualifico. Y vivo solo solo resivo 7,000 y por no tener sufiente ingresó.no puedo tener un plam médico.Dios mio que hago

Nancy Mills on

Do something self-employed to make up the difference, so you can report income of more than the minimum. Not sure what that is in 2016, probably around $12,000 – 13,000. You’ll still be in a low enough tax bracket you won’t have to pay much or any federal income tax. If your income is earned income, you get a little earned income credit to offset whatever income tax you might owe. You will have to pay social security tax (about 7 1/2 % I think) but this is far less than the value of the health insurance subsidies you’ll get. Hope this helps. It sucks that in Florida, if you pop out a bunch of Medicaid babies you qualify for Medicaid yourself, but if you’re single and poor, you’re just screwed.

Beehive on

The amount you project will determine your coverage. In other words , if you tell them that you MAY make 11,870.00, you will receive a subsidy. And if you end up making less than what you projected (11,870.), you will not have to payback anything because you made less than what you projected.

Deborah on

I am 62, single, made $13,000 for 2015, and live in Texas. I also sold my house, which I rented for six years because I could no longer afford to live there. I received $45,000 in equity, but I sold it for a loss so I lost money on the sale. A person from The Marketplace told me that the equity counts as income so I actually made $58,000; therefore, I do not qualify for Obamacare. How can my equity possibly count as income since I made mortgage payments from the rental money? Also, the $13,000 is my gross income; does my NET have to be at least $11,770, or is the $11,770 for gross?

ObamaCareFacts.com on

Here is an explainer on MAGI (the type of income that counts): https://obamacarefacts.com/modified-adjusted-gross-income-magi/

The person who told you that is wrong as far as I know. Equity only counts as income https://www.healthcare.gov/income-and-household-information/income/

Ann Coleman on

I think that what they were trying to say is that equity isn’t a tax issue. The Marketplace person was probably confused about the difference between equity and capital gains. If you had sold the house for more than it was worth, you would have a capital gain which is included as income. In you case, you received the return of the money you used to buy and pay for the house (at least some of it), but you made no profit, so owe no tax on the equity that was returned to you.

Ann Coleman on

To the moderator — I should have said “if you had sold your house for more than you paid for it..” Not for more that it was worth. Sorry.

Dee on

Your AGI is your reortable income. Your equity is not taxable income. You just converted to cash.

gwendolyn Key on

My state does not do the extended medicaid, I’m 62, going to be hard to find a job, my S.S. will only be $672.00 , what am I to do, I can’t afford what they’re asking without tax credits, this is so not right. Ga. needs to change,

Angie on

My husband was covered by obama care from Jan 2015- August 2015. He made less than 10K for the year. We married September 2015 and he joined my healthcare insurance which is not obama care. When we filed for taxes it took in consideration my 45K income and now we are being taxed an additional 1,500 to obama care because we make too much money?? How can you tax my income when my husband only had obama care up until the month before we were married?

Cindy on

Your question is old, but there is a special computation on Form 8962 if one of your got married during the year, to correct much of the problem you had. You may need to file an amended 2015 tax return.

Nancy on

“We suggest getting a silver plan if your income is below 250% of the poverty level. These plans will qualify for cost sharing reduction subsidies to lower out-of-pocket costs.”

Please tell how this would differ from getting a Bronze plan. Thanks!

ObamaCareFacts.com on

Silver plans are the only ones that you can get cost sharing reduction subsidies on. So this will mean way less out-of-pocket spending. Since cost assistance is based on income, going silver is always a really smart plan. It will be flexible for more savings if income changes. The true perk of a bronze plan is limited mostly to having low premiums.

Donna monroe on

Is it $11,700 before deductions? Or just have an income of $11,700.00?

ObamaCareFacts.com on

$11,700 household income (family size versus the federal poverty level after deductions). MAGI for a single person. https://obamacarefacts.com/modified-adjusted-gross-income-magi/

Daphne on

If you make 15,900 is that to much

ObamaCareFacts.com on

It is based on family size and income. This page explains in detail: https://obamacarefacts.com/federal-poverty-level/

Cheryl on

If you make $15,900 you’re good

Angela on

Is this minimum of $11,770 gross income or net?

ObamaCareFacts.com on

MAGI, so household income for a family of 1. In bigger households calculating household income changes. In short, it is a type of gross income.

Tob on

What is actually covered on the bottom tier.?

ObamaCareFacts.com on

Essential health benefits, and at least the minimum cost sharing. Every plan and every region is different: https://obamacarefacts.com/essential-health-benefits/

kathy blair on

what happens if you fall short of the projected minimum salary requirement to get a subsidy from the marketplace? does the govt try to recoup the subsidy from future tax returns, etc?

Pam St John on

I received health care subsidies based on the amount of money I actually earned, not the adjusted amount after tax deductions. I live in Florida, which does not offer Medicaid expansion. Will I have to pay back the full amount for all premiums subsidized because I drop below MAGI? If not, do I have to pay back anything? Is it better to just not take any deductions?

Michelet Michel on

What is the minimum income for obamacare in the state of Florida?

ObamaCareFacts.com on

Same as anywhere else. See the federal poverty level: https://obamacarefacts.com/federal-poverty-level/

nuf on

If I only made 10000 do I have to pay back the subsidies

ObamaCareFacts.com on

It is my impression that you do not. I know the chart says $200, but I clearly remember this as being waived below 100% FPL. With that in mind, I can’t seem to find the documentation that confirms this. The repayment limits are shown on page 14: https://www.irs.gov/pub/irs-prior/i8962–2015.pdf

Bob Franklin on

This problem in 20 states of having people who make too little income to get the ACA, but can’t get Medicaid, is caused directly by obstructionism from Republican governors and legislators. They have been trying for years to make health care reform fail, and causing enormous difficulties to millions of citizens in the process. Remember that when you vote.

Deedre on

This is in response to Bob Franklin who explained why the ridiculousness of those of us who find themselves “too poor” to receive obama care (yes, too poor) only to be told to go to our states Medicaid, which, our state decided to opt out of letting us in!
Bob is right! President Obama did “not” have this mess in mind when he was first trying to implement our healthcare reform. It was due to all the wailing, complaining and interferrence from the Republicans (who just didn’t want any healthcare reform and wanted Obamas plan to fail) which resulted in Obama having to relent on some of the aspects of his plan, with one of the changes giving each state a choice in whether they would opt in (to letting all of as who don’t make the minimum $11,700) in accepting the overflow in their Medicaid system. And, a lot of states opted out! This was “not” Obama’s plan at all and because he ended up having to finally give in to the many Republican whiners, the healthcare reform he had originally wanted to implement (which showed to be successful already on a state level) is now the mess we see today! Yes, remember that when you vote and make sure you do “not” blame the wrong person for it’s inadequacies!

george washington on

This is funny. Obamacare also known as aca-affordable care act, has fallen apart in the first few years regardless of the gap between eligibility for aca and medicaid (which by the way that gap has nothing to do with the failing insurance companies). Obamacare has bankrupted most of the nations major insurance carriers. it has made everyone in the medical industry richer than rich because insurance companies were paying all the claims for people who have never had insurance due to not being able to afford, until recently when they quit paying claims sliding into their defaults. your a joke. Obamacare only benefited the republicans from the start.

tina on

Is the $11,770 the Gross Income amount or the Net Income on taxes. I earned $12,201, but had expenses I wish to claim on my Florida tax return. Looking at the summary, it is showing “Adjusted Gross Income” of $11,339.

ObamaCareFacts.com on

That is MAGI, so AGI (Adjusted gross income, modified for some deductions).

Here is a breakdown: https://obamacarefacts.com/modified-adjusted-gross-income-magi/

Mary C. O'Dell on

Hi,

I qualified for Obamacare on January 1st. I was unemployed. I had a temp job for three months, and I am now on unemployment. My projected income for the year is 14,000. I was told I didn’t qualify for the exchange and that I would need to apply for Medicaid. I am an Oregon resident. Is this true?

Thank you for any information you can provide.

Shelia Moore on

If I am going to receive Obamacare, How much income do I need to make per year for me & my husband?

Mary Pattison on

I make $12,000 a year whic is between the 100 and 400% allowed for a subsidy, yet my insurance company made me pay back all the money that the federal government paid on my monthly insurance bill. Please explain why. I was told”that is what the system said “

Cindy Ellis on

My daughter bought a policy thru covered CA in 2014, was earning $22,000k a year and received a subsidy. In 2015, she was in a bad accident and has not been able to work. We continued to pay her policy as she needed good medical care, and did not want her to go on Medicaid. We did not report the income change to Covered CA, as we thought she would be getting back to work. However, she had complications and many surgeries. Covered CA is now asking for income verification (she made $800 in 2015 but we did not file a return) and saying they might cancel our coverage. All premiums has been on time.Can we lose our coverage even if we paid on time and are willing to repay any subsidies she received? Helpl!

Paul on

This Obama Carr is strength most Americans that work. You pay a discounted price but the coverage pays very little most of you bills you have to pay. If you don’t get insurance that includes drug treatment and such like dental you get penalty at the end of the year. If you make enough not to be homeless you get penalties. The fines are lower than insurance you are forced to get . If you save your money instead of paying for an Obama insurance you will save up to 2000.00 a year after penalty. It’s one thing to offer health care to people but to fine them for not getting it is criminal as extortion.companies have been able to offer great insurance but with all the additions that Obama care forces companies to offer their premiums went to the sky causing the WORKING people to suffer extremely high premiums. So we have no choice, pay for a gov insurance that pays next to nothing and have us pay more out of pocket with penalties if you make enough to pay you bills or pay a fine for not having coverage and going bankrupt if you go into the hospital. Or pay for coverage at work and loss our home due to it taking almost half your income to keep insurance.

tim quigley on

WTF is going on anymore. It seems like the best thing to do is quit work,,and become a deadbeat sucking off those that work for a living and pay all the taxes.I’m self employed,never took a dime of unemployment or financial assistance,work like a dog all my life,,and the state of Iowa just announced another 43% health care increase after tacking on a 50% increase last year. I now will be paying near 25K for middle of the road health insurance.The news said it’s due to increased Obama costs. I don’t know,,who can figure this crap out. It’s painfully obvious why working class folks may vote for anyone but the same old worthless politicians that are running for office. We really need to turn this country on its head. There is too many people that vote for a living verses those who work for a living.

araceli lopez on

my household income is approximately 60,000 a year.we are 2. do we qualify for obama care? we live in california.

thank you so much!

ara lopez

Steven delk on

My daughter only makes about $7000 a year. She can’t get Obama care insurance. I would like to know if this true. I thought the insurance plan was put their to protect the impoverished?

Paula on

I just checked today. I’m not sure if it is different states. I would think the same. If she lives with ? They consider how many people live at the home and how much they make. Try this # 800-318-2596. My insurance went up for 2017 by $37. I hope they help. They did me. Ask if she has subsidized discounts. I did. It helped me.

lucy on

Family of two, age 62.Live in Florida. Our income is $1647.40 monthly Can we apply for Obamacare?

ObamaCareFacts.com on

Yes, you would qualify. But you must enroll during open enrollment. https://obamacarefacts.com/obamacare-open-enrollment/

Daryle on

I am a single male 56 years old no spouse or kids. I living in a studio apartment in Sacramento ca, I I get a job what’s the most I can make and still get free medical with no co-payment or medication prices

SJ on

I received a tax credit based on my projected income for this year.

I knew my work contract would be ending in the beginning part of this year (which paid $29,000 a year), and that I would need to find a new source of income, so I guessed $18,000 for this year, given the gap in employment. However, I was pretty far off, because I haven’t yet been able to find a new job. My yearly income will definitely be below the poverty line. Will I have to repay my tax credits?

margot on

if you are living off a trust fund because you choose not to wok, can you qualify for tax credits?

ObamaCareFacts.com on

In the case where your income does not count as MAGI then you can get cost assistance (including Medicaid), however, with a Trust you are likely going to have to claim your income as MAGI and thus it would be counted. This doesn’t barre you from tax credits or assistance, it is just counted like regular income. The rules are designed to help those with things like survivors benefits and social security, not meant to be a handout for people with lots of saved income who choose not to work. But there is overlap.

eleanor bramwell on

I am confused.

I applied for health care in Maryland and was deemed ineligible.

I make $15,500 yearly, and am self employed. I pay $363 in monthly business expenses and $80 in student loan interest.

If I do not qualify, how do I get health care?

If I do qualify, what happened in my application?

I would really like affordable health care, and don’t know how to get it.

erin.georgen@gmail.com Erin on

Based on the Federal Poverty Level guidelines you should be able to qualify for Medicaid in Maryland. Outside of applying for it, you will probably also need to provide a profit and loss statement for your business.

S.D. on

What is the maximum you can earn for 2015 and 2016?

Neil on

Hi, I’m self employed and my gross income is above the poverty level but my AGI is pretty far below due to a large amount of business expenses. In order to qualify for Obamacare in Maine, which has not expanded Medicaid, do I have to stop claiming those deductions and claim an AGI at the poverty level? In other words, pay more taxes than my actual AGI says I should? Or is there another way to get affordable care?

What happens if I project to make the poverty line but then end up claiming an AGI below it?

Brenda on

My husband and I make about 39,000. Is that to much to qualify. Are can we still get help

twalters on

My daughter is a full-time medical student who will only make about $3,000 from summer employment. She is financing 100% of her tuition & room & board. The school does not offer medical insurance. Can she get a reduced rate for health insurance through Obamacare? When I complete questions online she is left with $230+ monthly payment for minimum coverage with high deductible. She cannot afford this.

Melissa Moseley on

So a married couple with one child that has an income of 17,000 is that enough income in NC? Is that not enough for a plan?

sharon on

$11,880 before tax or after tax?

Erin on

The Marketplace insurance eligibility for cost assistance is based on Modified Adjusted Gross Income. You can find out more about it and how to calculate it here.

Paula Kelley on

Yeah it’s bullshit that you give healthcare free to people that are not even American citizens but yet I’ve worked for 30 years became disabled and I make too much money for healthcare from Obama that’s bull shit I make $22,000 a year I would say that the poverty level compared to $65,000 that I did make

Debra Weir on

For 2017 healthcare what year income do I report

Erin on

You are going to use your projected income 2017 and some states may ask about it if big changes from the previous tax year.

Karen on

I live in Maine and in 2016, I expected to pull money from my IRA to live on and I provided this amount ($12,500) as my projected annual income to the health care marketplace. I have been enrolled in a plan based on that amount all year. My mother died, however, and left me enough money to get by on until I start collecting social security in February, 2017. I have not, therefore, pulled the $12K from my IRA. I am not sure what to do now – should I go ahead and pull the money from my IRA before year’s end to be in good standing with the IRS/Marketplace, or can I report no income from my IRA? (I have no other earned income). I would prefer to leave my IRA money alone so it can continue to grow, but not if I am going to be hit with a penalty of some kind. Please help!

Erin on

I’m sorry for your loss. Any cost assistance you have received through the marketplace (advanced premium tax credits) or will receive when you file for because you had marketplace insurance (premium tax credits) are based on your income for the year. This includes income pulled from retirement and usually does not include inheritance, but be aware that your inheritance can affect other benefits like SSI or SSDI (if you are receiving those). If you have purchased private health insurance through the health insurance marketplace, there is no penalty for having income lower than estimated. You will also likely qualify for more Premium Tax Credits when you file form 8962 with your return. For that reason you may not want to pull any unneeded funds from your retirement account. Medicaid is also administrated by the state and has eligibility rules that vary a little state to state. If you are on you’re

Rhonda on

I am 63 and have been taking care of my mother, in her home…my annual income for 2016 was approximately $17,000. My mother recently had to go to a facility, and I will no longer incur that incom. My social security is only $477.00 a month which is far below the requirement for Obamacare…since this just happened and I had already picked a plan for healthcare, what are my options? I myself have disabling health problems, which make it impossible to work outside the home. I live in the state of Missouri. Please advise me as to what my options are, so I do not lose my healthcare deductions.

Erin on

If you are eligible for Social Security than you should be enrolled in Medicare. Call Medicare and let them know that your income has changed and ask them how you can apply for Medicaid (its sometimes different than enrolling when not eligible for Medicare). You should also check with Social Security Disability Insurance and let them know that your income has changed as it may increase your benefits.

kenneth on

My son works part time and has made slightly less than the 10,350 requirement to file a return. he will file a return to get his taxes back that we with held and I still claim him as a dependent. The problem is I need his income to stay qualified with our silver 87 plan as I did not make enough this year.. What will happen if I report his income on line 2B of form 8962 “premium tax credit” form and the income is less that the 10,350 requirement.

Erin on

I have answered your question here. I hope this information helps.

Monca Weiskopf on

Whats i the amout required need for 2016?? Thank You

Robin on

What happens if my projected income for 2016 (after registering for a 2016 Marketplace plan and receiving tax credits due to my low income):
(A) falls below what I projected, but still above 100% of the poverty level for 2016?
(B) falls well below what I projected AND falls BELOW 100% of the poverty level for 2016?

In either case will I be fined, or have to pay back any portion of the tax credits. I have heard the latter may be true, but am very concerned as to how to I will manage that if I make substantially less than I projected.

Finally, what is the poverty level for 2016. Is it exactly $11,870? Something else?

Thank you very much.

Erin on

If you ended up making less than you projected, than you will be able to claim and unused Premium Tax Credits you ended up being eligible for on your year end taxes. This is also true if your income ends up being below 100% the Federal Poverty Level. As long as your income was projected to be above 100% the FPL by the Marketplace at the time you enrolled, than there isn’t any penalty for coming in short. See “Estimated household income at least 100% of the Federal poverty line” on the Form 8962 instructions for more specifics. However, it can affect your ability to access the Marketplace the following year. For example, you may be asked to demonstrate that your income has increased or that the reduction in income was temporary and doesn’t affect your projected income for the next year.

The Federal Poverty Level is adjusted annually and it depends on your family size. The larger your family the higher your income can be and still be considered poverty. Additionally, the income being referred to for Affordable Care Act provisions is your MAGI and not your gross or net income.

Cindy on

I am trying to adjust my 2017 coverage, I live in IL. I would rather pay than be limited by Illinois Medicaid. My income was about $12K last year, and may be a little more in 2017. The marketplace site is not giving me a premium tax credit unless my income is over
$16394. I thought we could choose if our income was between $11770 and $16394.

Erin on

Unfortunately, the reality is that you are not eligible for Premium Tax Credits or Cost assistance on the Marketplace if you are eligible for a Medicaid program that is considered minimal essential coverage. Illinois Medicaid is considered minimal essential coverage unless you are only eligible for the Medically Needy program and are required to “spend down” your income. That doesn’t appear to be the case in your situation. Essentially, Medicaid coverage costs tax payers far less and is non-profit, so if you are eligible for it, than you are not eligible to get tax payer funded cost assistance for private insurance plans purchased on the marketplace. People on Medicaid often find a more limited provider network, but it usually covers far more actual healthcare and usually with no or very low out-of-pocket costs.

Eric on

fudge it slap me with penalty 600 some odd dollars for 2017, heck its cheaper than what i can afford for the year whats going to happen with the repeal , i figure it wont happen until several years into Trumps presidency, too late not soon enough!! i might make 10,000 in 2017 i have a chronic condition i wear glasses have arthritis, must get blood work 1 a MONTH, my teeth need work Am FUDGED NO FEDERAL insurance package for this pup!! Easy for Obama and his constituents to say and push this shamm of a deal,m am pissed!!

Nikkie on

If I make $6000 a year am I going to be fined $2000 for not having health insurance because I can not afford it?

Erin on

No, if you make under the tax filing threshold you are automatically exempt from the Individual Mandate to have health insurance or paying a fee (even if you file to get any other tax benefits you might be eligible for). Also, the fee is not $2000, it’s based on income, so even if your income was just over the filing threshold, it would not exceed more than 2.5% of your income or $695, whichever is higher.

Robyn Dardis on

My husband is on medicare and railroad retirement, I am unemployed. .I have been receiving Railroad health insurance until the end of 2016..My Husband bri gs home 4400 a month. .How much can we make to still qualify for the subsidy?

JAck on

I was denied credit because I make too little, but denied medicaid because I make too much! Something is broken for sure!

Angela on

My son has dual citizenship (USA and Canadian) just started university ( freshman) and will be declaring approx $6000 on US and Canadian income tax from scholarship monies and approx $1000 from working income. He goes to university in Ohio state for 9 months of the year.
Will he qualify for Obamacare?

Thank you for your time

Jen on

Can I get Obamacare if I make $17,000 a year. I live in South Carolina.

Nancy Miller on

This is so confusing! How is a person supposed to figure out what they need to do? I make $ 6,000 -$ 8,000 a year and cannot afford insurance. Do I need to try to get it anyway?

Brittany on

I’m a student and I’m lucky enough that I live rent free because my parents own 2 homes and I stay rent and amenity free in one. So basically all I need is money to take care of my necessities. So yes I make less than 11k some years but I don’t want medicaid…
its honestly too much bullshit just to get it. They want to have proof of this and that.
They want to know how I afford rent when I say I don’t have rent and I’m not homeless they don’t believe me. So I just rather not deal with it and I haven’t been to a doctor in years. It just sucks ACA does not have options for the extremely low income brackets other than Medicaid.

Joy on

What if you own rental properties and the depreciation makes the income on line 37 too low to quality for the health care? I signed up but got a letter stating I need to provide income documentation as to meeting minimum income requirements. I googled and talked to someone who works with the marketplace and wants to charge an extra hundred a month to jump through the hoops to help me qualify. She says there is a way since I do not qualify for Medicaid. My state does not have expanded Medicaid.

ObamaCareFacts.com on

Yeah, that is a bizarre situation that one can find themselves in: 1. making more than enough gross 2. having money in savings. 3. having your taxes set up to where you are taking losses from investments (like real estate) to the degree that MAGI is below the 100% FPL threshold.

There is no great solution aside from suggestions on perhaps restructuring things so you take an income of over 100% FPL and then have a business that takes the loss.

To be clear, when people say “lazy welfare recipients” and think they are talking about someone who doesn’t work, they are really also talking about people like you, me in the past, or even the President in the past who may take a loss in a given year despite investing, running a business, and paying other taxes.

But such are the dangers of rhetoric, right?

toney. ingram on

can I use my Amerigroup Insurance in Las Vegas in Florida I’m down here visiting

Edward MacMillan on

This doesn’t say whether you’ll be penalized or not if you make less then $10,500 gross for not having insurance. What is the highest amount you can make without being penalized?

ObamaCareFacts.com on

You can see the yearly amount on form 8965, it is if you make less than 100% of the poverty level and that generally means if you aren’t required to file then you don’t have to pay the fee. https://obamacarefacts.com/federal-poverty-level/

Mike on

I am the Green Card sponsor for my parents, who now live here in Nevada legally as Legal Permanent Residents and have no health insurance, do not work an do not receive any government help.
My dad is 71 and is starting to work for Uber, but probably will not make much money this year.
My mom is 69 and last week was admitted to the hospital with Jaundice. They diagnosed her with Pancreatic Cancer and released her when her condition stabilized this past Sunday. It appears that she will be able to get Emergency Medicaid for this hospital visit, but nothing else, now that she is out of the hospital.
She will probably need surgery and Chemotherapy/Radiation, but without insurance, she will not be able to get anything.
I work and pay hefty taxes, but although I am her Green Card sponsor, I simply do not have 100s of thousands for surgery and therapy.
I know that both my parents are not eligible for Medicaid or Medicare and I have never wanted to apply for them, because I do not think it is right to get help for free, if they have never paid taxes here, but now her life depends on it.
I know that if my parents were illegal aliens, refugees, asylum seekers, etc, they would get help, but unfortunately for them they are legal, and I have paid and supported their way here.
My question is does my mom qualify for anything at all?
I have an LLC and can possibly hire her, so she can somehow get income to qualify for ACA.
What can I do? Is being legally here, but not having a health insurance a crime so horrible that it deserves the dead penalty? That is what she gets if she cannot qualify for any sort of help.

Rodney long on

I was told by a marketplace rep if I retired last year on the last day of June 2016, I would qualify for the tax credit for the last 6 months. I received these to help pay for the expensive health insurance and now am being to I have to pay the entire amount back almost $ 2000 dollars because I worked the first 6 months. Is there a provision for me to only count my income for the 6 months I was retired as I more than qualify if the amount I made while working does not count. Else I will struggle to pay this money back. Help if possible.

Pete on

I’m helping a relative complete the 1040 form and this is the most confusing thing I have ever seen. I read elsewhere that the minimum for 2016 was $11,880.

On Form 2014, is this number on : line 22, “total income”; or line 37 “adjusted gross income”?

Erin on

Eligibility for tax credits and public programs are usually is calculated based on MAGI, this is the case with Marketplace coverage and premium tax credits. This is AGI plus certain tax exempt earnings are added back in.

Jordan on

What is the minimum smount of yearly salary I need to make to qualify for United Healthcare medical coverage through Obamacare if i live in NY zip 10580.

ObamaCareFacts.com on

It is based on household income and family size primarily. See the Federal Poverty Level (it doesn’t have to do with your region unless you are talking about Medicaid).

https://obamacarefacts.com/federal-poverty-level/

Jake on

Hello I am doing my 2017 incometax and received tax credit ($248) for health insurance but I made $10,043.00 instead of the $12,100 estimated. Will I have to pay anything back or will I lose my credit for next year? Or what happens exactly?

ObamaCareFacts.com on

You have to follow the directions on form 8962 and pay the correct amount. Given your income the correct amount is potentially $0 – $200. https://obamacarefacts.com/advanced-tax-credit-repayment-limits/

L R on

I find the answer confusing: The question is “What is the MINIMUM income for Obamacare?” but the answer pertains strictly to obtaining a subsidy, which is more related to the MAXIMUM income for Obamacare. I have heard that if I don’t meet a MINIMUM income that can be a problem but no one has been able to provide an answer. I am living off of my savings, therefore I apparently do not have sufficient income to qualify for ACA health insurance in any state if I have correctly interpreted the above information. What are people like me (retired or unemployed or disabled and not receiving “income”) supposed to do if we do NOT want to go uninsured and don’t want one of those nearly worthless short term policies that exclude all pre-existing conditions? I’ve been told that we can’t qualify for MediCAID if we have assets. I just want to be able to buy health insurance–has “the government” actually made it impossible for people in this situation to obtain a standard individual health insurance policy?

ObamaCareFacts.com on

This page does a good job of explaining Minimum poverty levels for Medicaid and marketplace cost assistance: https://obamacarefacts.com/federal-poverty-level/

In short, minimum income for cost assistance is 100% of the poverty level. Minimum for Medicaid depends on which state you are in. In states that expanded then anyone making less than 138% FPL qualifies, in states that didn’t it varies.

You might be in a state that didn’t expand Medicaid, as assets shouldn’t be a factor in states that did.

Dave on

Jan. 2107
Per above–For 2018 you must make a minimum of $12,060-gross income for a single person–i do not know about married people.
Bottom line–it depends which state you live in. I am 58 years old and care for my mother who is 90 and has many health issues but wishes to remain in her home. I live with her. I have sitters stay with her when I work PT outside the house. My mother pays me X wage and I receive a wage on my PT job outside the home. This totals a little over $13,000. I qualify for ACA insurance coverage and receive a subsidy each month that significantly lowers my premium. I live in Kansas and Blue Cross & Blue Shield covers most of this state and did not drop out of the ACA–thank God! I am sorry for those less fortunate who live in a state where the insurance companies have either pulled out of the ACA or you have a company where you have to pay very high deductibles and co-pays.

Dave on

oops…sorry, I meant I posted this on Jan. 2018.

Lea on

I am a full time college student and signed up for the Silver plan in 2017, I did not make $11,700 but was receiving the supplement, will I have to pay back my supplement, I do not understand what the tax credit is. I have no assets except my car which is worth about $2,000.

ObamaCareFacts.com on

I believe you are exempt from owing the subsidy due to your income level falling below 100% of the poverty level. Under 200% the repayment limit is $300, but I’m fairly certain it is waived under 100% (or roughly $11,700).

WIth this said, if your state expanded Medicaid it is likely the proper coverage for you would be Medicaid. You can always contact healthcare.gov and ask them for advice 🙂

https://obamacarefacts.com/advanced-tax-credit-repayment-limits/

Joe on

When they say “Income” do they mean Gross Income, Adjusted Gross Income or Taxable Income?

ObamaCareFacts.com on

It means MAGI, the type that is used for the ACA. There are a few slight differences between Medicaid and ACA coverage. See our page on MAGI. https://obamacarefacts.com/modified-adjusted-gross-income-magi/

Ron Williams on

What was the minimum income for a married couple for one of the parties receiving the health care subsidy?? We live in North Carolina.

ObamaCareFacts.com on

For ACA subsidies the levels are determined on a federal level and depends on family size. The minimum level for 2018 coverage for a family of 2 is $16,240 (please contact the health insurance marketplace HealthCare.Gov for direction). See Federal Poverty Level for details on how income is calculated: https://obamacarefacts.com/federal-poverty-level/

For Medicaid it is state-based. I believe it is still the case that North Carolina has not yet expanded Medicaid to all adults, but that they are working on a version of this. Here is that story (subject to change): https://www.healthinsurance.org/north-carolina-medicaid/