How can I get help paying for my health insurance?

Important Things you need to know if you are receiving financial help to lower your health insurance premiums.

Hi, everyone my name is Diana, I am a CoveredCa Certified Insurance Agent and today I would like to talk and explain how the subsidy or APTC (Advanced Premium Tax Credits ) Works and answer a few of the most asked questions regarding it.

What is APTC? 

How can I get help paying for my health insurance?

 What is the income limit to get help? What if my income changes during the year? 

What can I do to avoid owing money when I file my taxes? And so on!

 

So, the APTC - Advanced Premium Tax Credits are still available for the next year 2019. And it is very important to play by the rules in order to avoid any issues at the tax time.

If you never heard of APTC, I will explain what that is – basically if your income is below a certain threshold, you can get financial help to pay for your health insurance. In other words, the APTC lowers your monthly health insurance premium.

I recently posted 2 videos on my YouTube channel where I look at 2 scenarios

In one video I explore how much APTC is available to a singleperson living in San Francisco and making $40,000/year. In My other video I talk about a family of 4 living in San Jose and making a $100k per year! Please watch the videos to get a practical view on how these subsidies work via real examples.

And of course, if you haven’t subscribed to my channel – please feel free to subscribe and support it! 

O.K. so now that you know what APTC is, let’s talk about specifics. And before we proceed I want to mention that Getting the Right Financial Help is very important.

Again, Premium assistance, can lower the cost of health care for individuals and families. In California, It is only available to those who enroll in a Covered California health plan and meet certain income requirements. The amount of premium assistance you receive is based on how much money you make, your tax household size and where you live. 

Because the amount of premium assistance you receive is based on information that can change during the year, it’s important to keep Covered California updated about these changes so that your premium assistance can be adjusted if needed.

What do I do if I have a change in my income or application information at renewal or during the year?

During renewal, you can update your information at any time. Outside of renewal, you must report the change to Covered California within 30 days. If you have an agent, the agent can help with making those changes. If you don’t have an agent, please feel free to reach out to me, I can assist. By law there is no fee or charge involved. So, you can get professional help at no extra cost to you.

If you don’t have an agent and  if Covered California asks you to provide documents that verify your income, you must do so by the date listed on your notice. It is very important to respond as soon as you get this notice to avoid later issues with your account.

Now, remember if you are self-employed or have income that fluctuates during the year-  you don’t know exactly what your income will be one year from now. You can estimate. And that is totally fine.

It is possible that you will qualify for more premium assistance than you received because at the end of the year your income was lower or your tax household size was larger than what you reported to Covered California. If this happens, you may get money back when you file your taxes.

It is also possible that you qualify for less premium assistance than you received because at the end of the year your income was higher or your tax household size was smaller than what you reported to Covered California. If this happens, when you file taxes you will have to repay the extra amount you received.

Now, here is a very important question - What can I do to avoid owing money when I file my taxes?

If you are worried about owing money at tax time, you can choose to take less of the premium assistance each month. Your monthly premiums will still be lower, but not as much. By taking less premium assistance during the year, there is less chance you will owe back money at tax time. So, in other words take a more conservative approach. If you don’ t know how to do it, please reach out to your agent or to us and we will be glad to help with that a well.

You can also choose to pay the full premium amount each month. If you choose this option, the tax credit would be applied toward any taxes you owe — or you would get a bigger refund when you file your taxes.

So, let’s see if you qualify for premium assistance! 

By looking at this table, you can easily see if you qualify for a health insurance subsidy. Look at the household size and the income you make. So, for example, an individual living in California can get a subsidy and premium assistance as long as his or her income is below $48,560 per year.

Now, if the income for this person is below $16,754/year than he or she can get Medi-Cal (which is provided at no cost via the County of residence).

These figures are for year 2019.

Here is a more detailed table that also shows if you can get enhanced silver plans depending on income. The enhancements come in the form of lower copays and deductibles on top of lower premiums. I will post a side by side comparison of the enhanced plans shortly so you can see the difference.

If you have any questions about this information or anything is confusing, feel free to comment under the video. I am pretty good at responding to all the comments. If you have a specific question or issue, feel free to reach out to me directly and I will do my best to help at no extra cost. Remember, insurance agents working with CoveredCa are required to help consumers at no extra cost.

Again, please share our video and subscribe to our channel. By doing so you will help us keep up this channel alive and spread the word and perhaps you will get a few extra karma points as well!!!

Now, as I mentioned, here is a side by side plan comparison of enhanced plans.