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Old 02-18-2020, 07:09 PM   #21
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Originally Posted by meleana View Post
But it states this in the link you provided:

Does someone have to take the premium tax credit in advance in order to receive the cost-sharing reduction?

No. To get the cost-sharing reductions, a person only needs to be eligible for the premium tax credit. The person can still get the cost-sharing reductions if they choose to wait until they file their taxes to receive the premium tax credits.
I think getting the cost sharing reductions (CSRs) would require that the NH authorities accept your estimated income as being low enough to qualify for them (under 250%, 200%, or 150% of FPL for your family size).

CSRs are on Silver plans only. My understanding is that the insurance companies craft their Silver plans, then usually modify the deductibles and OOP maximums in order to create the CSR versions of those Silver plans. In order to get CSRs, you have to buy a CSR plan. The only way (I think) the exchange would let you do that is if your income level qualified you for them.

My state exchange has a "CSR eligible" checkbox that I can select. Yours probably will as well.

As I think has already been stated, once you buy the CSR eligible Silver plan and you utilize whatever services you utilize during the year, you either get a benefit from having a lower deductible or OOP maximum or not. It is not reconciled on your taxes in the same way that the PTC is. If your income ends up being higher than the estimate, nobody from the insurance company goes back and refigures what should have been done regarding your benefits. It's just water under the bridge, so to speak.
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Old 02-18-2020, 07:44 PM   #22
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Originally Posted by meleana View Post
I know what our income will be in advance as we can control it. We are living on cash. Based on our estimated income ($24,000- the lowest we can go before being thrown onto Medicaid), I would be getting full cost sharing also. A Silver plan and a premium of $40 per month. So you are saying that if for some reason my letter of explanation is not accepted and I have to pay full premiums, then when I file my taxes in 2020, I would get a lump sum refund of just the difference in the premiums, but not the cost sharing portion? This I do not understand. How do they calculate that one? Based on my usage? What if I never go to a doctor the whole year? (not likely- but just for example)
Wouldn't a Roth Conversion solve your problem?
You probably know this already but "Income" has to be taxable income. This was a shock for me my first year. I had estimated my income at 10K in taxable CD Interest and the remaining 15K was to be "cash" pulled from my savings account which was after tax money. Luckily Covered California needed documentation of my estimate and let me know after tax money was not considered income. In a panic I pulled 15K from my IRA account to resolve the issue and was approved immediately when I faxed Covered California the distribution paperwork along with my 1099-INT forms for the previous year. Meantime I learned about Roth Conversions on this website and was able to redeposit the 15K back into my bank as a Roth Conversion and live off my cash as originally planned.
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Old 02-18-2020, 08:03 PM   #23
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Wouldn't a Roth Conversion solve your problem?
You probably know this already but "Income" has to be taxable income. This was a shock for me my first year. I had estimated my income at 10K in taxable CD Interest and the remaining 15K was to be "cash" pulled from my savings account which was after tax money. Luckily Covered California needed documentation of my estimate and let me know after tax money was not considered income. In a panic I pulled 15K from my IRA account to resolve the issue and was approved immediately when I faxed Covered California the distribution paperwork along with my 1099-INT forms for the previous year. Meantime I learned about Roth Conversions on this website and was able to redeposit the 15K back into my bank as a Roth Conversion if not I would have been placed on MediCal similar to Medicaid
Right now the interest and dividends on our money and a RMD on an inherited IRA will be at about $21,000 or less based on last year. So yes, Roth conversions would also help us get to the $24,000 mark or simply just withdrawing some money from our IRA’s.
But my concern is that they will not accept my letter of explanation on income for the subsidies or cost sharing for whatever stupid reason and I will be stuck with high premiums and no cost sharing until we file our taxes and having to lay out all that money, when I could have just stayed on my retiree medical plan and not deal with all this craziness.
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Old 02-18-2020, 08:17 PM   #24
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Right now the interest and dividends on our money and a RMD on an inherited IRA will be at about $21,000 or less based on last year. So yes, Roth conversions would also help us get to the $24,000 mark or simply just withdrawing some money from our IRA’s.
But my concern is that they will not accept my letter of explanation on income for the subsidies or cost sharing for whatever stupid reason and I will be stuck with high premiums and no cost sharing until we file our taxes and having to lay out all that money, when I could have just stayed on my retiree medical plan and not deal with all this craziness.
I hear your concern, and I guess it is partly because you haven't dealt with the ACA before.

I guess I would encourage you to try to estimate the probability that your submittal to the NH ACA folks will be declined. You might look for data on that, or you might call and ask the ACA folks that question, or you might look for anecdotes.

Personally, I do not know anyone who has had their well-reasoned application for ACA subsidies declined. It may happen, but I've never heard of it. So I think the chance of any problem is very very low.

I do think (because I've seen evidence of it) that various ACA authorities vary in how stringent they are in evaluating submittals, so you may want to limit your investigation to NH data.
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Old 02-19-2020, 08:45 AM   #25
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Starting March 1st, I am enrolled in an ACA plan, BUT they need income documentation. My husband is on Medicare and I am no longer working, but not yet Medicare eligible. Husband retired 12/31/19. No SS or pensions and living off savings for 2020. Just moved to NH from NY.



I somehow found myself a broker who deals with the marketplace through an ex NH navigator (NH lost it's funding for navigators). The broker wrote a letter of explanation on my behalf. No documents provided as of right now. He said they probably won't even look at it until April.


The problem is by that time I would have put my retiree medical insurance on suspend (have to do that 3/2) and if the ACA denies me the subsidies then I would NOT be able to go back onto the retiree medical and the ACA plan premium would be double the retiree medical!!! In essence I would have "screwed myself"!

So I am losing sleep over this. It would be one thing if I could keep the retiree medical active by paying the premiums until the government decided I am eligible for the subsidies, but I do not think that is allowed. (I had to apply for the ACA plan now because you only have 60 days from the date of your move to apply, so the most I could do is change the enrollment date to 4/1 instead of 3/1- I suppose).

I have left a message for the broker but he has not yet returned my call and our Financial Advisor is not familiar with it in this state as he is in NY. This is what I was trying to avoid and why I was resistant to going on an ACA plan in the first place, but he encouraged me to do it. Of course, a $40 per month premium with no deductible is very enticing compared with a $545 per month premium and a high deductible. But there is something to be said for peace of mind too.

I had enough stress dealing with my husband's Medicare plans (2x in 2 months due to the move!) and I want this all to be over with and not hanging over my head for months. Should I just stay on the retiree medical, which is a sure thing, though expensive? That is what I am leaning towards just because trying to prove income with the bureaucracy will be a nightmare since last year we had income and this year we will not.


I need to decide NOW as 3/1 is around the corner! Any help appreciated.

Did you sign up for a silver plan that qualifies you for CSR?
If you signed up for one of these silver plans and you are getting your premiums at $40/month with no deductible. It looks like the Ambetter Balanced Care 11.
You are therefore getting the CSR and the PTC (normal premium looks to be about $877/month for a single(since your husband is on medicare he doesn't count) and I think you will be fine as long as at tax time your income comes in at what you said.
Even if your off a little you just make up the difference of your PTC and it won't amount to much at all.
No worries and next time don't use a broker it is very simple to do yourself!
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Old 02-19-2020, 08:52 AM   #26
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I appreciate your openmindedness.

I guess that we'll just agree to disagree.
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Old 02-19-2020, 09:12 AM   #27
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Cost sharing is only valuable to those that use quite a few services, so if you don't, don't worry about that. Consider the difference in cost between the Bronze and Silver.


Pick a number between 250% and 350% of FPL and enter it when you apply. Then make that a reality by Roth converting. If they ask for documentation, that happened to me after I applied, I gave them whatever they asked for, which was the most recent tax return and an explanation of why this year won't be like last year.



As mentioned, the worst they can do is stop helping you pay the monthly premiums. But come early 2021, when you do your taxes, it all gets evened out (if they didn't lower your monthly premium payment enough, you get money, if they lowered it too much you pay money).
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Old 02-19-2020, 01:12 PM   #28
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Did you sign up for a silver plan that qualifies you for CSR?
If you signed up for one of these silver plans and you are getting your premiums at $40/month with no deductible. It looks like the Ambetter Balanced Care 11.
You are therefore getting the CSR and the PTC (normal premium looks to be about $877/month for a single(since your husband is on medicare he doesn't count) and I think you will be fine as long as at tax time your income comes in at what you said.
Even if your off a little you just make up the difference of your PTC and it won't amount to much at all.
No worries and next time don't use a broker it is very simple to do yourself!

Actually, I did apply myself but when it came time to get information about what documentation I needed, things went downhill from there dealing with the representatives, who's replies were robotic and non helpful.



I got frustrated and my FA kept telling me to find a navigator like they have in NY and I kept explaining that NH lost their funding for navigators. But I came upon an ex navigator who put me on a 3 way call with this broker who helps people apply and he volunteered to write the letter and submit it electronically. I was so stressed out at that point I was relieved to have someone helping me.


Very sharp of you to realize what plan I enrolled in! I hope it all works out because I just need a break until I am 65 in 2021.
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Old 02-19-2020, 01:34 PM   #29
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Originally Posted by meleana View Post
Right now the interest and dividends on our money and a RMD on an inherited IRA will be at about $21,000 or less based on last year. So yes, Roth conversions would also help us get to the $24,000 mark or simply just withdrawing some money from our IRA’s.
But my concern is that they will not accept my letter of explanation on income for the subsidies or cost sharing for whatever stupid reason and I will be stuck with high premiums and no cost sharing until we file our taxes and having to lay out all that money, when I could have just stayed on my retiree medical plan and not deal with all this craziness.
I've personally filed a couple explaining major income changes and have participated in 25+ similar threads. If you're declined you will be the very first. This is done just to make sure you have some documentation, these reps can't deny you cost sharing or subsidies. There only there to discourage obvious frauds from applying.
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Old 02-19-2020, 02:12 PM   #30
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Actually, I did apply myself but when it came time to get information about what documentation I needed, things went downhill from there dealing with the representatives, who's replies were robotic and non helpful.



I got frustrated and my FA kept telling me to find a navigator like they have in NY and I kept explaining that NH lost their funding for navigators. But I came upon an ex navigator who put me on a 3 way call with this broker who helps people apply and he volunteered to write the letter and submit it electronically. I was so stressed out at that point I was relieved to have someone helping me.


Very sharp of you to realize what plan I enrolled in! I hope it all works out because I just need a break until I am 65 in 2021.



SO if you got a premium quote and you have signed up. The you must have received an "eligibility notice"
It usually shows up electronically in your application process.
ON this document it has a "results " page telling you exactly how much your premium tax credit is and further down the results page your cost sharing status.
It sounds like you received both of those by picking an appropriate silver plan.
On that eligibility notice it will tell you exactly what "next steps" you need to follow, if any , for documentation they want.
If the next step listed was to enroll in a plan then you should be all set until tax time next year when you verify the income figure you used to apply.


Did you receive an "eligibility notice and did it list any next steps?
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Old 02-20-2020, 07:02 AM   #31
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SO if you got a premium quote and you have signed up. The you must have received an "eligibility notice"
It usually shows up electronically in your application process.
ON this document it has a "results " page telling you exactly how much your premium tax credit is and further down the results page your cost sharing status.
It sounds like you received both of those by picking an appropriate silver plan.
On that eligibility notice it will tell you exactly what "next steps" you need to follow, if any , for documentation they want.
If the next step listed was to enroll in a plan then you should be all set until tax time next year when you verify the income figure you used to apply.


Did you receive an "eligibility notice and did it list any next steps?

I applied directly with Ambetter on the phone and picked the plan myself, though it was the one they suggested, and I have an email confirmation for the first month's payment. I am already enrolled- they just need the documents- which, of course, they don't specify exactly what they want from me, so the broker wrote a letter of explanation regarding my income.


I thought I received an email confirmation from them regarding enrollment and also to take action regarding proof of income. Then when I called to see exactly how I could prove it since it has not occurred yet (we are only in the month of February- last year we had income- this year it is very low)- that is what set me off as no one could tell me exactly what documents to send except I could write a letter of explanation.

I have an on line account with them and everything, but it has limited info. on it. The broker said I will probably get my card next week, but it could take them until May to get to review the letter- that is what makes me nervous- that they will decide it is not adequate and raise the premium and take away the cost sharing until we can send even more documents, whatever they may be. And there will go my bank account that we are living on for everyday expenses.


Going from laying out $40 per month to $900 per month- plus coinsurance- would be a killer.
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Old 02-20-2020, 07:48 AM   #32
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I applied directly with Ambetter on the phone and picked the plan myself, though it was the one they suggested, and I have an email confirmation for the first month's payment. I am already enrolled- they just need the documents- which, of course, they don't specify exactly what they want from me, so the broker wrote a letter of explanation regarding my income.


I thought I received an email confirmation from them regarding enrollment and also to take action regarding proof of income. Then when I called to see exactly how I could prove it since it has not occurred yet (we are only in the month of February- last year we had income- this year it is very low)- that is what set me off as no one could tell me exactly what documents to send except I could write a letter of explanation.

I have an on line account with them and everything, but it has limited info. on it. The broker said I will probably get my card next week, but it could take them until May to get to review the letter- that is what makes me nervous- that they will decide it is not adequate and raise the premium and take away the cost sharing until we can send even more documents, whatever they may be. And there will go my bank account that we are living on for everyday expenses.


Going from laying out $40 per month to $900 per month- plus coinsurance- would be a killer.

OK. You should have signed up step by step thru Healthcare.gov. This is where you would receive the eligibility notice results and exact PTC amounts etc.
Having signed up thru ambetter it sounds like they arrived at the same premium amount that Healthcare.gov would have. (That is how I arrived at your plan and premium based on your stated $24k of income)
Since you signed up directly with Ambetter it sounds like the whole paperwork trail will just be messier.

Healthcare.gov would have told you exactly what they wanted you to provide.


If it were me I would start an application and sign up thru Healthcare.gov even now.
You will simply go to their website and hit the "get coverage" button on top of the page.
It will then ask you to create an account and it will walk you step by step thru the process.
After you have entered all your data(including your estimated 2020 income) it will tell you your PTC and cost sharing options .
It will then send you to the page with all the plans and you just need to pick the same Ambetter plan you have already agreed to.
This way you are officially in the Healthcare.gov system and have an approved plan.
It will eventually get a response telling you that you have one final step and that is to pay your first months premium with Ambetter which you have already done.
This can all be done literally in about 15 minutes.
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Old 02-20-2020, 08:31 AM   #33
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Going from laying out $40 per month to $900 per month- plus coinsurance- would be a killer.
You'll get the money back at tax time regardless, you just won't get the CSRs.
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Old 02-20-2020, 08:46 AM   #34
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OK. You should have signed up step by step thru Healthcare.gov. This is where you would receive the eligibility notice results and exact PTC amounts etc.
Having signed up thru ambetter it sounds like they arrived at the same premium amount that Healthcare.gov would have. (That is how I arrived at your plan and premium based on your stated $24k of income)
Since you signed up directly with Ambetter it sounds like the whole paperwork trail will just be messier.

Healthcare.gov would have told you exactly what they wanted you to provide.


If it were me I would start an application and sign up thru Healthcare.gov even now.
You will simply go to their website and hit the "get coverage" button on top of the page.
It will then ask you to create an account and it will walk you step by step thru the process.
After you have entered all your data(including your estimated 2020 income) it will tell you your PTC and cost sharing options .
It will then send you to the page with all the plans and you just need to pick the same Ambetter plan you have already agreed to.
This way you are officially in the Healthcare.gov system and have an approved plan.
It will eventually get a response telling you that you have one final step and that is to pay your first months premium with Ambetter which you have already done.
This can all be done literally in about 15 minutes.

I am so confused now. I know I originally spoke with an Ambetter rep. but maybe they transferred me to Healthcare.gov- I have no idea. All I know is after the fact- when I got the broker involved- he pulled up all my info. on whatever website and uploaded the letter so he must know what he is doing. He didn't tell me any different.


I had called the Marketplace phone number in error at one point to ask a question about billing- I should have called Ambetter, which I eventually did. But anyway, the Marketplace rep. did see my info. in her system so I should be ok I would think. I don't want to make things more complicated than they already are.
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Old 02-20-2020, 09:20 AM   #35
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I'm not sure if NH uses the federal exchange or has it's own exchange. However, I have twice had to provide "proof of income" to Healthcare.Gov. The explanation I provided was accepted both times. Not knowing what you provided in way of an explanation, it's possible that you could be asked to provide additional information. But, based on the information you have posted, you should be ok. And as it has been stated, worst case scenario is you pay full premiums now and get a refund when you file your 2020 taxes.
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Old 02-20-2020, 09:27 AM   #36
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I am so confused now. I know I originally spoke with an Ambetter rep. but maybe they transferred me to Healthcare.gov- I have no idea. All I know is after the fact- when I got the broker involved- he pulled up all my info. on whatever website and uploaded the letter so he must know what he is doing. He didn't tell me any different.


I had called the Marketplace phone number in error at one point to ask a question about billing- I should have called Ambetter, which I eventually did. But anyway, the Marketplace rep. did see my info. in her system so I should be ok I would think. I don't want to make things more complicated than they already are.

OK then don't let me confuse it any further.
Just let it be and forget my advice on a new application.
I think you are fine and over worrying this. It sounds like you are already in the system and paying the proper premium.
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Old 02-20-2020, 12:22 PM   #37
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However, I have twice had to provide "proof of income" to Healthcare.Gov. The explanation I provided was accepted both times.
Those that have had to provide proof, What exactly did you provide? I'm not asking for personal specifics, I mean did you just show past interest income, past stock returns for the year?

A side note. I am also an extreme worrier! We just did our taxes. We talked over ways with our retiring cpa of how to get our agi up to the minimum subsidy level for coverage. We're too young to do a roth so would have to do a trad and pay the penalty. He'd not seen this at all but had seen many that horrifically finagled ways to get their income down so they could get below the maximum to get a subsidy. I want what I can get legally but Noooooooo way gonna scam it!
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Old 02-20-2020, 12:28 PM   #38
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Those that have had to provide proof, What exactly did you provide? I'm not asking for personal specifics, I mean did you just show past interest income, past stock returns for the year?

A side note. I am also an extreme worrier! We just did our taxes. We talked over ways with our retiring cpa of how to get our agi up to the minimum subsidy level for coverage. We're too young to do a roth so would have to do a trad and pay the penalty. He'd not seen this at all but had seen many that horrifically finagled ways to get their income down so they could get below the maximum to get a subsidy. I want what I can get legally but Noooooooo way gonna scam it!
I sent them a letter with my plan for income. I.E. I'll be doing withdrawals for 15k in addition to DWs SS. I sent no forms or documents.

I worked around a bunch of audit people and have a minimalist approach to what I provide when asked for information. Less is more.
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Old 02-20-2020, 01:29 PM   #39
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I went thru the same thing when I retired in Jan 2015, signed up for Obamacare and had to provide proof of income. I started compiling a list of documents, 1099-DIV, 1099-B & 1099-INT forms, a lengthy letter...


Then I chucked it all--I made a screenprint of my Vanguard funds and using a Sharpie, made 3 lines with arrows:


Money Market Fund ------------> WHAT I LIVE ON COMES FROM HERE
Total Stock Market Fund -------> I EARN 5K IN DIVIDENDS FROM HERE
Wellington Fund ----------------> THIS IS MY IRA, I WILL WITHDRAW ENOUGH MINUS 5K TO MEET THE MINIMUM INCOME NEEDED FOR ACA



(I didn't even tell them I'm actually converting that IRA withdrawal to a Roth. Anyway, my ONE screen print with 3 lines in Sharpie worked.)
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Old 02-20-2020, 05:22 PM   #40
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The year we retired I included a statement that DH and I had retired on 2/1 so we would only have 1 month of wages. I also provided a breakdown of what I thought our MAGI would be by source (Wages, Dividends, Capital Gains, etc.). I attached images of supporting documents (final paystub, previous year 1099s, etc.) My explanation was accepted without question.

The next year I included an explanation that was even more simple. Basically I stated we expected $X of income from investments and $Y from retirement accounts for a total MAGI of $Z. I did not include any supporting documentation this time. My explanation was again accepted without question.

I have not been asked to provide proof of income in the 2 years since then.
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