2022 ACA Exchange Experiences

[scrabbler1]

After 2 difficult years renewing and reapplying for the same ACA policy with the same insurer here in New York (state-run exchange), I was hoping to have an uneventful time this year. But it doesn't look like it will totally uneventful. I got a letter last week from the exchange telling me they need proof of income once again.

This seems odd because by now they would have access to my 2020 state and federal income tax returns, returns which show my greatly reduced income after I liquidated at the end of 2019 a stock fund which had been generating (or, "vomiting," as a fellow member here once described) cap gain distributions. I moved it to an index fund which generated smaller and far more predictable distributions. My 2020 actual MAGI was within $2k of my 2020 predicted MAGI in the application.

I guess I can always upload the 1099s for the 2020 year I used in my income tax forms. Calling those people at the exchange is rarely helpful because they are pretty clueless, but I suppose I will have to try. How would they not have access to at least my state income tax return they can use to verify my income??

One small complication which won't affect any income verification is that I may sign up for a dental plan. My current IC doesn't offer them, but I can sign up for one through another company. I still have some work to do on that as far as which plan I should choose. I have already discussed this with my dentist and they are willing to help me find a plan which meshes well with my current dental needs.

An update on my progress with these 2 issues.

Yesterday was the first day to enroll or update one's application with my state's exchange. I applied for the dental insurance program which went fine. After speaking with a phone rep Monday about the other item, he told me I had not checked a box which would allow them to access my tax returns. After going through the application again, I remembered I hadn't checked that box because at the time my latest filed tax returns were from 2019, the year with the huge income before I changed my portfolio to lower the income in 2020.

I checked the box and made a small adjustment to my projected income. The rep had told me that checking the box would, after 24 hours, allow them to access my tax returns. That is why, I assume, I still got a message telling me I had to provide proof of income. Will allowing them access to my tax returns (mainly, the 2020 ones) be the equivalent to uploading proof of income? I surely hope so, but I have time to get that resolved. They wouldn't need me to upload proof of income, if I still need to, for 3 months. It would still be a minor PITA to copy, add notes, scan, and upload versions of my 2020 1099s into their system.

The important thing is that I will have coverage, including dental, for 2022.

 

[Methos1979]

First post although been lurking awhile now. Wife and I (58/60) retiring at end of year and went to try to sign up for ACA through NH portal. Filled everything out honestly. They asked about current salaries and access to healthcare and future salary (low) and no healthcare. But when submitted it came back saying we didn't qualify for reduced rates based on this year's earnings. Next year we'll be living off a very meager retirement (probably $35-$40k) so by the website estimates we thought we'd get the break. Any ideas why? We were looking at a very basic bronze Anthem policy.

Update on our situation: My wife called the gov helpline which was no help at all. But I went back through the form today and found we had made a critical error. They asked if we would have medical coverage in 2022 and we said yes. It was right after the section where they were asking about salary for 2021 so we thought the question was for this year and not next. Once I fixed that error it asked for the qualifying event for losing the health coverage (of which retirement was one) and once I selected that we had our coverage!

Also for those reading, I had a concern that as a disabled veteran that gets some benefits from the VA, I might be denied the tax credit coverage. The ACA system automatically knew I was in the VA system and said that I just need to provide a letter from the VA stating that I was less than 50% disabled, which I am. At 50% you get full healthcare coverage from the VA and therefore are disqualified from the ACA tax credit.

SO, it looks like we will be good to go. This was the last 'piece of the puzzle' for our planned exit from the workforce.

 

[PaunchyPirate]

Update on our situation: My wife called the gov helpline which was no help at all. But I went back through the form today and found we had made a critical error. They asked if we would have medical coverage in 2022 and we said yes. It was right after the section where they were asking about salary for 2021 so we thought the question was for this year and not next. Once I fixed that error it asked for the qualifying event for losing the health coverage (of which retirement was one) and once I selected that we had our coverage!

Also for those reading, I had a concern that as a disabled veteran that gets some benefits from the VA, I might be denied the tax credit coverage. The ACA system automatically knew I was in the VA system and said that I just need to provide a letter from the VA stating that I was less than 50% disabled, which I am. At 50% you get full healthcare coverage from the VA and therefore are disqualified from the ACA tax credit.

SO, it looks like we will be good to go. This was the last 'piece of the puzzle' for our planned exit from the workforce.

Glad it worked out for you. The questions are tricky to follow, for sure. You have to study each one carefully. Welcome to retirement!

 

[djsander]

I believe my mistake was listing this years income which is what the question asked. I’ve got a message from them on proof of income that I haven’t been able to check. Also, received letters today from the state Medicaid agency asking for income from my employer for two pay periods in October. I had put on the ACA app that I was retired. I guess I’ll be playing spend the day on the phone with different government agencies. This is really frustrating. I still believe this just want you on either Medicaid or paying the full ACA amounts as all payments go through the states ACA exchange and not the insurer.

 

[ivinsfan]

Re the VA I don't believe this is accurate. Are you currently enrolled in the VA system? Do you get a 1099 indicating VA coverage.

 

[djsander]

Called the state exchange back today and actually got somebody that knows the whole process. He walked me through the income section and regardless of it saying current income you put in what you think will be next years. Then it still pops my wife over to medicaid with special conditions I asked about that as our income is above the thresholds. He said call the state medicaid department and get it straightened out with them. He said that they want income proof then it is just an explanation of next years and they send it back to them. Called the medicaid group and they were clueless. They said my wife was already approved for medicaid and just needed proof of income. I told them I made over 100k this year and that should not approve that and next years projected income is 40k and that would knock us out. They said they can’t do anything about next years only this year. I told them it’s for ACA coverage for 2022 and they said they don’t know anything about that works and only deal with the current year. I said we don’t need this and she said do you want to cancel the application. I said not if it affects our ACA subsidies and coverage. There response was they don’t know anything about that. So two state agencies that don’t know what each other requires. We finally convinced the rep to deny the application and left it at that. I asked if they send that back to the state exchange and they didn’t know about any of that. What a mess. The saving grace is we know my wife goes over to Medicare in March and the exchange let us sign up for 0$ gold plans and have until Feb. to prove anything. What a nightmare. We will plug on and see if anything pops up in the next few weeeks on this.

 

[ownyourfuture]

Monthly premium for my ACA HD plan through Medica (MNsure Minnesota) for 2021 was $433.38 Jan through May. Dropped to $221.66 in June, then rose to $327.52 for the rest of this year. ($7000 deductible)

In early October, received a letter from MNsure asking for a copy of my 2020 federal return.

Shortly thereafter, received a letter from Medica. My Applause Bronze HSA premium would be $453.09 for 2022. I knew the federal cut off (cliff) wouldn't be an issue in 2022, but I knew there was still state income guidelines related to the ACA.

Had a couple other questions as well. Luckily for me, there's a guy in town who has his own financial planning business, & also serves as a Medica rep.

Scheduled an appointment & met with him last Wednesday.
He logged in to my account & found a plan called UCare Bronze HSA. Same deductible, same network, $130 per month.

I was more than a little skeptical, but it was all there in black & white.
Not sure why he didn't do this first, but he asked me what my approximate gross income would be for 2022. It's going to be slightly higher next year, so to play it safe, we upped it from $130 per month, to $204

He said I'm all signed up & good to go. I'll receive confirmation within a week or 2.

I'm still pinching myself.

 

[scrabbler1]

An update on my progress with these 2 issues.

Yesterday was the first day to enroll or update one's application with my state's exchange. I applied for the dental insurance program which went fine. After speaking with a phone rep Monday about the other item, he told me I had not checked a box which would allow them to access my tax returns. After going through the application again, I remembered I hadn't checked that box because at the time my latest filed tax returns were from 2019, the year with the huge income before I changed my portfolio to lower the income in 2020.

I checked the box and made a small adjustment to my projected income. The rep had told me that checking the box would, after 24 hours, allow them to access my tax returns. That is why, I assume, I still got a message telling me I had to provide proof of income. Will allowing them access to my tax returns (mainly, the 2020 ones) be the equivalent to uploading proof of income? I surely hope so, but I have time to get that resolved. They wouldn't need me to upload proof of income, if I still need to, for 3 months. It would still be a minor PITA to copy, add notes, scan, and upload versions of my 2020 1099s into their system.

The important thing is that I will have coverage, including dental, for 2022.

Another update on my situation.

After getting a bill for Jan 2022 dental, I set up an online account with them. But when it asked me to choose a provider, I could not find my current dentist who supposedly was in the plan I chose. Upon further investigation, I discovered my dentist isn't actually part of the specific plan I chose but he is in different ones (not offered in the ACA). The only other plan he is in which the ACA allows me to choose (at a much lower cost) is a plan which offers insufficient coverage for my needs. Therefore, I just disenrolled from the plan. At least I learned of this now, before I made any premium payments and before I had any dental services done; the latter in particular would have been really bad.

I checked out the other IC the dentist is in, and the plans allowed by the ACA are not those the dentist is part of. So, no dental insurance for me in 2022.

On the income verification issue, I see I can use my annual statement which comes out in early January instead of waiting for the 1099 form to come out in early February. The data is the same in both documents, and I don't need to see which dividends are Qualified versus non-qualified (MAGI doesn't care). This gives me more time to assemble and upload the marked up documents I will need to show proof of income by 2/15/2022.

 

[scrabbler1]

Another update: On the income verification issue, the annual statement hadn't come out yet, but I used the year-end income amounts shown in the December 2021 statement, the same data. I added some handwritten notes and redacted some other irrelevant data from the key page of the report and uploaded it. A few days later (today), I got a reply: Accepted! I am good for the subsidy for the rest of 2022.

 

[RetiriusMinimus]

This has been an informative thread as I’m 2-3 years from retirement and will have another 3 til Medicare eligibility. I’ve run some scenarios based upon withdrawal sources looking a few years out, but….in 2023 doesn’t the cliff come back..? Or do you expect congress to extend it out?

 

[SecondCor521]

This has been an informative thread as I’m 2-3 years from retirement and will have another 3 til Medicare eligibility. I’ve run some scenarios based upon withdrawal sources looking a few years out, but….in 2023 doesn’t the cliff come back..? Or do you expect congress to extend it out?

Yes, the cliff does return in 2023 unless Congress acts. Who knows if they will, and if they do so, what they might do.