ACA and Medicaid

[Alex The Great]

I know it may had been discussed somewhere but it is hard to find now.
I try to keep MAGI ~$23K annually to qualify for ACA subsidy. This is the first year I enrolled. Year before that, I used to have much higher income and was on employer's insurance.
However, my actual monthly income is variable. Some monthly income comes up less than $1,677 Medicaid (MediCal here in CA) threshold.
I'm not sure if ACA monitor it, but I repeatedly got letters about Medicaid eligibility and enrollment. Did not pay much attention to it.
But in my account at coveredca.com, there is always a link to provide the proof of income.
I believe I provided estimate to them somewhere in Feb, based on last year records from Fidelity and some bank accounts. But they keep asking for that.
My question is: do I need to do anything is this case? Do I need to call them for clarification? Or it is just a normal routine everyone experience?

 

[jim584672]

The current number is $1,732 a month. If you want to avoid it never have income under this number.

 

[Alex The Great]

The current number is $1,732 a month. If you want to avoid it never have income under this number.

Thank you. Well, initially they referred to $1,677 in a letter sent in December of 2023.
Of course I can bring monthly income above the MediCal threshold, but it will reduce the subsidy.
Anyway the question I had: do I need to do anything at this point, in order to keep coverage?

 

[jim584672]

If you are CoveredCA and want to stay on it just never report a month under the limit.

 

[Alex The Great]

If you are CoveredCA and want to stay on it just never report a month under the limit.

Sorry what do you mean? I did not report anything. These are just my internal spreadsheets that reveal monthly income falling below MediCal limit for a couple of months.
What I reported is an estimate for annual income in 2024. Which I believe is accurate. I thought ACA operates on annual income, rather than month-to-month.
I wonder if they monitor my income and how they can do that?

 

[jim584672]

ACA is calendar year, Medicaid is current month income. If you lost your job and your income dropped this would enable someone to go on Medicaid and not have the previous months high income be held against them.

 

[MichaelB]

Sorry what do you mean? I did not report anything. These are just my internal spreadsheets that reveal monthly income falling below MediCal limit for a couple of months.
What I reported is an estimate for annual income in 2024. Which I believe is accurate. I thought ACA operates on annual income, rather than month-to-month.
I wonder if they monitor my income and how they can do that?

The problem is CoveredCal is based on annual income, MediCal is based on monthly income, and MediCal assumes if you are eligible for MediCal you will opt for it.

The way to avoid this and remain on the ACA policy, as jim584672 points out, is to ignore the requests to report income. You provided an estimate, you qualified for CoveredCal, and when the year ends you will reconcile to that. In the meantime you don’t need to do anything.

 

[Alex The Great]

The problem is CoveredCal is based on annual income, MediCal is based on monthly income, and MediCal assumes if you are eligible for MediCal you will opt for it.

The way to avoid this and remain on the ACA policy, as jim584672 points out, is to ignore the requests to report income. You provided an estimate, you qualified for CoveredCal, and when the year ends you will reconcile to that. In the meantime you don’t need to do anything.

Thank you so much for clarification. Yes I believe this is as much as I can do at this point.

 

[Alex The Great]

ACA is calendar year, Medicaid is current month income. If you lost your job and your income dropped this would enable someone to go on Medicaid and not have the previous months high income be held against them.

In 2024, I'm on ACA for the entire year. In 2023, I've been on employer's insurance most of the time. The remaining month or so I did not buy any insurance and reported it on tax return. Therefore, 2024 is really the first ACA year for me.

 

[fh2000]

We have used Covered California for 5 years now. Each time I have a question, I simply call their help line at 8AM Pacific time when they open.

Contact Us​

Have a question? Please contact an office for assistance.
Covered California
Phone number: (800) 300-1506

Their representative will help me, renew, change plan, upload documents, and answer any questions I have.