ACA wants estimated income. I'll drop from $1M to $0.00 this year.

[rmcelwee]

This will be my first time getting marketplace health insurance. I estimated $50K in income when I applied. During that online application they questioned my wife's $0 yearly income. I sent them a screenshot of her SSA.gov yearly income showing she hadn't worked since 1993. Now they've sent me a form in the mail to fill out concerning annual income. Last year we sold $1M in stocks to fund a house build. This year I will possibly have $0 in income (well, $6,609 in pension). I'm looking for advice. Do I send them last years 1040 showing $1M? What do they want me to do? What is the best thing for me to do?

 

[Sunset]

I've never had ACA or Marketplace ins.

Didn't you have interest and dividends last year ?

I'd show them what you will have this year, example: pension, interest and dividends.

 

[Aerides]

I have never been asked to show documentation, not even the first year. Are you doing this through healthcare.gov or a state site?

Either way, the form, and your answers, should reflect your 2026 expected income.

Zero is tricky because that means your wife has no interest income, no dividends, no nothing at all? No savings in her name?

 

[FD1000]

What matters is your income estimate for 2026, not what happened in 2025.
I would show at least $25K income.

 

[Montecfo]

When I had ACA through fed site and then through state site they took my word for income.

 

[ArmchairMillionaire]

Per Google:

"For 2026 ACA coverage, the minimum income to qualify for premium tax credit subsidies for a family of two is 100% of the Federal Poverty Level (FPL), which is $21,150, with subsidies available up to 400% FPL ($84,600) unless Congress acts to extend temporary enhancements. You must generally earn between 100% and 400% FPL, though there are exceptions for those below 100% FPL. "

So Zero would probably not be a good estimate to give them.

 

[swakyaby]

I’ve had to provide proof of income several times during the 7 years I was on ACA insurance. Because they would ask for proof early in the year, I would initially sign the attestation statement of estimated income (should be above Medicaid income limits), and respond to their 2nd request to show proof (social security statement, dividend and capital gains statement). It should be income for the year ACA benefits are received.

 

[GenXguy]

You also don't want to estimate $0 or too low of an income for any month. Divide by 12 for a monthly estimate. Otherwise, you will get thrown over to Medicaid.

I'm starting my 3rd year on ACA. Despite earning over my estimate the previous 2 years, I have never had to provide any proof of income.

 

[PaunchyPirate]

This will be my first time getting marketplace health insurance. I estimated $50K in income when I applied. During that online application they questioned my wife's $0 yearly income. I sent them a screenshot of her SSA.gov yearly income showing she hadn't worked since 1993. Now they've sent me a form in the mail to fill out concerning annual income. Last year we sold $1M in stocks to fund a house build. This year I will possibly have $0 in income (well, $6,609 in pension). I'm looking for advice. Do I send them last years 1040 showing $1M? What do they want me to do? What is the best thing for me to do?

What does the form they sent you actually ask for?

 

[Aerides]

What we do is divide that estimated total by two, then enter each person by month or whatever it required. Since we are MFJ, it doesn't really matter about accuracy for one vs. the other, but no one has zero.

 

[Exchme]

Remember, t-IRA withdrawals and Roth Conversions count and since they are looking for a MAGI, dividend and LTCGs count as does muni bond interest.

 

[Tetto]

You also don't want to estimate $0 or too low of an income for any month. Divide by 12 for a monthly estimate. Otherwise, you will get thrown over to Medicaid.

I'm starting my 3rd year on ACA. Despite going over my estimate the previous 2 years, I have never had to provide any proof of income.

In the same boat for my first year in going over my estimate by $40k. What do they do? Claw back premiums for the whole previous year?

 

[COcheesehead]

In the same boat for my first year in going over my estimate by $40k. What do they do? Claw back premiums for the whole previous year?

You’ll pay more when you fill out your taxes. They’ll take back some/all of the subsidy.

 

[COcheesehead]

I have never had to prove income for ACA, but I did have a reconciliation at tax time.

 

[GenXguy]

In the same boat for my first year in going over my estimate by $40k. What do they do? Claw back premiums for the whole previous year?

For 2024, I had to pay the maximum $950 (based on my income) back of the advanced PTC I had received. I'm estimating $325 clawback for 2025, which is well below the $975 cap for my income range. For 2026, the capped payback limit disappears for all income ranges. My estimate should be even closer for 2026.

 

[rmcelwee]

What does the form they sent you actually ask for?

Submit one or more documents to confirm annual household income. 1040, wage and tax statement, pay stub, SS statements, written explanation.

I guess I can give them a written explanation but I have a gut feeling that will get kicked right back to me.

I'm wondering if my huge 2025 income is making them suspicious of my low 2026 income estimate.

 

[rmcelwee]

I’ve had to provide proof of income several times during the 7 years I was on ACA insurance. Because they would ask for proof early in the year, I would initially sign the attestation statement of estimated income (should be above Medicaid income limits), and respond to their 2nd request to show proof (social security statement, dividend and capital gains statement). It should be income for the year ACA benefits are received.

How do I give a dividends and capital gains statement in the 3rd week of January? I haven't sold anything yet. Not even sure I am going to. We will have a ton of cash in the bank left over, possibly, from the house build. I'm thinking we might have enough to live on for the next two years without touching anything.

 

[COcheesehead]

If you sold a million in stock, your income was the gain on that stock, not a million unless you bought it for a penny.

 

[rmcelwee]

If you sold a million in stock, your income was the gain on that stock, not a million unless you bought it for a penny.

I think our LTCG were around $700K. So, how do I use that 1040 as proof that I will only make $50,000 this year?

 

[ArmchairMillionaire]

How do I give a dividends and capital gains statement in the 3rd week of January? I haven't sold anything yet. Not even sure I am going to. We will have a ton of cash in the bank left over, possibly, from the house build. I'm thinking we might have enough to live on for the next two years without touching anything.

Maybe you could do a Roth conversion of $23K to still meet the minimum ACA income requirements?

 

[RetiredAndLovingIt]

In the same boat for my first year in going over my estimate by $40k. What do they do? Claw back premiums for the whole previous year?

They will claw back a portion after recalculating your subsidy based on your actual income when you file your 2025 taxes. You will get a Form 1095-A showing how much premium you received then the reconciliation will be done on Form 8962 and Turbo Tax will handle it for you.

 

[cathy63]

In the same boat for my first year in going over my estimate by $40k. What do they do? Claw back premiums for the whole previous year?

You can look at Form 8962 at IRS.Gov and see how you'll be affected.

 

[COcheesehead]

I think our LTCG were around $700K. So, how do I use that 1040 as proof that I will only make $50,000 this year?

Well you can’t.
If it were me, I would create income in January and show how that extrapolates out for 11 more months using my brokerage statement as proof.

 

[cathy63]

Submit one or more documents to confirm annual household income. 1040, wage and tax statement, pay stub, SS statements, written explanation.

I guess I can give them a written explanation but I have a gut feeling that will get kicked right back to me.

I'm wondering if my huge 2025 income is making them suspicious of my low 2026 income estimate.

They have no idea what your 2025 income is yet because you haven't filed your tax return. They are asking for proof because this is your first year on ACA. You can give them your 2024 1040 since that's the most recent one and add a cover letter that says you expect your 2026 income to be $x. I don't have any experience in your state, but that's all it takes for Covered CA.

 

[ArmchairMillionaire]

Well you can’t.
If it were me, I would create income in January and show how that extrapolates out for 11 more months using my brokerage statement as proof.

If the OP plans on living off savings for 2026, he could do a $2K Roth conversion in January like you said and do the extrapolation thing to estimate $24K for an annual income to meet the minimum ACA income requirements.