VanWinkle
Thinks s/he gets paid by the post
I appreciate your openmindedness.
I guess that we'll just agree to disagree.
+1
Qualifying for an ACA subsidy
- Thread starter meleana
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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).
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).
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.
MRG
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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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.
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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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.
GTFan
Thinks s/he gets paid by the post
You'll get the money back at tax time regardless, you just won't get the CSRs.
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.
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.
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.
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!
MRG
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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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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CountryBoy
Dryer sheet aficionado
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.)
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.)
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.
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.
In 2018, the first year we were eligible, we did not try to get the APTC and just knew we'd have a huge tax refund. For 2019, we did our 2018 taxes in Feb and uploaded the return prior to the March deadline. For 2020 they haven't asked for anything.
When you say "we're too young to do a roth so would have to do a trad and pay the penalty," I don't think you and your CPA are understanding how a Roth conversion works. With a conversion, you don't take the money out in cash and there's no penalty, you just move it from your tIRA to your Roth IRA where it continues to grow tax free. The amount you convert is taxable and it counts towards your income for ACA subsidy purposes. Lots of us are limiting the amount we convert to stay below the subsidy cliff, but if you have the opposite problem, you can just convert enough to get above the Medicaid threshold.
Although we live in Massachusetts I think our situation is similar to yours. My wife does most of the work on this but I think the figure we needed to stay under this year (2020) is 38K. My wife makes more than half of that working part time. This leaves about 17K or so that we needed to make sure we did not exceed. Of course dividends are considered taxable income and I wanted to sell some stock of which was nearly all long term gains which is also taxable income (I was uncomfortable having too much of this former company stock). Like you (if I am reading you correctly) we have to justify all of this which was a bit uncomfortable because I am recently retired therefore previous years incomes are in the neighborhood of 150K-180K. I was thinking that their perspective it would look pretty strange that our income is 15-20% of what it used to be.
There was some back and forth in the justification process but it was mostly misunderstandings. We ultimately were approved for our income estimate of 35-36K and are happy with our plan (around 200$ premium with low deductibles).
My problem will be pulling this off for another 5-6 years where my wife is only 59. I'll need to stretch my cash reserves out for a while. Probably mixing cash with IRA withdrawals and be careful to not exceed the "number" and, of course, not run out of cash.
Note: Financial advisers (IMO) should advise people to save a substantial amount of after tax savings as well as pre-tax so that they can play this game when the day draws near. I understand the advantage of saving pre-tax but there should be a balance. Pay now or pay later. Especially for those that may wish to retire "early". In this case, cash, really is king.
RetiredAt55.5
Full time employment: Posting here.
THIS is what I keep pointing out in the "should I pay off my mortgage before retiring" threads!
THIS is what I keep pointing out in the "should I pay off my mortgage before retiring" threads!
I remember thinking in 2008 how much I wished I paid down my mortgage with money I put into my retirement fund. I recall thinking "if only I put all that money I lost into paying down my mortgage, I would not have lost it".
Nobody or no economic downturn can take your lack of debt away from you.
RetiredAt55.5
Full time employment: Posting here.
You're missing the point - instead of paying down the mortgage, keeping the cash on hand is an option worth considering if ACA subsidies is a goal.
