Answer ACA subsidies are based on annual income, that means if you need assistance for part of the year you can end up owing credits if income increases later in the year. On the flip side, if you make less than projected you can actually end up getting a bigger refund or not owing anything.
Full Answer
Is the ACA better than Medicare for my spouse?
The one plus is that your spouse will still use household income to determine subsidies. Thus, at some incomes this works out to a great deal (in my opinion better than Medicare cost-wise), but only at some incomes. I am preparing to retire. My spouse is 58. I have been checking locally for the ACA policies available.
What happens to my health insurance when my spouse goes on Medicare?
If your health insurance coverage comes through your spouse’s job, you may lose that coverage when he or she retires and goes on Medicare. Not so long ago, this was a scary and expensive prospect, but things have changed.
What happens if a family member qualifies for Medicare mid year?
The instructions walk through an example where a family member qualifies for Medicare mid year and the family retains the tax credits for the family member who stayed on a subsidy eligible plan. You may want to have BCBS clarify what they meant.
What happens to my ACA premium credit when Medicare Part A starts?
“Once your Medicare Part A coverage starts, you will no longer get premium credit through the ACA. If you continue to keep your marketplace health plan, you will have to pay the full cost.”
Can I get Obamacare if my husband has Medicare?
Can I enroll in Medicare as his spouse? No. Although your husband now qualifies for Medicare, you will not qualify for Medicare until you turn 65. If you do not have health insurance now, you can consider signing up for health insurance coverage through a Marketplace plan.
What happens to the ACA subsidy when one person goes on Medicare?
Individual market plans no longer terminate automatically when you turn 65. You can keep your individual market plan, but premium subsidies will terminate when you become eligible for premium-free Medicare Part A (there is some flexibility here, and the date the subsidy terminates will depend on when you enroll).
What happens to my spouse when I go on Medicare?
The answer is no. Medicare is individual insurance, so spouses cannot be on the same Medicare plan together. Now, if your spouse is eligible for Medicare, then he or she can get their own Medicare plan.
Does my spouse income affect my Medicare premiums?
No. Your eligibility for premium tax credit subsidies and the amount of your premium tax credit will be based on your family income. The amount your spouse pays for his Medicare, Part D, and supplemental insurance premium costs will not be taken into account.
Can you have Medicare and Obamacare at the same time?
No. The Marketplace doesn't affect your Medicare choices or benefits, so if you have Medicare coverage, you don't need to do anything. This means no matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan (like an HMO or PPO), you don't have to make any changes.
What are the income limits for healthcare subsidies 2021?
Obamacare Subsidy EligibilityHousehold size100% of Federal Poverty level (2021)400% of Federal Poverty Level (2021)1$12,880$51,5202$17,420$69,6803$21,960$87,8404$26,500$106,0004 more rows•Jan 21, 2022
How does Medicare work for married couples?
Medicare has no family plans, meaning that you and your spouse must enroll for Medicare benefits separately. This also means husbands, wives, spouses and partners pay separate Medicare premiums.
Can my wife go on Medicare when I retire?
Some are under the impression that Medicare will automatically cover a younger spouse when they themselves qualify, but it doesn't. There is no family coverage under Medicare. Indeed, nobody can obtain Medicare benefits before age 65, unless they are disabled or have end-state kidney disease.
Why is my Medicare premium higher than my husbands?
If you file your taxes as “married, filing jointly” and your MAGI is greater than $170,000, you'll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status, and your MAGI is greater than $85,000, you'll pay higher premiums.
What income affects Medicare premiums?
How much will I pay for premiums in 2022?Yearly income in 2020: singleYearly income in 2020: married, joint filing2022 Medicare Part B monthly premium> $114,000–$142,000> $228,000–$284,000$340.20> $142,000–$170,000> $284,000–$340,000$442.30> $170,000– < $500,000> $340,000– < $750,000$544.30≥ $500,000≥ $750,000$578.302 more rows•Nov 16, 2021
What income is used to determine Medicare premiums?
modified adjusted gross incomeMedicare premiums are based on your modified adjusted gross income, or MAGI. That's your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS.
What income is included in MAGI for Medicare premiums?
Monthly Medicare Premiums for 2022Modified Adjusted Gross Income (MAGI)Part B monthly premium amountIndividuals with a MAGI above $170,000 and less than $500,000 Married couples with a MAGI above $340,000 and less than $750,000Standard premium + $374.205 more rows
How long do you have to work to get Medicare?
First, it is important to know how eligibility for Medicare works. Most Medicare beneficiaries have worked and paid Medicare payroll taxes for at least 10 years to qualify for premium-free Medicare Part A as well as Part B coverage. If you have not worked for 10 years but your spouse has, you are allowed to claim benefits on their record.
Can a spouse with a low income get medicaid?
Medicaid is a joint Federal and State program designed to help people with low incomes cover healthcare costs. If, by retiring, your income falls under a certain level, the younger spouse may be eligible for Medicaid coverage. Be aware, as a family, you have to have a very low income and very little assets, so many people will not qualify.
Can a non-working spouse get Social Security?
If the non-working spouse is older than the working spouse, the non-working spouse can qualify on on the working spouses work record if they are at least 62, since that is when qualification for Social Security begins. In this case, if the working spouse is still working, the non-working spouse should stay on the work health insurance ...
Can a spouse get health insurance after 65?
The other option would be for the younger spouse to find a job that offers health insurance until they turn 65. While this is a long-shot, some companies will provide coverage for the younger spouse even after the working spouse retires.
Can a non-working spouse claim Medicare?
If the working spouse is no longer employed, the non-working spouse should go ahead and apply for coverage fully from Medicare. If the working spouse is younger than 62, the non-working spouse will not be able to claim on the record.
Does Medicare cover spouse?
Medicare will only cover you, not your spouse or children if they are not eligible on their own. This is where problems begin, especially when a working spouse is older than a non-working spouse. Say the working spouse turns 65, retires, and claims Medicare. The other spouse is only 61.
Can a spouse have the same birthday?
While it would be convenient for spouses to have the exact same birthday, this is not usually the case. For many couples, their age gap becomes a problem when it comes time to sign up for Medicare. When one spouse goes on Medicare and the other spouse is not yet eligible, what options do they have?
What happens if your MAGI is 100%?
If your MAGI income is right around the 100% poverty level you might be dipping below the subsidy cliff and thus losing credits. Likewise, if your income is over 400% you might be dipping over the cliff on that side. I can’t exactly tell which would be happening, but it seems like you may be going under 100%. So this would be one thing to consider.
Is Cobra more expensive than subsidies?
In your case COBRA will be more expensive if you get subsidies, if you don't then it's a toss up depending upon what COBRA offers and the plans in your region. Typically holding a policy for a limited time isn't good for much beyond catastrophic coverage, benefits covered by copays, and avoiding the fee.
Is Medicare essential coverage?
No, Medicare is minimum essential coverage, thu s having Medicare means not owing the fee.
Does Medicare premium stay the same?
As I understand it, the premium should stay the same when one spouse goes on Medicare, presuming the income stays the same, but you also have to then pay the Medicare premium. You come out behind because of that and also because the Medicare participant’s expenses won’t count toward the same out of pocket limit the rest of the family has on the Marketplace plan. When things get tough, the plans get tougher.
Does spouse use household income to determine Medicare?
Yes, this is all correct. The one plus is that your spouse will still use household income to determine subsidies. Thus, at some incomes this works out to a great deal (in my opinion better than Medicare cost-wise), but only at some incomes.
Is it fair to have Medicare if you are the breadwinner?
Of course, when the situation is not this it feels very unfair. I get that. It would be nice if the family could choose, or in states where Medicaid was expanded, if Medicaid didn’t count that income.
Is the ACA fair?
With that said, we can see how simplifying this process should be on the table. The ACA and IRS in general is so insanely fair it creates a lot of paperwork and rules, i’m not sure this is the most elegant longterm solution… but back to the topic, i’ll be looking into this one. Anyone else feel free to post with details below.
Can a married person file joint tax returns?
In order to qualify for a subsidy, married applicants must file joint tax returns. If your wife experienced a qualifying event (for example, losing her employer-sponsored plan when she became self-employed), she can enroll in the exchange during the special enrollment period triggered by her qualifying event. If not, she’ll have access to individual market plans when open enrollment begins again on November 1.
Can my wife use my recent tax return?
Your wife can use your most recently filed tax return to provide income information to the exchange. But if your household income has changed significantly as a result of her recent self-employment, she can instead provide the exchange with an estimated projection of your household income, and then provide updates to the exchange later on if her income changes again.
Is there an income limit for subsidy?
So technically there is still an income limit for subsidy eligibility, but it varies depending on the applicant’s age and location, since those determine the cost of the benchmark plan. In an area where premiums are higher than average, and if the person is on the higher end of the age range, subsidy eligibility will extend far above 400% of the poverty level. But for a younger person in an area where premiums are fairly inexpensive, subsidy eligibility will stop at much lower income levels.
Is subsidy eligibility a function of income?
Keep in mind that subsidy eligibility is a function of income related to the poverty level. Although your total household income is obviously higher than your wife’s income alone, the poverty level for a household of two is also higher than the poverty level for a household of one.
Will we qualify for a subsidy?
The exchange will look to see what percentage of your total household income is necessary to cover the full-price cost of the benchmark plan for your wife. If it’s more than the percentage of income that people are expected to pay for their coverage, she ’ll qualify for a premium subsidy. But the amount that you pay for your Medicare coverage will not be counted; they will only look at how much your wife’s policy costs in relation to your total household income. Here are some examples of how differing family sizes affect total subsidy amounts, as it can sometimes be a bit counter-intuitive.
When do spouses have to enroll in Medicare?
Check whether your spouse’s employer plan requires you, as a covered dependent, to enroll in Medicare when you turn 65. Some plans — notably the military’s TriCare-for-Life coverage and health benefits provided by an employer with fewer than 20 employees — automatically become secondary to Medicare when an enrollee becomes entitled to Medicare.
What happens if you don't have Medicare?
In this case, if you’re not enrolled in Medicare, you would receive almost no coverage from the employer plan. If you are not married but living in a domestic partnership and you are covered by your partner's health insurance at work, you should enroll in Part A and Part B during your initial enrollment period at age 65 to avoid late penalties. ...
How to disenroll in Social Security?
You'll need to fill out a CMS-1763 form (pdf) and submit it to SSA. A personal interview with a Social Security representative is also required to disenroll; call 800-772-1213 or contact your local SSA office to arrange one.
How long does it take for Medigap to sell?
After six months, Medigap providers can deny to sell you a plan, or can alter your premiums, based on preexisting conditions. Under various laws, employers with 20 or more workers must offer exactly the same health benefits to employees and their spouses over age 65 as are offered to younger workers and spouses.
How long does a spouse have to sign up for a new employer?
This period lasts for up to eight months after employer coverage comes to an end.
Do you have to enroll in a special enrollment period?
You’re not obligated to enroll, of course. But if you don’t, and some years down the line those retiree benefits come to an end for some reason, you would not then be entitled to a special enrollment period and would therefore be liable for permanent late penalties.
When does family HSA coverage start?
Family coverage begins on the 2nd of the month. Not eligible to contribute for that month, but can contribute going forward. Note that they have the option to make this up this missed month using the Last Month Rule . In all of the above examples, HSA coverage exists but due to other factors, the individual has a $0 contribution limit ...
How long does it take to fill out Form 8889?
It asks you simple questions and fills out Form 8889 correctly for you in about 10 minutes.
What is family coverage?
Family coverage includes the eligible individual and at least one other individual – whether they are an eligible individual or not.
Can a child contribute to HSA if they are not 55+?
If child is an eligible individual, family contribution applies (no 55+) but must go into eligible individual’s (child’s) HSA. If child is not an eligible individual, no contribution limit seems to apply.
Can a wife contribute to an HSA if only her husband and child are covered?
If only the wife and child are covered by the HSA insurance, a strange situation develops since the wife is not HSA eligible. Based on the IRS rules in Form 969, at least one eligible individual is required to contribute to the HSA: This is supported by Form 969, which defines self-only and family coverage. Note the specific language ...
Can Medicare affect HSA?
Note that Medicare can retroactively affect your HSA coverage. Either way, the IRS test for contribution is called HSA eligibility. It contains 4 rules which are: If any of the above are violated, the individual is not HSA eligible and they cannot open or contribute to an HSA.
Can adult children fund HSA?
Of course, they would need those funds, or you would need to contribute it for them. Note that this is the scenario discussed in Your Adult Children can Fund their HSA. However, note that the parent’s could not fund the HSA in this scenario.
What is the ACA premium credit?
Your premium credit under the Affordable Care Act (ACA) is based on your income compared to the Federal Poverty Level (FPL), issued every year by the Department of Health and Human Services, said Deva Panambur, a fee-only planner with Sarsi, LLC in West New York and an adjunct professor of personal finance at Montclair State University.
When do you have to apply for Medicare?
When you turn 65, you will have to apply for Medicare if you are eligible for it. “You have a seven-month period enrollment period — three months before the month you turn 65 to three months after the month,” he said. “Once your Medicare Part A coverage starts, you will no longer get premium credit through the ACA.
What is ACA premium responsibility?
Panambur said the ACA specifies what your premium responsibility is as a percentage of your income. Anything over that, up to the cost of the benchmark plan is offered to you as a premium credit, he said.
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Do you get a tax credit if you apply for health insurance?
When you apply for health insurance on the marketplace, your premium credit is based on an estimated income for the year ahead, he said At the end of the year, depending on your income, you will receive a refundable tax credit — if your income turns out to be less than what was used to calculate the premium credit — or you will owe taxes if your income turns out to be higher, Panambur said.
When does Medicare coverage take effect?
If you complete the enrollment process during the three months prior to your 65th birthday, your Medicare coverage takes effect the first of the month you turn 65 ( unless your birthday is the first of the month ). Your premium subsidy eligibility continues through the last day of the month prior to the month you turn 65.
When does Medicare subsidy end?
The short story is that if you enroll in Medicare during the first four months of your initial enrollment window, your transition to Medicare will be seamless, with subsidy eligibility continuing through the last day of the month prior to the month that your Medicare coverage begins. If you enroll in Medicare during the final three months of your initial enrollment period, your premium subsidy will likely end before your Part B coverage begins, although your Part A coverage should be backdated to the month you turned 65. And if you don’t enroll in Medicare at all during your initial enrollment window, your premium subsidies will end a few months after you turn 65. Here are the details:
What happens if you don't sign up for Medicare?
And if you keep your individual market exchange plan and don’t sign up for Medicare when you first become eligible, you’ll have to pay higher Medicare Part B premiums for the rest of your life, once you do enroll in Medicare, due to the late enrollment penalty.
How long does it take to get Medicare if you are not receiving Social Security?
If you’re not yet receiving Social Security or Railroad Retirement benefits, you’ll have a seven-month window during which you can enroll in Medicare, which you’ll do through the Social Security Administration. Your Medicare card will be sent to you after you enroll. Your enrollment window starts three months before the month you turn 65, ...
When will Medicare be enrolled in Social Security?
Here are the details: If you’re already receiving retirement benefits from Social Security or the Railroad Retirement Board, you’ll automatically be enrolled in Medicare with an effective date of the first of the month that you turn 65. As is the case for people who enroll prior to the month they turn 65, premium subsidy eligibility ends on ...
When will Medicare be sent to you?
Your Medicare card will be sent to you after you enroll. Your enrollment window starts three months before the month you turn 65, includes the month you turn 65, and then continues for another three months. (Note that you’ll need to enroll during the months prior to your birth month in order to have coverage that takes effect the month you turn 65.
When do individual market plans end?
Individual market plans no longer terminate automatically when you turn 65. You can keep your individual market plan, but premium subsidies will terminate when you become eligible for premium-free Medicare Part A (there is some flexibility here, and the date the subsidy terminates will depend on when you enroll).
What is a hold harmless on Medicare?
If you pay a higher premium, you are not covered by “hold harmless,” the rule that prevents most Social Security recipients from seeing their benefit payment go down if Medicare rates go up. “Hold harmless” only applies to people who pay the standard Part B premium and have it deducted from their Social Security benefit.
What is the Medicare Part B rate for 2021?
If your MAGI for 2019 was less than or equal to the “higher-income” threshold — $88,000 for an individual taxpayer, $176,000 for a married couple filing jointly — you pay the “standard” Medicare Part B rate for 2021, which is $148.50 a month.
What is Medicare premium based on?
Medicare premiums are based on your modified adjusted gross income, or MAGI. That’s your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS. To set your Medicare cost for 2021, Social Security likely relied on the tax return you filed in 2020 that details your 2019 ...
Does Medicare Part D increase with income?
Premiums for Medicare Part D (prescription-drug coverage), if you have it , also rise with higher incomes .
Can you ask Social Security to adjust your premium?
You can ask Social Security to adjust your premium if a “life-changing event” caused significant income reduction or financial disruption in the intervening tax year — for example, if your marital status changed , or you lost a job , pension or income-producing property. You’ll find detailed information on the Social Security web page “Medicare ...
Do you pay Medicare Part B if you are a high income beneficiary?
If you are what Social Security considers a “higher-income beneficiary,” you pay more for Medicare Part B, the health-insurance portion of Medicare. (Most enrollees don’t pay for Medicare Part A, which covers hospitalization.) Medicare premiums are based on your modified adjusted gross income, or MAGI. That’s your total adjusted gross income ...