Do I Qualify?

Do I Qualify for Covered California Subsidies and Applications?

If you make between 138% and 400% of the federal poverty level you could be eligible for a premium subsidy. If you make between 138% and 250% of the federal poverty level you could be eligible for a premium subsidy and a plan with enhanced benefits. Below is a chart showing the federal poverty level for different household sizes. Couples must file their taxes jointly to be eligible for a subsidy.

The Modified Adjusted Gross Income (MAGI).

Eligibility for Medi-Cal and Covered California subsidies will be based on a household’s Modified Adjusted Gross Income (MAGI). For most taxpayers, MAGI is the same as Adjusted Gross Income (AGI) which can be found on Line 4 on a Form 1040EZ, Line 21 on a Form 1040A, or Line 37 on a Form 1040. Taxpayers who receive non-taxable Social Security benefits, earn income living abroad, or earn non-exempt interest should add back that income to AGI to calculate MAGI.

The Federal Poverty Level.

If you make between 138% and 400% of the federal poverty level then you could be eligible for a premium subsidy. If you make between 138% and 200% of the federal poverty level you could be eligible for a premium subsidy and a plan with enhanced benefits. Below is a chart showing the federal poverty level for different household sizes.  Couples must file their taxes jointly to be eligible for a subsidy.

48 Contiguous States and DC

Note: The 100% column shows the federal poverty level for each family size, and the percentage columns that follow represent income levels that are commonly used as guidelines for health programs.

 Household Size

 100%

 133%

 150%

200%

 300%

400%

 1

$11,490

$15,282

$17,235

$22,980

$34,470

$45,960

 2

15,510

 20,628

23,265

  31,020

46,530

62,040

 3

19,530

 25,975

29,295

  39,060

58,590

78,120

 4

23,550

 31,322

35,325

  47,100

70,650

94,200

 5

27,570

 36,668

41,355

  55,140

82,710

110,280

 6

31,590

 42,015

47,385

  63,180

94,770

126,360

 7

35,610

 47,361

53,415

  71,220

106,830

142,440

 8

39,630

 52,708

59,445

  79,260

118,890

158,520

 For each additional person, add

$4,020

 $5,347

$6,030

  $8,040

$12,060

$16,080

Do You Qualify?

If you think you might qualify for a premium subsidy you can to go www.coveredca.com and use the Shop and Compare tool at the bottom of the home page to help you determine if you qualify. We can help you understand the plans and your options, so if you are going to apply please give us a call. There is no additional charge for our help.

The main reason to apply through Covered California is to take advantage of a premium subsidy. If you do not qualify for a premium subsidy we recommend that you do not apply on the Covered California website. You will be able to get the exact same plans at the exact same prices outside of the exchange, and there will be more plan options to choose from. We can be your agent if you buy your policy on the exchange or off the exchange and there is never a charge for our help.

If you want to apply through Covered California all you have to do is go to www.coveredca.com and click on Get Started and it will walk you through setting up an account. If you want your policy to start on the beginning of the following month you must apply by the 15th of the current month, otherwise your policy will start on the first of the second following month.

You are not automatically assigned an agent.

When you apply through Covered California you will not automatically be assigned an agent. If you would like to designate us as your agent please follow the instructions below. We will get credit for helping you and we will be able to assist you if you have questions now and in the future.

Go to www.coveredca.com and click on Start Here on the home page. On the next page select Individuals and Families and click GO. Follow the prompts on the screen to register and set up a user ID and password.

Once you’ve registered and you are logged in click on the link in the upper right hand corner of the screen that says Find Help Near You. Then choose Find Agentsthen type in my first and last name Robert Cavaness and click search and there will be an option to designate me as your agent. You should get a confirmation screen that your designation is complete.

When you apply online they will ask for quite a bit of your financial information to determine if you qualify for a subsidy. Subsidies are based on what you have made in the past and what your current financial situation is. They do not do asset testing but they will ask for documentation showing proof of you previous or current income.

Keep in mind that if you are offered affordable health insurance through your work, or your spouse’s work, then you and your immediate family will not be eligible for asubsidy. Health insurance is considered affordable as long as you don’t have to pay more than 9.5% of your taxable income for employee only coverage on the lowest cost plan offered to you.

Please feel free to contact us if you have questions or need more information on this topic.

FAQ’s

 
Here at Santa Barbara Health Insurance Services we know that no web site can substitute for courteous service from an experienced professional. Our staff is always happy to help with your California health insurance, California dental insurance, or term life insurance needs. Feel free to call us any time at (800) 765-1540.