Saturday, June 22, 2024

Can I Get Covered California If I Am Unemployed

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Health Insurance Options For The Unemployed


As mentioned above, if you get unemployment benefits for at least one week in 2021, the American Rescue Plan Act guarantees that you can receive a mid-level Obamacare plan for 2021 at no cost to you. This is because the law will disregard any income you earn over 133% of the federal poverty level this year. And that, in turn, locks in the highest level of financial assistance under the Affordable Care Act.

Youll be able to apply for this benefit through May 15, 2021, if you purchase an insurance plan through Covered California. Be prepared to prove that you are receiving or have received unemployment compensation this year. If you get a job, your eligibility will change.

All plans available through the marketplace offer essential medical benefits, including preventive care, emergency services, and prescription drug coverageand you can’t be turned away if you have a pre-existing medical condition.

COBRA. If youve been laid off, the Consolidated Omnibus Budget Reconciliation Act usually allows you to keep your employer-sponsored coverage for up to 18 months. This benefit is often prohibitively expensive, however, because you usually have to pay the full premium plus an administrative fee your former employer contributes nothing.

Extra Deductions Deflate Income

If you hand your W-2s, 1099s, and a box of receipts to your tax preparer every year to do your taxes, figuring out what is actually considered income can be a little confusing for the ACA tax credits. Even for the seasoned do-it-yourself tax people, deciding what dollar amounts Covered California wants in which income sections can be complicated. Even though your income might be correct, theres the possibility the wrong deductions are added to the Income Deduction deflating the MAGI and setting you up for the repayment of excess tax credits the following year.

Medicaid Chip And Insurance Plans Through The Marketplace

When you fill out a Marketplace application, youll find out if you qualify for any of these types of coverage:

  • A Marketplace insurance plan. You may qualify for premium tax credits and savings on deductibles, copayments, and other out-of-pocket costs based on your household size and income. Some people with low incomes may wind up paying very small premiums. Learn about getting lower costs on a Marketplace insurance plan.
  • Medicaid. Medicaid provides coverage to millions of Americans with limited incomes or disabilities. Many states have expanded Medicaid to cover all people below certain income levels. Learn more about Medicaid and how to apply.
  • Childrens Health Insurance Program . CHIP provides coverage for children, and in some states pregnant women, in families with incomes too high for Medicaid but too low to afford private insurance. Learn more about CHIP.

After you finish your Marketplace application, youll get an eligibility determination that tells you what kind of coverage you and others in your household qualify for.

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Can I Qualify For Medi

Yes. Your enrollment in private health coverage will not jeopardize your participation in Medi-Cal. Obtaining private health coverage may allow you to access providers or services you may not have had available to you on Medi-Cal alone. If you have private health coverage and are eligible for Medi-Cal, you may qualify for the Medi-Cal/HIPP program, which can pay for your insurance premiums.

When using private health coverage and Medi-Cal simultaneously, the private health coverage is billed first. After the private health carrier pays or denies a claim, Medi-Cal is then billed and will pay for services it covers.

Note: You cannot get government subsidies to buy an individual health plan on Covered California if you are on Medi-Cal.

Exhibit 1 2021 Coverage Year Percent Of Household Income Paid For Covered California Benchmark Silver Premium

Income Guidelines Chart Covered CA
Income Range

Notes:* Individuals with income at or below 138% FPL are generally eligible for Medi-Cal. In certain limited circumstances, however, they are eligible for the federal premium tax credit and the California state subsidy program.** Under the ARP, Covered California enrollees receiving Unemployment Insurance in 2021 are treated as though their income is no more than 138.1% FPL for the purposes of the federal premium tax credit meaning their required contribution for a benchmark plan will be 0%.*** Eligibility for the California state subsidy program ends at 600% of the federal poverty levelSource: Covered California, March 2021 Board Meeting

The ARP will provide additional subsidies for the 1.35 million Californians already enrolled with subsidies through Covered California as of . Without the ARP, these Californians would have received subsidies worth an average of $411 per person per month in 2022 through a combination of ACA and California-specific subsidies under the ARP, they will get an additional $91 per month.

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Who Is Eligible For Unemployment

The unemployment-based subsidies are available to anyone who has received or been approved to receive unemployment compensation at any time this year.

Eligibility for the unemployment-based subsidies includes people whose income is under the federal poverty level, as long as theyre not eligible for Medicaid. People with income under the poverty level are normally not eligible for subsidies, which means theres a coverage gap in the states that have refused to accept federal funding to expand Medicaid. But a person who would otherwise be in the coverage gap can receive a full premium subsidy and full cost-sharing reductions in 2021, if they receive unemployment compensation at any time during the year.

CMS has confirmed that the full premium subsidies are only available if its a taxpayer who is receiving the unemployment compensation. If its a dependent who is receiving it, the household is eligible for the cost-sharing reductions , but not the full premium subsidies.

Even if you only received unemployment compensation for one week of 2021, youre potentially eligible for the enhanced subsidies for the entire year. But subsidy eligibility would end if and when you become eligible for employer-sponsored health coverage , or premium-free Medicare Part A.

The ARP has not fixed the family glitch, so family members would also lose access to any subsidies in the exchange if they become eligible for employer-sponsored coverage thats considered affordable for the employee.

My Benefit Year Ended And I Think I Earned Enough Wages But I Cant Reapply In Ui Online Why Not

According to our records, you did not earn enough wages to establish a new claim, so we will continue to process federal extension weeks on your claim. Continue to certify for benefits if you have weeks available and check your payment status on UI Online.

Note: If you think you earned enough wages, but your employer did not report them to us, you can submit a new application by paper or phone.

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Obamacareincreasing Costs And Lower Benefits

You may be thinking that Obamacare was supposed to take care of the affordability of health insurance and medical care. After all, the legislation was named the Affordable Care Act.

Many of the supporters of the ACA truly believed that it would not only increase access to health insurance but also stabilize premium costs. They thought the affordable part would come through increased competition that was expected with the federal government paying tax credits.

However, it hasnt worked out that way the Affordable Care Act has made health insurance affordable only for those who can qualify for tax credits. For the rest of the American population, the ACA has been part of the cause of increasing premiums.

More Answers: Who To Include In Your Household

Covered California Open Enrollment 2022: How to Get $0 Health Plan? Covered CA Health Insurance
What if Im single without dependents?
  • If you arent claimed as a tax dependent by someone else and have no tax dependents yourself: Count only yourself in your household.
  • If you are claimed as a tax dependent by someone else: Youre counted as part of their household, not your own.
Do my spouse and I have to file taxes jointly to get Marketplace savings?

Yes, with certain exceptions.

  • If youre married and will file a joint federal tax return for the year you want coverage: Youre eligible for a premium tax credit and other savings if you qualify based on your income and other factors.
  • If youre married and will file separately for the year you want coverage: You can enroll in a Marketplace plan together but youre not eligible for a premium tax credit or other savings, and you may have to complete a separate application.
  • If youre married and plan to file as head of household for the year you want coverage: You can say youre married, and wont file a joint return, on your Marketplace application. If you meet other criteria, like living separately from your spouse, well then ask if youre planning to file as head of household. Youre eligible for a premium tax credit and other savings if youre planning to file as head of household and you qualify based on your income and other factors. See IRS rules for filing as head of household.
  • See the next question for an exception for victims of domestic abuse and spousal abandonment.

Read Also: How To Get An Extension On Unemployment

Do I Need To Add My Dependents Income To My Modified Adjusted Gross Income For Covered California

Yes, but only if your dependent is required to file a Tax Return because their income meets the Income Tax Return Filing Threshold. For 2020, the Income Tax Return Filing Threshold was $1,100 for unearned income and $12,400 for earned income .

You do not include the income of any dependents who are filing a Tax Return only to claim a refund of tax withheld or estimated tax.

If your dependents income meets the Income Tax Return Filing Threshold, then you would add their MAGI to yours in order to determine the household MAGI that should be used for Covered California. In some instances, you may receive more tax credits through Covered California if you choose to no longer claim a dependent that is earning more than the Income Tax Return Filing Threshold.

Losing A Job Is Tough But Finding A New Health Plan Doesnt Have To Be

Hereâs how to navigate your health insurance options to find the coverage you need.

If losing your job and your paycheck isnât hard enough, it often also means losing your health insurance. This can be a challenging time, but remember, when it comes to getting covered, you have options. Avoid a lapse in health insurance â and the California state financial penalty that comes with it â by understanding your choices and selecting the best path for you and your family. This process may seem overwhelming if youâve never done it before, but hereâs a guide to help you through.

Check Your Spousal Benefits

If your spouse or domestic partner has a job that provides health insurance, you might be able to get covered under their plan. He or she may need to contribute more to their employer-sponsored health insurance, but this is often an easy, lower-cost option.

Find Out If COBRA Is Right for You
Look Into Purchasing a New Plan

You can also buy a health plan directly from an insurance company. If youâre shopping for a plan, explore Covered California, a free service that connects California residents with brand-name health insurance companies such as Anthem, Blue Shield, Kaiser, Health Net and more. Through Covered California, you will be able to shop for and compare various plans to find the one that works best for you.

See if You Qualify for Medi-Cal
When to Apply

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Every Family Income Is Different

The Federal tax forms are a guide to previous income and adjusted gross amounts. Each family will be different and their household income can fluctuate widely from year to year depending on type of employment and other factors. Its just important to forecast the income as accurately as possible to avoid having to pay back premium tax credits because the household income was higher than expected.

When you are ready to enroll, have the following:

  • Number of people being enrolled , including the birth date of each person
  • Social security number for each family member
  • Home ZIP code
  • Most recent income tax filings, including dependent tax information and head of household status
  • Legal immigration information, such as your immigration number
  • Information about your status as a member of a federally recognized tribe

How Do I Calculate My Modified Adjusted Gross Income For Covered California

How to file for unemployment benefits in California

For most individuals, your Adjusted Gross Income is the same as your Modified Adjusted Gross Income unless you are receiving Social Security, Foreign Earned Income or Tax Exempt Interest. If you are receiving any these types of income, then please use the calculation method below to determine your MAGI for Covered California.

  • Start with your Adjusted Gross Income
  • Add any Tax-Exempt Interest
  • Add any Foreign Income & Housing Deduction amounts
  • Add the Non-taxable Social Security benefits, which is the difference from subtracting line 6b from line 6a on Form 1040

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What Is The Income Limit For Covered California 2021

The Covered California income guidelines take into consideration your household income and size. In 2021, if you are a single person earning less than $47,000 per year, you qualify for government assistance. A family of four with an annual household income less than $97,200 qualifies for government assistance.

Applying With 0$ Current Income

Question: My son is going to be 26 on 1-3-2014. He is covered on my insurance until 1-31-2014. He is living at home and is between jobs and does not have income. Covered California does not allow him to enter information without showing an income. Also, askes for number of people in household. My husband and I have our own insurance so we would not be applying. How does he fill in this information. He does not need his insurance until 2-1-2014, however, he needs to be covered. We have both tried calling but to no avail as the system is super busy. Please explain how my son proceeds.

Answer: Your son should apply for coverage through Covered California anytime after December 23rd and before January 15th for his coverage effective 2/1/2014. He is a one-person household and since he is estimating his income for 2014, he must enter in income figure even though he is earning $0 today. A number under $16,000 will make him eligible for Medi-Cal. He must promise to file a tax return for the 2014 tax year.


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Is All Of My Income Taken Into Account When Determining 250% Of The Federal Poverty Level For This Medi

No. This program uses Social Security’s countable income calculation to determine your income. Additionally, the WDP Program does not count unearned income from private or public disability benefits when determining your countable income.

Important: Medi-Calâs deeming rules apply when a worker has combined household income, for example income from a spouse.

The Subsidies Apply To Both Premiums And Out

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The unemployment-based subsidies are two-fold:

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What If I Already Have Coverage

Covered California automatically renews the policies of current enrollees unless they choose a new one. But many people who renew may see notably higher premiums, even though average premiums will rise only 1.8% in 2022.

Two factors are at work here. Californians who received unemployment benefits qualified for additional premium subsidies in 2021 that will not be available next year. And Covered California provided a years worth of extra American Rescue Plan dollars in only eight months once the money is spread over the full year, the discount wont be as large.

Even if youre happy with your current coverage, make sure to alert Covered California to any changes in your income, because that could affect how much aid youre eligible to receive.

How Do I Return Unemployment Benefits I Shouldnt Have Received

If you received unemployment benefits you were not eligible for , we will send you a notice. It is important to repay this benefit overpayment as soon as possible to avoid collection and legal action. After receiving a notice, visit Benefit Overpayment Services to learn how to repay an existing overpayment.

If you want to repay these benefits before receiving a notice, review the following:

  • Benefit check not cashed Return the original check to the EDD.
  • Benefit check cashed Send a personal check, cashiers check, or money order made payable to the EDD.
  • Debit card If the funds are still on your card, transfer them to your bank account and then repay them by sending a personal check, cashierâs check, or money order made payable to the EDD.

Include a letter with the following information:

  • Name.
  • Social Security number or EDD Customer Account Number .
  • Week or weeks that the returned payment applies to.
  • Reason for returning the benefits.
  • Date you returned to work .
  • Gross earnings for each week of benefits being returned .

Mail the payment and letter to:

Employment Development Department Overpayment CenterPO Box 66000

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