OE9 Webinar: Part I Households & Income

admin — Tue, 14 Sep 2021 13:49:23 +0000

Determining Households and Income for Premium Tax Credits and Medicaid

In this Beyond the Basics webinar presented on September 14, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, and Jen Wagner, Director of Medicaid Eligibility and Enrollment, detail the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits and Medicaid.

↓ View Presentation Slides (PDF)

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Why Household Size & Income Matter

ACA Eligibility Overview
How the federal poverty line (FPL) effects expected premium contribution

Why Tax Filing Status Matters

Overview of tax filing statuses
Marital status and premium tax credits (PTC)
Head of household questions
Exceptions to the joint filing requirement for PTC

Determining Households for Premium Tax Credits

Types of tax dependents

Determining Households for MAGI Medicaid

Medicaid household rules

What Counts as Income for PTC and Medicaid

Modified Adjusted Gross Income (MAGI)
Rules for counting income
Tips for counting self-employment income

Annual vs Monthly Income Counting

Entering monthly income
Entering annual income

Examples of Combining Household & Income Rules to Determine Eligibility

Additional Resources

Yearly Income Guidelines and Thresholds

Medicaid Household Rules

Determining Households for Medicaid and CHIP

Determining Households for PTC

Income Definitions for Marketplace and Medicaid Coverage

Self-Employment Income Estimator Tool

Health Care Assister’s Guide to Tax Rules

Yearly Income Guidelines and Thresholds

admin — Mon, 13 Sep 2021 07:02:06 +0000

Reference Guide: Yearly Income Guidelines and Thresholds

Eligibility for subsidies in the Marketplace is determined in part by using specific percentages and thresholds that are indexed and change each enrollment year.

In addition, people who received advance premium tax credits (APTC) in the prior enrollment year will need to complete a tax return for that year and will need to use percentages and thresholds applicable to that tax year.

This reference guide lists all the indexed guidelines and thresholds that change each enrollment year.