Affordable Care Act Deductible

[felizcortez]

The deductible for subsidized plans on the cost sharing silver plans changes based on income of around 35-36k in California where I live.  What happens if you qualify for the lower deductible plan when you sign up and then your income puts you in the higher deductible amount at the end of the year?  Your deductible is different by about $5k so would you owe that back if you met a portion of it?

[Frankies Girl]

In terms of your monthly payment, that part gets sorted at tax time. If you underestimated your income and should have been paying say, $50/month more, then they'll just assess it as owed when you file taxes. Same if you overestimate; you'll get a refund.

If you underestimate your income for the cost sharing however, it doesn't result in any claw back on things like lower OOP, deductables, copays, etc. The cost sharing subsidies for the silver plans are just there. If you severely underestimated, or do this several years in a row, they may require more documentation from you in some form for the basis of your next yearly assessment. I personally don't feel the need to test the cut offs on that one myself.

[alcon835]

The deductible for subsidized plans on the cost sharing silver plans changes based on income of around 35-36k in California where I live.  What happens if you qualify for the lower deductible plan when you sign up and then your income puts you in the higher deductible amount at the end of the year?  Your deductible is different by about $5k so would you owe that back if you met a portion of it?

You pay it back at tax time. Happened to me about a decade ago.

[jpdx]

You do not reconcile any Cost Sharing Reductions.

You only reconcile the advanced Premium Tax Credit.