Author Topic: Is the FPL calculation for the ACA different in California?  (Read 1028 times)

Comenius

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Is the FPL calculation for the ACA different in California?
« on: November 09, 2016, 07:09:21 AM »
I retired last week and just put in an application for Covered CA for coverage effective January 1st. I listed an estimated 2017 AGI of $23,400.  I came to that figure based on a few thousand dollars in 1099-DIV and 1099-INT income and a few thousand dollars in Schedule C consulting income that I expect to continue, along with an estimate of planned Traditional IRA to Roth IRA conversions.

Based on my understanding, $23,400 should be just under the 200% FPL limit for single people of $23,760 ($11,880 x 2) and qualify me for a Silver Plan with subsidies and cost sharing. However I just got a message from Covered CA saying that I've qualified for MediCal (California's Medicaid).

Am I missing something obvious? Is Covered CA ignoring my 2017 AGI estimate?

Anyone have any idea what's happening, or what to do about it?

Medi-Cal Eligibility

Good News! Based on the information you gave us, we believe you may qualify for coverage through
Medi-Cal, or may continue to be eligible for Medi-Cal. The Medi-Cal office in your county will contact
you if they need more information.

You will get a separate notice about your eligibility for Medi-Cal. If you have already received a notice
about your Medi-Cal eligibility, please disregard this message.

Covered California Eligibility

You do not qualify for health insurance through Covered California, premium assistance (a federal tax
credit) or cost-sharing reductions (lower co-payments and deductibles) because:

You do not qualify for premium assistance (a federal tax credit) or cost-sharing reductions (lower copayments and deductibles) because your income is too low. This was based on your household
income of $23,400.00 for the year ($1,950.00 a month).

« Last Edit: November 09, 2016, 07:45:44 AM by Comenius »

Lake161

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Re: Is the FPL calculation for the ACA different in California?
« Reply #1 on: November 09, 2016, 08:27:03 AM »
Here is the official CA chart for 2017:

http://www.coveredca.com/PDFs/FPL-chart.pdf

Unless you entered your family size wrong, I don't see why you would be a Medi-Cal eligible.

Comenius

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Re: Is the FPL calculation for the ACA different in California?
« Reply #2 on: November 09, 2016, 10:24:11 AM »
I just double checked my application and I only applied for myself... Family size of one, just me.

Lake161

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Re: Is the FPL calculation for the ACA different in California?
« Reply #3 on: November 09, 2016, 07:45:44 PM »
I put in $29k of income for a household of two and it went through fine for the Silver 87% plan.

One odd thing I spotted this year is that if you have a one-time payment (I had a lump sum pay out this past February), it didn't count it toward my monthly income after February. Did you list an end date for any of your income sources?