Currently on a cost sharing reduction plan...and anticipating both some major expenses AND possible major income due to a client paying for next year's project this year.

If the client does pay, and I don't go for the expenses, then my income will be significantly higher than forecasted. I should know by December what my year end will look like...but by then I'll have paid my last premium for the year.

Next year looks lower income. My illness is worsening and I'm not up for the load I took this year. Plus, if this client pays ahead, I'll look even lower next year.

I don't want to break any rules or be blacklisted...but I also am wondering if it creates MORE trouble to update my 2024 income when I know 2025 will be back to low and cost share-y.

Trying to guess income ahead is so damn stressful.

Hello all! Insurance matters confuse the heck out of me so I was hoping to get some advice here!

My husband and I currently have a plan through the marketplace. My 2 kids currently have a plan through FL Healthykids.

My husband just got a new job that offers what seems to be pretty crappy ins through Imagine360. So, I would REALLY like to stay with the Marketplace Coverage.

So here is the breakdown and where I am not sure if I am figuring stuff out correctly and need some help:
Husbands salary - 72,000 a year
My salary - can be anywhere between 12,000 - 20,000 a year (I am an Independent Contractor and it depends on how much work I am offered so no way of telling for sure at all how much I will make).

So, household income can be anywhere between 84,000 and 92,000 / year

Cost of the plan for Employee plus family is 318.33 semi monthly. We would have to do the whole family as kids will no longer be eligible for Healthykids. That's 636.66 a month. Times that by 12 its 7,639.92 a year for coverage.

My basic confusion is... Is that considered affordable for 2025? I see the affordable rate is 9.02% 9.02 of 84,000 is 7576. But, 9.02 of 92,000 is 8298. So, how can I tell really if it is considered affordable if I do not know how much I will make? What happens if I say no but I end up getting a lot of work and we end up being closer to 92,000?
Side note: He asked his employer if the coverage meets the health care law’s minimum value standards and they didnt seem to know really what that was but said yes. Not sure how confident I am in that.

Any help or advice you can provide is greatly appreciated. Both my kids have medical issues so coverage is of the upmost importance to us!

I’ll be applying for Obamacare Health Insurance for 2025. I am currently unemployed, so I don’t have any employment income, but I do have several bank accounts that will earn interest. Plus, I’ll be taking a $15k distribution from an Inherited IRA in 2025. All in all, when I complete my 2025 tax return, I’ll likely have about $20k in interest income from various high yield savings accounts plus the $15k from the Inherited IRA distribution for a total of $35,000. That would be my gross income for 2025.

When the application asks, “How much money will you earn this year?”, do the 2 things I mentioned above count as income as far as Obamacare is concerned, or do they only count employment income when determining the subsidy people qualify for? Thanks

I haven;t searched Obamacare in years, but now things at home have changed. Is Easy Pricing something useful to people looking for desired coverage at lowest cost? Or should I ignore it? Or do something in between? Thank you.

My mom is trying to get health insurance through the affordable care act but the coverage is terrible and it costs 800-900 dollars a month. How is that affordable and why is it so expensive?

Hello everyone, I am a health insurance agent, and I've heard some rumors about possible changes in the agent change process for Open Enrollment 2025, including the possibility of using links for clients to authorize the change. Has anyone else heard anything about this or have more detailed information? Any data or recent experiences would be very helpful. Thank you!

Hi, if I have Obamacare and then have to leave the country for a few months, and I choose to cancel the insurance, will I still get the subsidy for the month I cancel? For example, if I cancel the insurance on the 10th of the following month (say November), and the insurance company charges me a prorated amount for November, will I still receive the full subsidy for November? I understand that the subsidy is not prorated. Thanks.

My guess is that they might want to alter it. I heard “concept of a plan” comment and I did research on what did GOP try to do earlier. I think they will make it a block grant to the states and cut the amount of this block grant. States will then have to come up with options to provide healthcare and the amount of discounts to be provided.

I am particularly interested as I am an early retiree and still have lots of years to go before I would be eligible for Medicare.

So it seems, premiums would move higher. Hope they don’t end pre-existing condition coverage.

I just hope democrats can hold on to at least one of the 3 branches to avoid this situation

I am 63. Planning to retire in 2025 between May and July. Will Obamacare (ACA) coverage be feasible if I make around $25k then retire on go on a very small pension? I am wondering how much longer I should work. I have a few bills I'd like to finish paying off before retirement. Insurance is the only drawback from being sure of when I should pull the trigger. Thanks

My kids are both adults, live at home and have no income. We claim them as dependents on our taxes. As my income has gone up, their tax credits for ACA have gone down. I know that if we stop claiming them as dependents and they file their own taxes, their tax credits will change and they may even be eligible for Medicaid (we are in Washington, so that's called Apple Health). But what if we continue to support them with room and board? Will that affect their eligibility?

Okay, I'm so bad at understanding insurance, so I'm hoping you guys can help a bit! So I switched jobs and was waiting on insurance to kick in, but they're going to have to temporarily lay me off before that insurance actually kicks in. My COBRA from the last job is like 700$ and I absolutely can't afford it right now. My issue is the fact that my roommates both make good salaries, both like 40-50k and year or so which puts me at the really high end of the ACA spectrum. Will their incomes affect me as well?

Hello, based on my income, CC is telling me I only qualify for MediCal, which I don't want. I need to purchase a PPO plan in order to keep my doctors. Is there any way to do this? I'm 47 years old and my annual income for this year was about 20,000. Obviously I'm hoping to find a better-paying job next year and I live in California.

There is a reconstructive surgery I need. I live in San Diego, but the surgeon I need to see is in LA. My medi-cal insurance doesn’t cover anything outside of San Diego, no exceptions.

There is a surgeon in-network in San Diego who can provide the same surgery. However, I can’t find any before/after photos from anyone who has gotten this surgery from this particular surgeon and I have found a whole bunch of negative reviews. These are red flags that indicate a high likelihood that I will be unhappy with the results of the surgery.

So I am considering moving to LA to get LA care, which the better surgeon accepts. However, that would mean losing my job and losing my friends (I cannot maintain long distance relationships, it’s especially hard without a car). This is not ideal.

What I am wondering is, what is the criteria to “live in LA?” Can I legally “live in LA” but spend most of my time in San Diego (Only popping up to LA for occasional appointments)? Do they have any way to check that you actually live where you report you live?

Was recently laid off 3 months ago, employer insurance stops September 30.

I in my plan my wife who takes Levothyroxine. And my 3 daughters all younger than 13. 2 of my daughters have dental brackets. They require insurance.

I’m giving all of my EDD benefits to my wife for weekly spending, and I’m paying my mortgage and all other monthly expenses from savings. (About 5,000 monthly)

Checking Obamacare the cheaper I see is, is $870.00 + dental (about $100). With high deductible.

Paying Obamacare will add an additional $1,000 drain from my dwindling funds.

I been working hard on getting a new job but no luck!

Question how common is to take a gamble and go uninsured ?

and just pay Cobra dental : ($190 mensual)

Ps. I do not qualify for Medicaid. Because I have a rental property.

I’m a 1099 employee and my boss has offered to pay my premium. Somehow seems like it will benefit him more than me. Will it affect my subsidy?

Professional, 55yo, planning to retire in February. It's a few years before my retiree medical coverage would kick in, but I'm mentally done, and I've got some money. I'm assuming, perhaps pessimistically, that the 400% of poverty level cliff starts back up in 2026. So for 2025, I'll use COBRA, I'll get a few months of pay, 17 weeks of unused vacation pay, and then spend 5 years living off cash with maybe some 401 withdrawals (I'm 55 so can do that without the 10 percent thing). At 60 I'll start getting my pension, which is probably 200% of poverty level, and at 65 medicare and by my election social security will kick in. So.... I'm assuming that what really matters is what's on the 1040 at the end of the year, if I keep my taxable income and taxable gains (from a mutual fund I'll be in part living off) under the cliff and as low as possible until 65, that's all they look at, although I might overpay or underpay if I estimate wrong. Am I right, and if not, how am I wrong?

Hi, I'm self employed. I had US Healthcare, aka Ascension Care in Texas for 2024. Back in May the insurance company was unable to process auto payments for everyone (it was malfunctioning), and they sent out an email warning about this. I thought was bizarre that they couldn't process auto payments. [it is my belief that this was a fabricated issue with the intent of dropping members because the plan is being discontinued in 2025]. I've been traveling all summer for work and have not been able to receive mail. While I was getting some emails from them, I did not get regular invoices from them prompting to pay, and definitely no warnings on being past due. When I log in to the website, it appears as if the auto pay is working when in fact it is not (another bizarre anomaly) that they warned about in one of their emails. Well, in all of the confusion I missed one of the payments and my insurance was cancelled. I received no emails notifying the cancellation, and the website when logged in had no indication of my insurance being cancelled. I thought everything was working (auto pay appeared to be working, insurance appeared to be active when in fact none of it was active). I just thought all of this was bizarre and poorly administered. Like really poorly executed, possibly nefariously intentionally done this way.

I had an accident this week, dislocated my shoulder due to a fall and had to go to the ER. I thought I had insurance but I did not. I called the insurance to inquire and they said it was cancelled and cannot be reinstated. I called the MarketPlace and they said my insurance was still active, but after digging, they too discovered that it was not active. I filed an appeal with the Marketplace to reinstate my insurance and that's where it's at today. So right now I can't buy insurance and have no insurance and have to pay for all of my care for my injury out of pocket.

I'm feeling very disappointed in the administration of the health insurance company, and do believe that they are very delinquent in administering their website and electronic communication - I do believe it was intentional, but also let down by all the hoops and gates that healthcare.gov / marketplace puts on us consumers and not making it easy for us consumer to just buy insurance whenever we want, just like car insurance.

Wondering if anyone has any advice on this situation? I'm considering hiring a legal help to assist with this situation and could use pointers on firms to contact.

Thanks.

K

UPDATE 2024 10 22:

Last week I submitted an appeal form to the Marketplace called the Special Enrollment Period Appeal Questionnaire. It was a simple form with questions and multi choice checkbox answers. Custom answer are also possible. I'm waiting for the "hearing". Not sure when that is but I need to call them to better understand the timeline for a hearing. Hoping it's days/weeks, not months.

Anybody familiar with the law regarding coverage gaps?

I am currently on a market place plan (california), I am planning on being out of the country for a month, I get some subsidy but its still $400 a month; since i am not getting any benefit from the insurance while i am outside of the country, can I just terminate my plan for that month, and then resume when I am back, saving $400? Does anybody know if that works or am I gonna be hit with a hefty penalty?

I am making a low income which is around 30k$ yearly and my husband is making a high earning, would that affect my enrollment to Obamacare insurance if we are separated?

I'm a U.S born college student. However I've been living in the Caribbean for most of my life. As an adult , I'm back to America and I need some help applying for Obama care cause I have no healthcare/insurance whatsoever.

Someone told me to do obamacare and get Healthcare for free.

Any tips? How does it work? Is it actually free

Thanks in advance.

Do life expenses affect affordable healthcare act tax credits. I just moved out of my parent's house and am paying rent now. Just wondering.

An unemployed friend hasn't had insurance of any kinds in several years. (He's not right in the head.) In New Jersey, does the ACA insurance cover the newer treatments for diabetes such as Jardiance/Farxiga and Ozempic?

Say i am eligible and next step is to chose a plan (Pic 1). But when I click "continue to enrollment", it says "You don't qualify for a Special Enrollment Period at this time" (Pic 2). I recently moved states and performed the steps to acknowledge that. What should i do?

https://preview.redd.it/r6d5tu7wuomd1.png?width=1178&format=png&auto=webp&s=1994e4a30eca0aeb54c4025ad556c1b4d9300a4d

https://preview.redd.it/azjwqu7wuomd1.png?width=958&format=png&auto=webp&s=c2be0865a148061fbe50f107b8643e72b8fd141b

I'm trying to get insurance for me and my 2 kids. Me and their father live together, but I will be claiming the kids on my taxes. He wont be claiming me or the kids on his and we are not married. I'm only getting insurance for me and the kids. Do I have to include him and his income in household? I called the market place and spoke with a representative and she told me I didn't have to add him because he won't be on my taxes and wont be getting coverage for himself. I saw online though that he would have to be added because we have kids together so i'm confused. I would think that the people working for healthcare.gov would give the best information because they work there, but I can't afford to pay that back if it's wrong.

A few months ago I moved from California where I still work to a new state. Just before we had open enrollment I figured I would check the healthcare.gov website and see if there would be an affordable option for me in my new home state as opposed to choosing the PPO option that my employer provides and just paying the higher out of network cost if/when I need care.

I scrolled through the few options that were provided, and saw that there really wasn't anything that would be worth it, and ultimately chose to stick with the California PPO provided by my employer. This is when the problems started.

I started getting upwards of 20 calls an hour and the number of text messages offering $0 deductibles are not countable. I have done what I could to block the endless phone calls and text messages, unsubscribing as often as I could, but it is like whack-a-mole.

If changing my phone number was an option, I certainly would have, but I have had this mobile number since the late 90s and I use it heavily for work as well as for personal reasons, so this is not an option right now. I actually have considered getting a new job (I have worked for my current employer for just under 20 years now) just so it wouldn't cause as much issue if I got a new number.

What is so ridiculous, is I am on the do not call list, I have health coverage now, I do not want this to continue. This is supposedly a government program and they are clearly selling our information to predatory third-party entities that refuse to leave you alone for an indefinite amount of time. There has got to be a way to make this stop because it is absolutely ludicrous.

I signed up in Jan of this year (2024) and my agent double insured me, meaning I will be penalized and owe money when I do my taxes. I cancelled one immediately. And by the time I noticed, it was halfway through the year.

I spoke with 5-6 people between the two sites who gave me completely different excuses and answers. Not one person actually fixed the issue- I wanted them to backdate the cancellation to Jan 2024. I talked to the “supervisor” who couldn’t help and suggested I appeal.

I spent hours writing up my appeal. I received a letter from health insurance marketplace stating that “Your appeal request described an issue that we don’t have the authority to review”.

I have been searching the web EVERYWHERE to find a place to write a review for them- does anyone have a link or suggestion? I don’t want anyone else to go through what I’ve gone through with them!

Maximus the company that contracts to answer calls for ACA is using vague language and saying too bad or outright lying to me but I can't find anyplace I can report them too? My Deductible was 4000 in Jan, then 4500 in June, and now it's 4900 because I moved 7 blocks away from my old place. And no I did not change zip codes or move to another state or county. Their system is obviously glitching but all I hear is too bad. No one there knows anything about the law that is the affordable care act.

My dad is 70 years old. He has been living with me for two years after getting a green card.. He has no income, has never filed a tax return, and my tax returns do not claim him. I have been buying monthly travel insurance for him. When it expires on 8/30 (next week), I plan to stop buying travel insurance and plan to buy obamacare. I have a few questions to ask when filling out the application form.

1) “Will he file tax return for 2024”, and “Will someone else claim him as a dependent on their 2024 federal tax return?”

For the purse of applying for Obamacare, should I claim him in next year's tax return, or should he file tax for himself? if it doesn't matter, I will answer No

2) The form requires filling out the income of each person in the household. My understanding is that I need to fill out his and my income. I put $0 for him. Then I planned to choose "add additional income" for my income, but the form still said "his income" which confused me.

Should I fill out my income in the application?

3) "Disabilities & help with activities", he has a disability, I plan to fill in yes. The Instruction says that if you fill in yes, it will send a message to the state government to let them see if it is eligible for medicaid.

I am curious if this will complicate and delay the obamacare insurance? My goal is to purchase obamacare insurance soon so he is covered starting 9/1/2024.

4) "Upcoming coverage change, Will he lose qualifying health coverage between 8/20/2024 and 10/18/202. ”Special Enrollment Period eligibility" Open Enrollment Period of November 1 - January 15."

He is currently with travel insurance, and expired on 8/30/2024. I should answer yes?

5) I see someone in this sub mentioned they went through agent.

I am curious what’s the difference than purchasing it myself online v.s. through an agent?

Thank you a ton!

Hi everyone,

I recently moved to Chicago, and I’m trying to figure out how to apply for ObamaCare.

What steps do I need to take to get started, and are there any specific requirements I should know about?

Any advice would be helpful!