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Hey everyone. I think this is my first call for help diary since I joined Kos back in 2004. I hope the community can help me answer a few stupid questions about enrolling in the Affordable Care Act.

First off I am sorry I haven't been writing diaries since the election. I have been reading and "lurking" a lot just not really posting. A lot has been going on. I checked into the site tonight because of two very big things happening.

First and foremost we have this stupid Government Shutdown. Every time a Republican in the House speaks I face-palm. Partially because I can't believe how stupid these people are but also because the only time they make any sense to me is after suffering a slight trauma to my head.

Second we have open enrollment for Obamacare, and it's on that issue that I need some help. So if you're in mood to offer advice please follow me down below the cloud of Cheeto dust and see if you can answer my questions.

So one of the big things that has been going on with me since I wrote my last diary almost a year ago "An Open Letter to the GOP" and why I am interested in the Government Shut Down and the Obamacare enrollment is that I was fired on Friday.

Don't get me wrong, other big things have happened since November. But the most pressing right now is the whole feeling washed up and not having job thing. That sucks. I am not the type of person who likes to do nothing. Sure, now and then when I feel like I deserve a break I will take a few days and have some fun. But I can only enjoy that because I know I earned that time off and I am going right back to being a productive member of society after the fun is over.

Today I just feel useless. I feel like a failure.

My boss for the last 4 years decided to call it quits when another doctor offered to purchase his practice. Of course he will not be hiring on any of my bosses staff. He just wanted the patient records, the equipment and the elimination of near by competition.

Like a large portion of the uninsured people in this country I am a single man. I'm 32 years old and despite having worked lots of jobs ever since I was old enough have one, I have never had health insurance. None of my employers have ever once offered that as a benefit.

I live in California so I can enroll in Obamacare using the very handy marketplace website Covered California.

But I am not sure what to put for my annual income. Being recently let go I don't know if I am supposed to put what I have made in 2013 or what I expect to make next year. I have been reading everything I can find on both the Covered California site and the federal website. I can't seem to find anything on this. Last year I made just over $16,000 and I was on track to do so again this year but now I am unemployed.

Do I put the year-to-date as of my last pay stub?

Am I supposed to include unemployment benefits? I haven't gotten any yet, and I might not at all if the Government Shutdown goes on indefinitely. Did that "sequester" ever end? I stopped paying attention to that hot mess. Also since health coverage doesn't start until January of next year am I supposed to put my projected income for 2014? Because at the moment I feel like that's probably a big fat zero.

I am not optimistic. Last time I was unemployed it took me 10 months to find a real job. I worked some minimum wage, part time gigs here and there during that time period, but I was basically unemployed the whole time. It sucked. I am going to be pounding the pavement every chance I get to find a new job, but in the meantime I don't know what to do.

What happens if I enroll using one estimate, and then I get a really good paying job? Can I go back and change that? I have no idea how long I will be unemployed this time around, or how much I will make when I do finally find a job.

I suppose I can wait until January to see if things are clearer and easier then. I am not sure it will be. But either way I have gone this long without insurance I guess I can wait and hope I find a job between now and the end of Open Enrollment.

What bothers me is I am sure there must be somebody else out these in a similar situation who does in fact need to get signed up in a hurry. What information do they input in a situation like this? Personally I am mostly worried about committing insurance fraud if I fill this out wrong.

Any help or information would be very much appreciated.

Originally posted to DeanDemocrat on Tue Oct 01, 2013 at 09:37 AM PDT.

Also republished by Unemployment Chronicles.

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Comment Preferences

  •  Tip Jar (3+ / 0-)
    Recommended by:
    wu ming, worldlotus, JamieG from Md

    We lose if we choose to forget; the lives of men, and money spent.

    by DeanDemocrat on Tue Oct 01, 2013 at 09:37:11 AM PDT

  •  Good Questions. (2+ / 0-)
    Recommended by:
    Lily O Lady, worldlotus

    Sorry for your job loss and I hope things turn for the better soon.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Tue Oct 01, 2013 at 09:39:53 AM PDT

  •  I'm in the same boat. (2+ / 0-)
    Recommended by:
    wu ming, worldlotus

    The navigators and the operators at the site will help you with that.  That's their job.  I was in a full time teaching job until June, with the pay from the contract ending in August.  I've started a part time teaching job that pays a third of what I was getting.  So like you, I'm not sure.  I've HEARD, only heard, that it's based on projected 2014 income.

    But I could be wrong.

    "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

    by zenbassoon on Tue Oct 01, 2013 at 09:41:56 AM PDT

    •  zenb - that's what I have heard as well (3+ / 0-)

      Expected 2014 income because that is what the subsidy will be based on. You can estimate and then work out the difference when you file your 2014 tax return. If you estimated your income too high you can receive a refund and if you estimated your income too low, you will owe the IRS the difference.

      "let's talk about that"

      by VClib on Tue Oct 01, 2013 at 09:46:07 AM PDT

      [ Parent ]

  •  I don't think an error in filling out the form is (1+ / 0-)
    Recommended by:

    insurance fraud.  So I think your best reasonable guess is probably what you want to use.

    Even if you list $16k, you will likely be eligible for full subsidies.

    Now, IANAL, nor an expert in insurance applications, but if it were me in your situation, I'd calculate my unemployment pay (over 6 months, or however long it pays in your state) and use that for my estimate.  And submit the application this month.

    Best of luck!

    Socialist? You keep using that word. I do not think it means what you think it means.

    by Kimbeaux on Tue Oct 01, 2013 at 09:48:50 AM PDT

  •  call the covered CA people (1+ / 0-)
    Recommended by:

    they're really good at answering questions about the system.

    that sucks about your job, i really hope you land back on your feet soon.

  •  One thing to think about is whether your income (2+ / 0-)
    Recommended by:
    Alice in Florida, worldlotus

    would shove you into a Medicaid, involuntarily.

    The upside: the Medicaid coverage is free, or nearly so.

    The downside: sometimes finding a provider who accepts Mecidaid can be an issue.

    Literally the dividing line between "you have no other choice but to enroll in Medicaid" and "you have a really low income and are eligible to purchase one of the cheaper, qualifying, highly-subsidized with a sliding scale for deductibles/co-pays silver plan" is $1.00 on the positive side of the dividing line.

    I don't know where that line is in your state.  But in signing up I would look at it both ways in a situation where you are basically providing an estimate of 2014 income because of recent unemployment, etc.

    Another issue is that being a Medicaid client can also access some some other subsidies/assistance in other areas in some states. (Possibilities: rent, energy, food stamps, etc.)

    Since you don't have insurance now (and hopefully ill stay healthy until Jan. 1)  I would not get panicky, put give the CoveredCa a chance to settle down and then drill down what you can find out.  (CoveredCa is probably the best of the state-run sites.  Excellent info, better than my own NYS Exchange site, I think.

    There are two very useful charts on the CoveredCa site:

    Basic comparisons among different levels of coverage:
    This is called the health benefits comparison chart

    Chart showing how income comes into play in the case of the lower-end incomes for the qualified Silver level plan.  This is not the same as the income-varied amount of premium subsidies, but is in addition to them to make paying deductibles and co-pays even lower.

    This one is called the Health Benefits Summary it covers the sliding scale info.

    I have saved these as .pdfs to my hard drive and could send them to you via Kosmail if you can't winkle them out on your own, or if the website is still overloaded.

    I'm sure you will be able to get affordable coverage, but of course I hope you get a new job with fab benefits and become ineligible for the Exchange!


  •  Subsidies are based on "MAGI" (0+ / 0-)

    which stands for "modified adjusted gross income."  That will generally be your "adjusted gross income" plus tax-exempt interest and certain excluded foreign earned income.

    Assuming you have neither tax-exempt interest nor foreign earned income, your MAGI will be your salary/wages, your unemployment benefits, and whatever other income you might have.

    "Well, I'm sure I'd feel much worse if I weren't under such heavy sedation..."--David St. Hubbins

    by Old Left Good Left on Tue Oct 01, 2013 at 10:17:57 AM PDT

  •  you won't have to worry about your unemployment (1+ / 0-)
    Recommended by:

    your unemployment check comes from your state, which hasn't shut down.

    "Kossacks are held to a higher standard. Like Hebrew National hot dogs." - blueaardvark

    by louisev on Tue Oct 01, 2013 at 10:20:49 AM PDT

  •  Your answer (1+ / 0-)
    Recommended by:
    Question: Is there a penalty for under-projecting the income? Are they planning to charge interest on the subsidy difference? All I have heard is that one has to replay the subsidies, but nothing the interest or penalties. Also. I understand that in addition to the direct subsidy on the premium itself, one may qualify for a reduced co-payment and deductibles based on income. Assuming that is true, how will they claw that back if the actual income turns out to be more than the projected income. Based on the answers for the above, wouldn’t it make sense to always undershoot?

    Answer: Correction: (I misread this question first time around.) There is no penalty for taking more advance tax credit than you are eligible for except to repay the excess advanced. The cost sharing reductions are not subject to repayment.

    You can also get help from a trained professional insurance agent:

    In any case, take your time.  Coverage starts on Jan 1, and you can sign up until Dec 15.  If you're late, coverage will start Feb 1, or March 1 or April 1 or maybe May 1.

    •  About income: (1+ / 0-)
      Recommended by:
      Verifying Income

      Income information can be complex and this part of the Covered California application process is important. The Exchange incorporates electronic verification direct from the IRS The income data from the customer’s last federal income tax return is available to the online applicant or the CCR. The CCR can use this IRS data to help determine the customer’s estimated income for the year, but the customer can override the income tax data if there have been significant changes in his or her income for the current year.

  •  Coverage won't start until January (1+ / 0-)
    Recommended by:

    so you shouldn't be in a big rush to sign up right away, particularly if you have a lot of uncertainty about income.

    As the previous commenter noted, the big question is whether your income is too low for the exchange and you qualify for Medicaid instead.

    Regarding how to count your income, the answer is that everything counts, not just taxable income (unemployment counts as wages for tax purposes anyway, though many unemployed don't pay taxes because their income is too low).

    "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

    by Alice in Florida on Tue Oct 01, 2013 at 11:27:56 AM PDT

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