Calculating Income to Receive Premium Assistance and Cost-Sharing Reductions
When you apply for a Covered California health insurance plan with premium assistance, you will be asked to enter your current sources of household income. Only certain kinds of income are considered, such as:
- Annual income, including wages, salaries and tips.
- Business or self-employment income, including rental income.
- Interest received or accrued.
- Lottery and gambling income.
- Capital gains.
- Social Security retirement benefits.
- Foreign-earned income.
- Alimony income.
- Bartering income (i.e., exchange of goods or services without exchanging money).
To determine eligibility for premium assistance and cost-sharing reductions, Covered California uses the household modified adjusted gross income (MAGI). For most taxpayers, MAGI is the same as adjusted gross income (AGI), which can be found on line 4 of a Form 1040EZ, line 21 of a Form 1040A or line 37 of a Form 1040. Taxpayers who receive non-taxable Social Security benefits, earn income living abroad or earn non-exempt interest should add that income to their AGI to calculate their MAGI. It’s important to remember that if an individual claims their spouse or children as dependents, their incomes count toward the household income. Also, in order to receive premium assistance through Covered California, spouses are required to file their income tax returns jointly.
Documents to Confirm Eligibility
Covered California compares the information you enter on your application with government data sources or information you have provided before. If the data is inconsistent, we ask you to submit documents to confirm the new information. The links below provide examples of documents you can submit to support your application.
Household size, income and ZIP code are the items on this list that are most likely to change during the year. If you move, it is important to notify Covered California so we can update your mailing address. Additionally, if your ZIP code is in a new plan region, you will need to pick a new plan, and your premium amount and premium assistance will likely change.
It’s also really important to tell Covered California about changes in your household size and income, because these are part of how your premium assistance is calculated. If your household size and projected income change a lot during the year, the amount of premium assistance you are eligible for will change. So, during the year, it’s important to consider the income you entered at the time of your application and to notify Covered California if your income changes significantly, so that we can adjust your premium assistance.
You can report changes in your income through your online account, with the help of a certified enroller or by calling Covered California at (800) 300-1506
Canceling Your Plan
Covered California requires at least 14 days advance notice to process this request. It is strongly recommended that you request plan termination to be effective at the end of the month.