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Hoots : ACA subsidy while unemployed Suppose you currently have health insurance from your state's marketplace, and you have enough income that you are not eligible for any subsidy. Now suppose you lose your job and begin collecting - freshhoot.com

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ACA subsidy while unemployed
Suppose you currently have health insurance from your state's marketplace, and you have enough income that you are not eligible for any subsidy. Now suppose you lose your job and begin collecting unemployment, and your income is now in the range where you would qualify for a subsidy. How should this be treated when you don't know how long you will be unemployed for? Can you immediately begin to receive the subsidy and then immediately stop receiving it when you get a new job? (Let's assume the new job makes you ineligible for the subsidy once again.)

One important factor is that I'm guessing you wouldn't want your plan to change, because that could reset your deductible.

If rules vary by state, then I'm specifically interested in NY and IL.


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The income calculation for subsidy is on annual basis, and the final accounting is done on your tax return.

You get "subsidized" price based on your estimate, however at the year-end, on your annual tax return, you'll be calculating the actual subsidy. If the actual subsidy ends up being less than you received - you'll have to repay it back. Similarly, if you are entitled for more subsidy than you actually received - you'll get a tax credit.

That means that your estimate should be as close as possible to your actual annual income, so that at the year-end you won't get any nasty surprises.

For your specific situation, if you estimated based on full employment, but because of unexpected unemployment your income was less than the estimate and you end up qualifying for a subsidy - you'll get a credit on your tax return. You do this on Form 8962, which is a part of your tax return. Here's more detailed explanation on the IRS website.

You're not supposed to re-enroll every month, and you're not supposed to recalculate your premium mid-year, so your plan shouldn't change and what you pay for it shouldn't change, once you've enrolled. Depending on what exchange you used you may be able to update the subsidy, though, if your income estimation changes and the exchange allows updating it. See here the details for the HealthCare.gov (the Federal exchange), check your States for specific rules applicable on their exchanges.


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