Covered CA Brochure – Subsidy NOW or Tax Time?
Take it later
Take it Later
2 people Medi-Cal Limit

Dear Mr. Shorr,

I have covered california insurance (first year). I do not receive APTC, [Advanced Premium Tax Credit – aka Subsidy] because my estimated income was higher than 400 % of the FPL [Federal Poverty Level] . It will probably wind up being less than that but certainly well above the 138%. Since I am not getting APTC, and will get PTC next year, at tax time, unless I hit my projected income, does it matter what I make monthly; in other words, if one month I make under 1833, is that relevant?

***I understand how confusing it is, expecially when Covered CA asks so many questions about monthly income.  The point is when you file your taxes, what goes on line 37* Magi Income.

Although, Medi-Cal wants to write everyone and their calculations are based on monthly.

I have been told that if I claimed over 400 percent or selected receiving credits in one lump sum at tax time, instead of monthly, that only the annual sum is important.


I ask because part of my income depends on what my wife takes from her IRA. We are thinking of stopping withdrawals for this year, for tax purposes, but that could bring the monthly under 1833 for the month.

***Please talk to me in the bottom line MAGI income for the end of the year.    I don’t know how many are in your household.  Now I have to multiply 12 x $1,833 = $21,996 if you have a household of 2 it’s borderline, but you are right, that would put you in Medi-Cal.

Should we make it a point to have at least that much monthly income for the remainder of the year?

***The monthly amounts are all hocus – pocus with smoke and mirrors.   What counts is the annual.  Please use our quote engine and see what happens with your income on an annual basis.

Did you want to look at getting Enhanced Silver – Cost Sharing Reductions?

FYI, my wife does not have CC.

***The premiums are different without her, but she counts as part of the household for the Federal Poverty Level FPL calculation.


P . S . Do you sell health insurance not run through covered california?

***Yes.   Get quotes here.  If you want the subsidy though, you must have Covered CA.   Click here for instructions on how to appoint us as your agent, no extra charge.   Did you like our answer better than calling Covered CA?

Thank you for your response.

**You’re welcome.

Regarding the monthly income related to my wife’s Ira, I am a little confused. We have already made well above the annual 138 % FPL. We are thinking about not taking any more income from the IRA,

***Line 15 A of the 1040

from this point forward, because our annual income is already into the 40k area.

***Around 250% of FPL

Are you saying that I would drop into Medical [Medi-Cal] if the monthly income dropped below 1833 for the next month or even four months, despite the fact that the annual quota has already been surpassed.

***No, not at all.   It’s all annual MAGI.  This monthly is for people who want subsidies and can’t figure out the annual amount they will put on line 37*   Medi-Cal does want to write everyone and not let them out.

You said the annual income is what matters,

***Right.  But please do not quote me.  I only read the official IRS publications, namely publication 974 and  Covered CA bulletins.

but the part I described above and your response confused me. Are you saying that the annual is what matters as long as you make a minimum of 1833 for each month of the year?

***Yes.   Please, forget the monthly amount.  It’s just crap for those who can’t figure out what their MAGI* income will be on line 37.

How about appointing us as your agent so that we can get paid to help you.   Sure, Covered CA says find free help, but it’s not free.  It’s slave labor until I get appointed.  There is no extra cost to you.

Since you are not taking the advance premium tax credit and if I understand you correctly, are not taking it in advance next year, just put that down and you shouldn’t have to enter an income amount.

Thank you
Sorry. I forgot to add that there are only my wife and me in the household.

***Please use our quote and subsidy calculator.  You will note, it only asks for annual income.

I am not planning to stay on covered california. Perhaps, I can talk to you in November about another plan. I am in San Pedro.

***Great.  I’m in San Pedro too.

To clarify, my final MAGI will be at least 40k, even if my wife and I did not make another dime. So, can we stop taking money out of the IRA without fear of my falling into medi-cal?

***Right.   With two people you  might get subsidies up to $63k.  Please use our quote engine to see.



Hi Steve,

Thank you for the proposal. I have insurance for this year but will probably go off of Covered California next year (2017) or ask someone like you to act as my agent if I stay on CC. Actually, I will need an agent regardless.
As I understand it, insurance sign up starts in November.


So, I will call you then.

***Email is better

I have not gotten a subsidy this year, because my projected income is above 63k.

***That’s what the chart shows for a household of two, but it’s best to get a complementary quote and subsidy calculation.

However, I have so far made less than that.

***When you file your taxes, you can take the subsidy then.

I contacted you to find out if I needed to bring in a certain amount each month, or if I simply needed to make the minimum required annually. I had heard different versions and was confused.

***Everyone is confused.

I did not want to drop into medicare [Medi-Cal] if I made less than 1833 in a month).

***MAGI Income is ANNUAL – what shows on line 37 of your 1040.

If I can get tax credits when I file my taxes (provided that I wind up making below 63k for the year) great.

***Right, use my calculator – link above to see what the credit should be.

However, I definitely do not want APTC. [Advance Premium Tax Credit]

***That’s what the brochures on the above right and on this page talk about.  Take the credit now or later?  If your income drops below $34k you may qualify for Enhanced Silver Cost Sharing Reductions.

If I renew for CC in November and I indicate that I don’t want APTC, would I still have to provide a breakdown of projected income, along with documentation?

***No, note the new rule I just found that says Covered CA – the Exchanges MUST vette everyone who asks for Premium Credits.  (42 U.S. Code § 18081  * CFR § 155.320)

When you asked if I would give up the subsidy, did you mean APTC, or do you mean the PTC that one gets as a refund on taxes.

***You have to stay in Covered CA to get either subsidy.

Does one have to fill out the financial part of the [Covered CA] application for next year in order to get the PTC on the tax refund following the benefit year?

***Yes, as Covered CA must vette everyone under 42 U.S. Code § 18081  * CFR § 155.320

Again, I have heard different opinions on this.

***That’s because very few people actually read the CFR’s, actual IRS documents and the documents don’t always refer to the other relevant rules, codes & laws. Check our main page on take it (APTC or PTC)  now or later.

I am 49 years old and my birthday is in July.

***Please put your exact information in the quote engine for exact pricing.

Thank you,


Leave a Reply

Your email address will not be published. logo