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Affordable Care Act: The Do's and Don'ts of Applying

What sort of information do you need to provide in order to sign up for the Affordable Care Act?

The application process can be confusing. Let us help you with listing what sort of information you will need to provide in order to sign up for the Affordable Care Act.

What sort of information do I need to apply for the Affordable Care Plan?

As we move towards January 1, 2014, and the full implementation of the Affordable Care Act, you may want to find out if you qualify for lower costs on Marketplace coverage, you’ll need to provide information about your household members and income. The Marketplace application includes detailed instructions. It makes calculations using the information you provide to determine whether you’re eligible for lower costs. To better prepare you apply, here is a list of the Do’s and Don'ts.

Reporting on your household

When filling out your application, do include:

  • Yourself
  • Your spouse
  • Your children who live with you, even if they make enough money to file a tax return themselves
  • Your unmarried partner who needs health coverage
  • Anyone you include on your tax return as a dependent, even if they don’t live with you
  • Anyone else under 21 who you take care of and whom lives with you

Do not include:

  • Your unmarried partner who doesn’t need health coverage and is not your dependent
  • your unmarried partner’s children, if they are not your dependents
  • Other relatives who file their own tax return and are not your dependents

Estimating your income

When you apply for lower costs in the Marketplace, you’ll need to estimate your income for 2014.

You can start by adding up the following items for:

  • You and your spouse, if you are married and file a joint tax return
  • Any dependents who make enough money to be required to file a tax return

For each of the following sources, estimate what your income will be in 2014:

  • Wages
  • Salaries
  • Tips
  • Net income from any self-employment or business (generally the amount of money you take in from your business minus your business expenses)
  • Unemployment compensation
  • Social Security payments, including disability payments, but NOT Supplemental Security Income (SSI)
  • Alimony

Other items to include when estimating your 2014 income are:

  • Retirement income
  • Investment income
  • Pension income
  • Rental income
  • Other tax income such as: prizes, awards and gambling winnings

DO NOT include the following:

  • Child support
  • Gifts
  • Supplemental Security Income (SSI)
  • Veteran’s disability payments
  • Worker’s Compensation
  • Proceeds from loans (like student loans, home equity loans, or bank loans)

Modified adjusted gross income and household income

When you fill out the Marketplace application, your estimated household income will be calculated using the information you provide. Your household determines your eligibility for lower costs on Marketplace coverage.

Your household income is your modified adjusted gross income (MAGI or joint MAGI if you are married), plus the MAGI of your dependents who make enough money to have to file a tax return.

MAGI are generally your adjusted gross income plus any tax-exempt Social Security benefits, except for Supplemental Security Income (SSI), which is not counted, tax-exempt interest and tax-exempt foreign income.

You don’t have to figure out your household income or MAGI yourself when you fill out your application. It will be done for you with the income information you include on your application.

Partner Agency can provide you with professional expertise in understanding your health care options, and guide you through the application and eligibility process. We can offer you affordable health care coverage through Covered California or directly with medical insurance carriers for Individuals & Families or Employer Group coverage for groups of any size. Please feel free to contact us for a complimentary quote from various companies for almost any kind of insurance at (714)482-9500.