7

What effect will not paying COBRA for April and not signing up for an ACA marketplace plan (thereby going uncovered for one month) have? None. Your new employer coverage will begin May 1; and presumably are covered now. You would be responsible for any claims with dates of service in the month of April but that's it. As to the question in your title, ...


7

In general, there are some exemptions that may apply to your situation, but may not, depending on the exact specifics. In particular the two exemptions that seem relevant: If your wife and son are resident aliens, they may qualify for a resident alien exemption. They would need to be bona fide residents of India, or some other country, for the full tax ...


7

According to the IRS (look at the 11th question on this page) a nonresident alien is not covered by the individual mandate. If your wife has been in the country for less than 5 years on the F-1 visa, she is a nonresident alien. You will still need to file a W-7 to get an ITIN for her if you wish to file jointly with her. Some school insurance plans may ...


6

Yes, anything that lowers your MAGI will help you avoid the cliff, and all above the line deductions like HSA/IRA contributions do so. I'd prioritize maxing HSA contributions over maxing IRA contributions, but that's another topic. Here's a good article on avoiding the cliff, but you've already got it figured correctly: Stay Off the Obamacare ACA Premium ...


5

How frequently you can receive certain services will depend on the specific service. Some services are considered preventive and are mandated by law, these benefits will have certain age and frequency restrictions in order for the service to be considered and paid for as preventive, that should be pretty similar across different plans. Generally frequency ...


4

You asked, What effect will not paying COBRA for April and not signing up for an ACA marketplace plan (thereby going uncovered for one month) have? Considering that you asked this question well into May, and we can assume you didn't have significant unexpected healthcare costs during the period where you were not covered, the answer is basically nothing. ...


4

When it's time to file taxes, must the person pay back some or all of the subsidy received because they made more income in the year than their estimated income when signing up even though the new income realization occurred when not utilizing the ACA plan or receiving subsidies? Effectively, yes, when you calculate your return, the subsidy that was ...


4

To start: Do I have to get a policy that says it is "HSA compatible" in order to contribute pretax (or have the employer do it) into my HSA savings acct? Yes. There's more to an HSA compatible HDHP than simply the deductible amount. As you mention in your question, with an HSA compatible HDHP you pay all costs until you've met the deductible. Most non ...


4

Possible? Sure. Likely? Not a chance; there's to much money to be made from selling insurance policies, and the more open the market becomes, the more likely someone else will want to move in to capture some of those customers.


3

You're right. That's pretty much it. You get a deduction for any medical expenses above 10% of your Adjusted Gross Income. You also have to itemize your deductions; claiming the standard deduction won't do.


3

"Do capital gains impact my health insurance subsidy?" Definitely. "what could be the repercussions?" Maybe. I don't think so. https://www.healthinsurance.org/faqs/what-happens-if-my-income-changes-and-my-premium-subsidy-is-too-big-will-i-have-to-repay-it/ mentions only having to pay back the subsidies; nothing about penalties for ...


2

You can claim as often as you like. The "Metal" tiers just identify how much of the costs you pay versus how much the insurance company will pay (after any deductible). Plan Category The insurance company pays You pay Bronze 60% 40% Silver 70% 30% Gold ...


2

Yes, it applies to control groups. If I remember correctly common ownership rules are used to determine "Applicable Large Employer" status but if the time comes to owe a penalty, only the actual entity missing the mark will owe a penalty, not the entire control group. This is an excerpt from Section 4980H (the section that lays out employer requirements ...


2

Yes. While there are the normal annual enrollment periods, you are also granted a "special enrollment period" triggered by certain "qualifying life events." You'll typically have 60 days to make your election once you lose your prior coverage or have a different life event that would allow you to make a change. Some common qialifying life events are: ...


2

I helped someone with this a few years ago and AFAIK, the process is still the same. You answered the basic questions and they indicated that you are eligible for a $999 per month "Estimated premium tax credit". If you look at the available plans for your county, it will say "Estimated monthly premium" and a dollar amount after that. That represents your ...


2

You claim the tax credit for the tax year in which it was received. The government will send you a 1095-A denoting your monthly premium as well as your monthly advance premium PTC. You'll use form 8962 (Premium Tax Credit) in your filing and if your income ends up at your estimation, the tax credit is all yours.


2

No, they don't, but we need to be very precise in what we're discussing There are a couple of ways your main question can be read: Will the new insurer cover a service that their insurance contract includes, even if I know I will need that service in advance of signing that contract? Can I obtain approval for a surgical procedure under my current insurance,...


2

No, they are not required to cover it. When you switch, you will need to have the surgery re-approved under the new plan/provider. The negotiated rates could be different, if you switch providers (insurance company) the doctor may no longer be in-network, the doctor/hospital's rates could change in 2021, etc. Your new plan may have a different out-of-pocket, ...


2

You are cutting it so close to the minimum AGI, that you might benefit from filling out the draft tax forms for 2021. This way you will have the most accurate estimate of your 2021 AGI, which you can compare against the ACA minimum 'modified AGI'. These tax forms are the draft version, not the final version, but they should be more accurate for 2021 than the ...


2

While flinty New Hampshire has attempted to implement a Medicaid work requirement and asset test, they are not in effect in 2022 and their prospects are dim for future years. All members of your family may in fact qualify for Medicaid. Once you start working again and are dropped from Medicaid after reporting your income, your family will have a special ...


1

She is 'stuck', sorry. Aside: this is not actually a discount. Technically it is an advance payment, to the insurance company for your benefit, of (edit) an estimate of the (refundable) Premium Tax Credit (PTC), called Advance PTC (APTC), based on your projected income (more exactly household MAGI, see Are long-term capital gains considered for ACA subsidy ...


1

Pre-existing conditions are an odd thing, and people are often mistaken about exactly what one is. To be totally clear, As of this writing, you cannot be denied coverage for a pre-existing condition in the U.S. Additionally, the essential benefits defined in the ACA require that your insurance must cover certain medical needs, mostly without exception. What ...


1

Coverage for pre-existing conditions is one of the cornerstones of the Affordable Care Act. And yes, it also ended the practice of charging women more than men. Prior to its passage there were many insurance abuses that are no longer tolerated. The constitutionality of the ACA is now before the Supreme Court and the verdict on its survival should arrive ...


1

COBRA may not make sense for you in your situation, however, one place it makes a big difference is for someone who has already hit their deductible before the end of the year, switching plans would most likely reset it. Note this problem exists for anyone changing jobs with employer coverage too.


1

Stumbled upon the answer a year and a half later, in Pub. 535, Business Expenses: When To Deduct Premiums You can usually deduct insurance premiums in the tax year to which they apply. Cash method. If you use the cash method of accounting, you generally deduct insurance premiums in the tax year you actually paid them, even if you incurred them in an earlier ...


1

Here's what the instructions for the relevant line on form 1040 say: Enter the total amount paid in 2018 for health insurance coverage established under your business (or the S corporation in which you were a more-than-2% shareholder) for 2018 [...] Oddly, this says both "paid in 2018" and "coverage for 2018". This would seem to indicate that payments ...


1

It is clear from the instructions you quoted that there is no need to file an amended return. If it were expected, it would say so explicitly.


1

To answer #3 specifically, there are a number of exemptions from The Individual Shared Responsibility Payment (the "fine" or "penalty" for being uninsured). One of those is: You lived in a state that didn’t expand its Medicaid program but you would have qualified if it had. That exemption (others may well apply based on income to many people in this ...


1

1) When you apply for insurance you indicate your expected income, they figure the subsidy based on this. Note that while this data isn't checked it's only an estimate, any errors will be fixed at tax time so lying is just going to gain you an unpleasant tax bill come April 15. 2) It's not paid in installments, it's just a monthly premium. It's quite ...


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