Kevin Knauss: Health, History, Travel, Insurance
Posts related to eligibility for health care programs based on household income such as Covered California, Medi-Cal, Medicare usually based on federal poverty levels.
Submitting the online attestation for all of the household members, should clear the verification request. Confirm that all household members are no longer under the proof of income verification request. Once complete, you will be in good standing with Covered California for proof and verification of income. If you change your income during the year, a new income verification request may be generated.
New for 2026 is an orange band on top of the table. This is the income range that California will provide additional subsidy to help lower health insurance premiums for low income families and individuals. The extra subsidy will be provided to incomes up to 165 percent of the federal poverty level. There is a new 165% column indicating the maximum annual income that the subsidy is eligible for.
For decades, Medi-Cal has verified the income for applicants and renewing beneficiaries using federal and state databases. The process known as the Income and Eligibility Verification System (IEVS). The California Department of Health Care Services has provided county Medi-Cal offices with a reminder of the IEVS process in an All County Welfare Directors Letter, 25-16. […]
The main takeaway is that the calculations for the ACA health insurance income estimates are separate from determining the tax on Social Security benefits. Specifically, all the Social Security income is included on the Covered California application as income, but only ½ is used for the combined income calculation of Social Security income taxes.
If one of the individuals in that two-person household is pregnant, the pregnant individual could gain Medi-Cal if the income is under $3,756 per month. This is based on the 213% column, full scope Medi-Cal for pregnant individuals. The other adult would still be eligible for Covered California and the subsidy since the monthly income is over 138% of the federal poverty level.
For a married couple, they can earn up to $2,433 per month and still qualify for MAGI Medi-Cal. This represents a 3.44 percent increase from 2024. MAGI Medi-Cal is the expanded Medi-Cal for low-income adults between the ages of 19 and 64 years of age.
Covered California households with incomes below 250 percent of the federal poverty will be eligible for a reloadable debit card to purchase food. The monthly amount will be $80 for each eligible household member. Through the application process, it will be determined if the individual or family is experiencing food insecurity.
The MAGI reported on lines 11, 6a, 6b, 2a, 2b, and 1h. Income from the schedules, such as schedule C Profit Loss from a business, is funneled onto line 1. You may need to find a specific schedule to determine the income or deduction to properly estimate your future income for Covered California. This is an income estimate. It is not necessary based on your last file federal tax return.
Because of the Social Security Fairness Act, Jan will receive a monthly benefit of $1,000. Unfortunately, Jan doesn’t receive the one-time lump payment for 2025 until December, too late to amend their Covered California income estimate. Jan and David must reconcile the higher annual income on their federal income tax return.
For eligible households with income over 250 percent FPL, only the Silver 73 plan will be offered, which is a better value than a Silver 70. At least for 2025, there will be no Silver 70 for qualifying households. The Silver 70 will still be offered to consumers who opt not to be considered for the Advance Premium Tax Credit subsidies based on household income.
