Does Pennie want gross or net income?

Pennie wants your Modified Adjusted Gross Income (MAGI), which is based on your gross income rather than your take-home (net) pay.

How to Calculate Your Income for Pennie

• For regular jobs: Start with your federal taxable wages (gross income) from your pay stub. You can subtract pre-tax deductions that your employer takes out for health insurance, retirement plans (like a 401(k)), and child care.
• For self-employment: Pennie asks for your net self-employment income, which is your business income minus your business expenses.
• Overall household total: You must include the expected income for everyone in your household who is required to file taxes, even if they do not need health coverage themselves.

You can check out the official Pennie Income Guide for a complete list of what counts.

To update your income on Pennie, log in to your account and use the "Report a Change" feature within 30 days of an income shift.

Steps to Update Income

1. Go to Pennie.com and log in to your account dashboard.
2. Navigate to your active application under My Applications.
3. Select Report a Change to update your household income and expected annual earnings.
4. Enter your new estimated Modified Adjusted Gross Income (MAGI) for the year.
5. Submit the updated application to adjust your Advanced Premium Tax Credits (APTC) and financial savings.

Calculating Your Expected Income

• Start with the baseline: Use your most recent federal tax return. Look at your Adjusted Gross Income (AGI).
• Add specific items: Include tax-exempt interest, untaxed foreign income, and non-taxable Social Security benefits.
• Factor in changes: Adjust for expected raises, job changes, or a shift to part-time/self-employment work for the current year. Most users on Reddit agree that when calculating mid-year income shifts (like job losses), you should average past earnings across the 12-month period rather than just adding old and new full-time rates together.

If you underestimate your income on a health insurance marketplace application, you will receive larger monthly subsidies than you actually qualify for, which you must reconcile when you file your federal taxes.

The Tax Reconciliation Process

• Extra Subsidies: The government pays a portion of your monthly premium in advance based on your estimate (called Advance Premium Tax Credits or APTC).
• Tax Filing: When you file your taxes using IRS Form 8962, the IRS compares your estimated income to your actual yearly income.
• Repayment: If you earned more than estimated, you received too much subsidy and must pay back the difference, which reduces your tax refund or increases the tax you owe.

Repayment Rules

• No Caps: Under current rules, you may have to repay the full amount of the excess financial assistance you received.
• Income Over 400% FPL: If your actual income rises above 400% of the Federal Poverty Level (FPL), you lose eligibility for subsidies entirely and must repay all of the advance credits paid on your behalf.

How to Prevent Issues

• Update the Marketplace: You can log into your account on Healthcare.gov or your state marketplace at any time during the year to report a raise or new job.
• Adjust Monthly Payments: Reporting changes mid-year adjusts your future subsidies immediately so you do not face a massive bill at tax time.
• Use Pre-tax Deductions: Contributing to pre-tax retirement accounts or an HSA before the tax deadline can lower your modified adjusted gross income (MAGI) and reduce what you might owe.

Yes, you can enroll in a health insurance plan through Pennie if you quit your job and lose your employer-sponsored health coverage.

Special Enrollment Period

• 60-Day Window: Losing your job-based health insurance counts as a qualifying life event. This gives you a 60-day Special Enrollment Period to sign up for a new plan through Pennie, even if it is outside the normal open enrollment time.
• Deadline: You must submit your application within 60 days of the exact date your job-based insurance ends.

Financial Help and Savings

• Income-Based Subsidies: When you fill out an application, your financial savings depend on your new expected annual household income rather than your past earnings.
• Reduced Costs: Lower earnings after quitting a job may qualify you for larger tax credits to lower your monthly payments, or make you eligible for free or low-cost Medical Assistance (Medicaid).

The monthly cost of a health insurance plan through Pennie varies significantly by individual, but the average net premium for enrollees has dramatically shifted due to recent legislative changes. After the expiration of federal Enhanced Premium Tax Credits, average monthly out-of-pocket costs for enrollees doubled on average. Furthermore, the Pennsylvania Insurance Department approved an additional 16% average rate hike for 2027 plans.

Because costs are heavily tied to your specific situation, your true monthly price will depend on five legal rating factors: your household income, age, location (county), tobacco use, and how many people are on the plan.

Average Premium Estimates by Scenario

Because there is no single flat rate, individual costs fit into several broad tiers based on income-based tax credits:

• Subsidized Low-Income / Medicaid Transitions: If you make a lower income or are transitioning away from Medicaid, plan costs can be exceptionally low. About half of those who enroll in private plans after losing Medicaid pay less than $50 a month, and 20% pay less than $1 a month.
• Subsidized Individuals / Small Business Owners: For individuals earning a moderate income (such as $35,000 to $50,000), monthly net costs often land anywhere between $170 to $400+ a month depending on the "metal tier" chosen (Bronze, Silver, or Gold).
• Unsubsidized Individuals & Families ("The Subsidy Cliff"): If your household income is above the 400% Federal Poverty Level threshold (about $62,600 for a single adult or $128,600 for a family of four), you pay the full sticker price. Full-price individual plans regularly range from $400 to over $1,200 a month depending on age. For a family of four or older couples over 60, unsubsidized monthly premiums routinely reach $1,700 to $2,300+.

Plan Coverage Levels & Premium Trade-offs

When browsing plans on the Pennie Shop, you can choose between three primary tiers that dictate your monthly cost:

To find your exact monthly premium, use the official anonymous quoting tool directly on the Pennie Platform to enter your zip code and estimated income.