What happens if I overestimate my income for Covered California?
Asked by: Elnora Grant | Last update: September 7, 2025Score: 4.6/5 (34 votes)
What if I make too much for Covered California?
Even if your income is too high to get help paying for a health plan, you can still buy a plan through Covered California. You can also sign up for a plan on your own. You can apply through the insurance company directly, through an insurance agent or broker, or through another online health insurance marketplace.
Does Covered California check your income?
This is called “income verification.” Covered California does this by electronically asking the Internal Revenue Service (IRS) database and other databases if what you reported is the same as what they have on file. The IRS will not share your personal tax data with Covered California.
Will I have to pay back the Covered California subsidy?
Note that in 2021, some people got more state subsidy (also called California premium subsidy or Premium Assistance Subsidy) than they were entitled to. They may have to pay this extra money back when they file their 2021 taxes. The government refers to paying back subsidies you used in advance as “reconciliation.”
What is the income limit for Covered California?
Note that free health insurance plans are available, as California's low-income cutoffs are below $47,520 a year. Families of four who earn wages below the median household income in California — $97,200 per year — qualify for government assistance based on their income.
The Awkward Income Estimate for Covered California
What if my income is too high for Medi-Cal?
If your income is too high for Medi-Cal, you may qualify to purchase health insurance through Covered California. Covered California offers “premium assistance.” It helps lower the cost of health care for individuals and families who enroll in a Covered California health plan and meet income rules.
What happens if I don't report my income change to Covered California?
Costly repayments: Your account will be in arrears if you pay a lower premium despite your income change. This means you will be liable to pay back the insurer. Legal consequences: Failing to report an income change is considered fraud and, as such, you may face criminal consequences.
What happens if you overestimate your ACA subsidy?
Keep in mind that if you estimate your income incorrectly and end up claiming more help than you are eligible for, you may have to pay back some or all of the premium tax credit you received.
How will Covered California affect my tax return?
If you receive a tax credit through Covered California, you must file taxes for that benefit year. You will receive a 1095-A form, which shows how much Covered California paid to your insurance company to help with the cost of your health coverage. You will use the information on your 1095-A to fill out IRS Form 8962.
How can I avoid paying back my premium tax credit?
Report any changes in your income during the year to the Marketplace, so your credit can be adjusted and you can avoid any significant repayments at the end of the year.
Why am I not eligible for Covered California?
You do not have other health coverage (such as free Medi-Cal or employer-sponsored insurance) that prevents you from qualifying for insurance through Covered California. Covered California stated that you are not a California resident. Covered California stated that you did not pay your premiums by your due date.
What kind of money counts as income?
Generally, you must include in gross income everything you receive in payment for personal services. In addition to wages, salaries, commissions, fees, and tips, this includes other forms of compensation such as fringe benefits and stock options.
Why is my Covered California Premium so high?
The rate change can be attributed to many factors, including a continued rise in health care use, increases in pharmacy expenditures, the rising cost of care, labor shortages and other issues affecting the health care industry.
Does Covered California look at Adjusted Gross Income?
What Income should I Include on my Covered California Health Insurance Application? Generally, the projected annual income on your Covered California application should match your Adjusted Gross Income (line 11 of Form 1040) from your most recent Federal Tax Return.
What if I can't pay my Covered California premium?
If you or anyone in your tax household has offers of health coverage from a job or through Covered California that you cannot afford, you can apply for an affordability hardship exemption.
Do I make too much money for Covered California?
Covered California income limits are a household income of up to 400% of the Federal Poverty Level (FPL). Households who make more than that do not qualify for financial assistance with their health insurance plans.
Do I have to pay back covered CA?
If your income is more than what you told us on your application, you may have to repay some or all of the advanced premium tax credits that you got. There are limits to the amount you may need to repay, depending on your income and if you file taxes as “Single” or another filing status.
What is the penalty for Covered California?
The penalty for not having coverage the entire year will be at least $900 per adult and $450 per dependent child under 18 in the household when you file your 2023 state income tax return in 2024. A family of four that goes uninsured for the whole year would face a penalty of at least $2,700.
What happens if I underestimate my income for Obamacare in 2024?
For the 2024 tax year, if you underestimated your income and received a larger tax credit than you were eligible for, you must repay the difference between the amount of premium tax credit you received and the amount you were eligible for.
Why do I have to pay back premium tax credit?
If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return. If you've taken less than you qualify for, you'll get the difference back.
What happens if you don't report extra income?
Underpayment may happen if you don't report all your income or you claim deductions or credits for which you don't qualify. We apply 2 common accuracy-related penalties to individuals: Negligence or disregard of the rules or regulations. Substantial understatement of income tax.
How do I get out of Covered California?
If you need to cancel your health or dental plan, you can do so by logging in to your Covered California account. Covered California requires at least 14 days advance notice to process this request. It is strongly recommended that you request plan termination to be effective at the end of the month.
What happens if you lie to Medi-Cal?
And the felony penalties for this form of Medi-Cal fraud include: Felony probation; Two (2), three (3) or five (5) years in county jail; and/or. A fine of up to fifty thousand dollars ($50,000) or double the amount of the fraud, whichever is greater.