Calculate Income for Health Care Marketplace Insurance

By | March 2, 2015

When you are in the online health care market, you answer detailed questions about your income and your home.The health care market place does the math and tells you which programs and savings may receive.Before applying, you can make a rough estimate to see if you qualify for savings.  The Market makes the final decision on your eligibility for savings. The following method only helps you to make a rough estimate which is very useful before you apply.


How to Estimate Income for HealthCare Marketplace?

Start with your adjusted gross income (AGI)  You will find this in your last federal tax return. For most people, the AGI is used as the approximate estimated market eligibility. Officially, the income measure used by the Market called “modified adjusted gross income,” or MAGI. It is not an amount shown as a line on your federal taxes. It is the modified adjusted on your federal income tax plus the excluded foreign income gross income, Social Security benefits not taxable (including tier 1 railroad retirement benefits), and interest tax exemption received or accrued during the taxable year.

Where to find AGI in IRS tax forms:

  • 1040: Line 37
  • 1040 EZ: Line 4
  • 1040 A: Line 21

Add or subtract certain types of income

Some people have to add or remove items from your AGI to make a more accurate estimate.

  • Add the following types of income, if any:
    • Excluded foreign income
    • Social Security benefits untaxed (including railroad retirement benefits 1st level)
    • Exempt interest income
  • Do not include Supplemental Security Income (SSI)

These types of income are considered with health care marketplace benefits.

  • Wages and salaries, as reported on your W-2 form
  • 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
  • Retirement or pension income, including most IRA or 401k withdrawals
  • Investment income, like dividends or interest
  • Rental income
  • Other taxable income such as prizes, awards, and gambling winnings


Income sources that are not included in AGI:

  • Child support
  • Gifts
  • Supplemental Security Income (SSI)
  • Veterans’ disability payments
  • Workers’ compensation
  • Proceeds from loans (like student loans, home equity loans, or bank loans)

Federal taxable wages

Don’t include as income any money that an employer takes out of your paycheck for child care, health insurance, or retirement plans that is “not taxable.” Sometimes these are called “pre-tax deductions.” Your pay stub should list these deductions individually.

The pay stub may list your “federal taxable wages.” If it does, use that figure to estimate income from your job.

Now adjust its estimated 2016

Remember, your eligibility for tax credits and savings in your pocket are based on its estimated 2015 income, not what you earn in 2014. So do your best to count the changes you think will happen in 2015.

  • Consider things like: Expected increases, new jobs or other changes in employment;deductions higher or lower taxes; and changes in income from self-employment.
  • Also note any changes you expect in your home, including winning or losing dependent.

Now that we have an estimate . You can use this amount if you are applying for a Special Enrollment Period and in case you want to see plans and pricing based on income before placing your order or to see if you qualify for tax credits for premiums and other savings. Of course you never know what will happen next year. That is why it is so important to update the application of market throughout the year whenever you have changes in income or home that may affect your coverage.


Income for Insurance Marketplace

There may be some differences, depending on the state you live and other factors. Market application will ask specific questions to determine if you are eligible for Medicaid. When you fill out an application Market, whether based on information you provided seems that someone in your household is eligible for Medicaid or program Children’s Health Insurance will send your request to the agency in your state. You may be asked more information. If it is eligible, they will help you enroll.

The subsidies, which are available to those earning between 100 percent and 400 percent of the federal poverty level, are based on your modified adjusted gross income, or MAGI. That includes things like wages and interest, less deductions like tuition and alimony, and additional payroll taxes paid by the self-employed. You’ll be asked to estimate what your income will be for next year; if you’re wrong, you’ll have to reconcile with the IRS come tax time the following April.