What documents does Covered CA accept as proof of expected MAGI Income – Line 37 + ?* income?

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Report Changes as they happen

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 Copy of last year’s federal tax return along with federal schedule E that accurately reflects current income

  • Copy of last year’s federal tax return along with federal schedule C. D, E, or F as appropriate that accurately reflects current income
  • Court papers
  • Copy of check
  • Copy of pay stub
  • Copy of pay stub showing garnishment specified for alimony
  • Sworn affidavit from absent parent
  • Award letter or most recent cost-of-living increase notice
  • Current bank statement
  • Copy of the current benefit check
  • Signed statement from the individual or organization providing the income
  • Gift income letter —  Covered CA is the worst blight I’ve seen in the Insurance Industry in my entire career!   Just because they say something and I copy it, does NOT make it right!  Please check the entire website, our new page on gifts, tax and law professionals for what really is MAGI Income Line 37 of your tax return!
  • Pay stub
  • Signed letter from employer that displays the gross income, payment frequency, and date of paycheck
  • Other documents to support Proof of Earned Income
  • Bank statement
  • Investment account statement
  • Payment records (notes and mortgages)

 

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. Medi-Cal Proofs – Page 8   

Income Section Navigation

Most of the time Covered CA and Medi-Cal don’t need your proof, they get it from Big Brother and the Federal Hub.   They need your consent though.  Check out this problem for January 2017 where Covered CA didn’t get consent.  View Covered CA warning letter.

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Income and Household Size 
Page 5.206 

Applicants report income and tax household size on their application, which is then checked against data sources using the federal verification hub.

For Medi-Cal, if the income information submitted by the individual is “reasonably compatible” with the information obtained through the electronic data sources, e.g., IRS, state wage data, unemployment, Social Security, Medi-Cal accepts the amount
listed on the application.126 The two amounts are “reasonably compatible” for MediCal in any of the following circumstances:

• Both show the individual’s income above the relevant income standard;
• Both show the individual’s income is at or below the relevant income
standard; or
• The individual states their income is above the income standard and the
information obtained by the state shows the individual’s income is at or below
the relevant income standard. 127 In this case, the individual must be told that
the income information they provided was higher than the information the
state obtained through electronic verification and the individual may request
to have their income determined at the lower, verified amount.128

If the income information obtained through electronic verification is not reasonably compatible with the information provided by the individual, the individual must provide additional information that explains the discrepancy, such as pay stubs or other documentation regarding income.  WIC 14013.3  *

For Covered California, income information is checked against an applicant’s
previous year’s tax return through the IRS database. If the applicant says that the
income and tax household size on their last year’s tax return represents an accurate
projection of their income and household size for the benefit year for which they
are applying for coverage, Covered California uses that tax information.130 Covered
California accepts self-attestation of income and household size if tax data is
unavailable or the applicant attests that a change in income or household size has
occurred or is reasonably expected to occur such that the tax data is not accurate
for this benefit year.131 If, however, Covered California finds that the application’s
attested income and household size are not reasonably compatible with other
information from the applicant or information Covered California has other than the
tax data, then the attestation will be verified against state electronic data sources. If
state sources are unavailable, the applicant must submit documentation to support
their attested income.132
There is an alternative verification process for individuals who attest to projected
household income.133 If their projected income is no more than 10% below the
income on their most recent tax return, it must be accepted without further
verification. If the projected annual income is more than 10% below the latest tax
income or if the tax data is unavailable, the applicant’s attested income is verified
with state data sources or by requesting documentation from the applicant.134
When income cannot be verified electronically, Covered California notifies applicants
of what information is needed and gives them 90 days to provide it.135 If the
applicant does not provide the information within 90 days, Covered California uses
the information available through electronic databases to determine their eligibility.136
For MCAP, if income cannot be electronically verified, paper documentation is requested.137

 

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28 comments on “Proof of Income – Accepted Documents

  1. What counts as projected income for this year 2018?

    How to project income for 2018?

    Attestation of anticipated income for the 2018 year.

  2. If I qualify for subsidies, when do I receive that money? Is it deducted from my monthly premium or do they reimburse me later?

  3. I expect to make a lot more than the 26K I made last year.

    Are the subsidies based on last year or on this year’s earnings?

  4. I am an independent contractor. I have 2015 1040 Profit and Losses [Schedule C?] and adjusted income proof.

    It should be the same for 2016. However, since taxes aren’t due until April and we already filed for an extension with the IRS, how can I prove my adjusted gross income? I won’t have until we file. I have 1099 forms from 3 employers but the losses are not included–it’s gross which is not what I clear.

    What to do?

  5. Dear Sir: you probably have answered these before somewhere but I hope you don’t mind I ask again.

    1. My wife and I filed joint return, and the same for 2017. No dependent. If only one of the spouses has income, and we try to apply for Family Coverage on Covered California, are we going to be split into two different insurances? One spouse with income qualifies to buy subsidized metal plan and the other spouse without income only qualifies for Medical? Our line 37 will be approximately $28,000

    2. Regarding child eligibility. If I understand it correctly, ACA says you can keep your child under the family plan until he/she turns 26, but Covered California says a child cannot be included in the family plan unless he/she is claimed as a dependent on your tax. which one is correct?

    Thanks for your help.

    • Married people are mandated to file a joint return. Please get a quote from our complementary quote engine so that we can better help you. The subsidies are by tax return. See our income chart. You probably both qualify for Silver 87.

      Both answers are correct about age 26 and getting subsidies. Since your adult child won’t get subsidies as they are doing their own taxes, they should just get their own policy. There is really no family discount.

      Sorry, I had a computer SNAFU and didn’t see your question before. I hope you got coverage, as Open Enrollment is over. Do you have a Special Enrollment reason?

  6. Please help me. I am 75 yrs old retired newly immigrant. I just got my GC this year and I have never worked in US. I have income from my investments and from my pension in India.

    I applied for Obamacare coverage. On one side they want my income proof and on other side they are not able to direct me what documents I can show to them to verify my income in India.
    I submitted my annual statements from my banks in India which clearly show what my pension is and what my returns on investments are but still they do not agree to the documents.

    They need income proof documents like people have in US but in India there is no such such documents .

    Please suggest me what to do.

  7. Hi Steve:
    I got a letter from Covered CA asking more proof of income or risk of losing coverage or subsidies by April 10th. I had a full time job in 2015 so my income is much higher than what I will have in 2016 since I’m now retired due to health. I submitted an affidavit explaining my situation as well as an letter from my former employer stating this fact. Also, I’ve submitted the final paycheck stub and my investment account statement.

    As of today, I’ve also submitted the 2015 Federal Tax return along with Schedule D. I don’t know what else will they need since they are not very specific on what kind of form they want to see and if my last year income will affect the subsidy amount.

    Thank you in advance for your response.

    Ryan Le

  8. i am self employed and won’t get all the docs i need to file 2015 taxes until much closer to 4/15/16. However, Covered CA wants proof of income or threatens dis-enrollment by tomorrow, 3/10. How can they do that and what do i do?

    • That’s a really good question. Let’s take a look at the letters and information they sent.

      Given a little more time, I’m sure I could find a reason that they can’t. Everything I’ve seen before said one had 90 days to prove income, lawful presence, Insure Me Kevin.com. We could look up those citations. In the meantime, I suggest you appoint us as your agent. No charge. Send us everything you have to show 2016 and 2015 income and we will contact them and ask for more time. It doesn’t make sense they would want your 2015 tax return as it’s not due till 4.15.2015.

      What is your expected MAGI income for 2016? What was it for 2015 and 2014? What income proofs have you sent so far? When did you first get coverage with Covered CA?

  9. I know my friend that I sent you as a referral was concerned about last nights deadline. Glad to know that she would be eligible for a special enrollment period once she gets her 1st paycheck. Is it ok that she is 1099, not w2?

  10. I am going through a divorce that will finalize this year and as a result will lose my health insurance. Last year I filed taxes jointly and thus do not have my own filing for proof of income. I’m only receiving income via spousal and child support. What kind of documentation can I provide as proof of income?

  11. If someone loses their job and unemployment states that they can not get unemployment how can they prove they do not have income? How do you verify proof of income if you do not have an income?

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