Marketplace Clients at Minimum Income Level for APTC

[insuranceagent024]

In Florida, a state that hasn't expanded medicaid, if a person on a marketplace plan is just above 100% of FPL for 2024, but doesn't update their application and their income becomes below 100% of FPL for 2025, does that person lose their tax credit eligibility and get auto-renewed with no tax credit?

 

[Yagents]

In Florida, a state that hasn't expanded medicaid, if a person on a marketplace plan is just above 100% of FPL for 2024, but doesn't update their application and their income becomes below 100% of FPL for 2025, does that person lose their tax credit eligibility and get auto-renewed with no tax credit?

It will auto renew at the same FPL% for 2025, with tax credits. If they had tax credits in 2022 and 23' and did NOT file taxes, then the APTC will be taken away in 2025

 

[DonP]

That's why in health sherpa you're starting to see some "Did not file tax return notices" . All these people that have never had jobs and were getting free Aca for yrs never have filed returns . That games over with as they'll be booted off subsidies . Much likes what's going on with Medicaid were people not even getting notices to reapply and getting booted off Medicaid .Here's something that worked in the past will it continue working ?Let's say Bill signed up for Aca in 2022. He was showing only $20k of income . He got $150 a month premium but more importantly he got huge cost share . Let's say in 2023 he made $75k . Bill at the end of the yr owes premium at $500 a month and pays what he owes . But Bill just leaves his income as is and will again in 2024 just pay what the premium would be when he files taxes. But bill still gets that huge cost share subsidy because he leaves his income low. In the past 5 yrs the govt's has never taken that important cost shar away even though you made a lot more money . Does anyone think that will change in 2025 were the irs automatically updates your income on your app so you can't get that cost share ?

 

[insuranceagent024]

It will auto renew at the same FPL% for 2025, with tax credits. If they had tax credits in 2022 and 23' and did NOT file taxes, then the APTC will be taken away in 2025

Is there any cms/marketplace documentation that shows this?

 

[Yagents]

Is there any cms/marketplace documentation that shows this?

Check your carrier broker portal if carrier has info on client 2025 auto renewal. Most do have it like ambetter Oscar aetna