Let’s say you’re one of the 12 million people who signed up for health insurance during Open Enrollment. You completed your eligibility application and enrolled in a health plan. Then, several months later, your family moves to another city. You might already know you need to report your new address to the Marketplace. But what other major life events do you need to report? Generally, you should report any changes that impact your household income, family size, or health coverage. Now let’s look at each of these in detail and how to submit your updated information:
Changes to your income
The application for Marketplace plans asks for your household’s anticipated yearly income. That means the number that you give is your best estimate of what you think you will earn in the coming year. But the unexpected often happens, for better or worse. In November you might be working full-time and not realize you will be switching to a part-time schedule in April. Or that your spouse will get a raise in August.
When the unexpected does happen and causes your household income to significantly increase or decrease, contact a HealthSherpa consumer advocate (or submit the updated information to the Marketplace if you did not enroll through HealthSherpa) as soon as possible.
Making these changes can also be beneficial for you. You might be able to 1. Save immediately 2. Save when you’re filing your taxes 3. Qualify for Medicaid (depending on your new income level and location). On the flip side, if your income increases to the point that your premium tax credit assistance is higher than you qualify for, you may owe the extra amount when you file your federal tax return and you may lose your tax credit when reporting the change.
When you DON’T need to report your income change
In some cases, your income might increase but won’t need to be reported to HealthSherpa or the Marketplace. Because financial eligibility is determined by a number known as the MAGI (modified adjusted gross income) some of your income might not be included in making the calculation.
Change in income examples you do not need to report:
- You receive an inheritance
- Your teenage son or daughter gets a summer job and earns less than $6,300
- Your spouse is awarded a college scholarship that pays for tuition and related fees
Changes to your household size
Your household size also determines what financial assistance you qualify for along with coverage options. So when the size of your household becomes larger or smaller than what you originally put down on your application, you will need to report the change to make sure you receive the correct level of financial assistance.
Examples of household changes to report:
- Placement of a child into foster care
Note that the Marketplace counts foster children as part of your household. However, the income you receive as compensation for their care is not counted.
Changes to your health coverage
Finally, you need to notify the Marketplace if you or another household member experiences any changes with your current coverage. For example, report if:
- Your daughter or son turns 26 years old and can no longer be covered on your plan
- You lose your job-based coverage
- Your spouse is offered job-based coverage
- Your dependent mother or father begins receiving Medicare
How to report your major life change
There are a few ways to submit your updated information. If you enrolled through HealthSherpa, one of our consumer advocates can help you over the phone. You can contact someone from our team at (855) 772-2663.
If you enrolled through the Marketplace, there are two ways to submit your change. You can log into your healthcare.gov account and update your application. Or you can contact one of their customer service representatives at (800) 318-2596.
What else you need to know when reporting a major life change
There is no limit to the number of times you can report changes to the Marketplace about your income, members of your household, or changes in insurance eligibility.
You’ll get a new Marketplace eligibility notice after reporting a life change. This notice will tell you if your life change qualifies you for a different amount of financial assistance or makes you eligible for another type of coverage.
If you have any questions about whether to report changes to HealthSherpa or the Marketplace, contact the HealthSherpa Consumer Advocates team, who can explain the rules and how they apply to your situation.