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Health & Fitness

Health care Q&A: Would divorce increase eligibility?

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Published:   |   Updated: August 11, 2013 at 12:59 PM

You’ve been hearing about national health care reform for a long time, and for the most part politicians have been doing the talking. But now, The Tampa Tribune wants to break down what the national Affordable Care Act means for you.

This fall’s launch of the online insurance exchange, or Health Insurance Marketplace, is the biggest move so far. Millions of Americans will be able to get health insurance through the program. Many others, however, will be mostly unaffected and will keep the existing health insurance they have through their employer. And maybe you have no idea where you stand.

Starting today, we will be featuring one question and answer about the Affordable Care Act — what it means to individuals, business owners, families, etc. — each Monday in the Tribune, but you can check out more at TBO.com/health, or submit a question of your own on the website.

This week, we heard from a couple wondering if they can catch a financial break on their insurance if they end their marriage.

Question: I’m a 61 year-old “pre-retiree” paying for my own coverage. My wife is on Medicare already, but has considerable investment income. We are considering obtaining a divorce so that I may be single as of Dec. 31, making only $20,000 annual earned income. This should gain me the maximum health insurance subsidy rebate, or whatever they call it, as it would otherwise be severely limited as a family of two looking only at AGI (annual gross income). I understand I will be purchasing through the federal exchange. My question is, will I have to make some sort of income-based application once I have filed my 2013 taxes and, most importantly, will that qualify me for the 2014 subsidy amount? All other considerations have been made, and we already plan to re-marry once I’m on Medicare. I look forward to your answer to my question!

– Lee from Largo

Answer: I’m no Dear Abby, so I’m steering clear of the whole relationship part of this question. But I can tell you what will happen regarding eligibility and subsidies.

Regardless of your marital status, you will be eligible to buy insurance off the Health Marketplace, which opens for consumers on Oct. 1.

In general, if an individual makes less than $48,000 a year, there will be some financial help to cover the monthly premium. Your $20,000 estimate if you are single (129 percent of the federal definition of poverty) would qualify for a larger subsidy than someone making twice that.

Here’s a good resource for you: The Kaiser Family Foundation has developed a great subsidy calculator (http://kff.org/interactive/subsidy-calculator/) that predicts subsidies based on your specific information and general cost estimates that already have been released. Just be aware that it’s a general estimate.

mshedden@tampatrib.com

(813) 259-7365

Twitter: @MaryShedden

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