He works part time and says he'd spend half his take-home pay buying a private policy. His wife makes a lot more, and the reader says he was told that because they're not divorced, his household income includes her pay, which puts him out of range for tax credits on the Affordable Care Act exchange.
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| Image: wikihow.com |
I thought I knew the answer (yes, but you can apply once the divorce goes through), but Madison Hardee of Legal Services of Southern Piedmont says it's not that simple.
"Marketplace eligibility for couples who are married but separated is complicated," she wrote. "You are correct that the marketplace asks consumers for their current marital status. However, at tax filing, the IRS will consider the marital status on December 31st of the tax year. For example, if a consumer is currently married and then gets divorced in July 2015, the IRS will consider that person unmarried for the entire 2015 tax year."
So if the reader, who asked that I not share his name, applies now, he'll presumably be denied any financial aid based on the combined income. And if he doesn't enroll in a plan before the Feb. 15 deadline, he won't automatically be eligible for special enrollment based on the divorce. But if he enrolls now, he can go back to HealthCare.gov after the divorce, report the change in income and select a new plan if he qualifies for subsidies, Hardee said.
Hardee is a lawyer who has been trained in ACA enrollment, so she added even more caveats based on special circumstances.
My takeaway: Anyone like this reader, who faces crucial decisions about paying for care, needs to hustle to take advantage of 10 more days of free assistance. Don't ask your neighbor or your aunt or even a reasonably well-informed reporter. Sit down with an expert who can review your individual circumstances and talk you through options.
To get free help in North Carolina, call 855-733-3711 or visit www.getcoveredamerica.org/connector. In South Carolina, call 888-998-4646 or visit www.signupsc.com. Don't dawdle; I'm hearing that appointments are filling up.
You can also call an insurance broker. Or do a walk-in at Get Covered Mecklenburg's last-minute enrollment event from 10 a.m. to 4 p.m. Feb. 14 at the Children and Family Services Center, 601 E. Fourth St.
Just don't kick yourself on Feb. 16 for procrastinating.