QUESTION

How do I project my household size/income for next year if I’m pregnant now? I’m married and this pregnancy will be our first child. We want to find subsidized coverage in the marketplace.

Individuals with no coverage | How Premium Tax Credits And Cost-Sharing Reductions Work
ANSWER

This fall you and your husband will apply as a household of two. When the baby is born, you must update your family information with the marketplace within 30 days to reflect that you have become a household of three. The birth of a baby is a qualifying life event that entitles you to a special enrollment period. At that point, you may qualify for a larger premium tax credit. For example, in 2018, if you and your spouse together earned $30,000, as a household of two you would be required to contribute 6.34 percent of your household income toward the premium, or $190/month, for the benchmark plan in the marketplace. This is because your income is at least 150 percent of the federal poverty level, but less than 200 percent of the federal poverty level. Once the baby is born and you are a household of three, you would only be required to contribute 4.03 percent of your income, or $121/month. With your income and the expansion of your household, your household will be less than 150 percent of the federal poverty level. (26 C.F.R. § 1.36B-3; 45 C.F.R. § 155.330; IRS, Rev. Proc. 2017-36).

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