When you fill out your Maine Health Insurance Marketplace application, you’ll need to look into your crystal ball and estimate what your household income is likely to be for the coming year.
Marketplace savings are based on your expected household income for the year you want coverage, not last year’s income.
You must make your best estimate so you qualify for the right amount of savings.
You will have the option to enter your income as monthly or yearly.
If your income is different from previous years, you will be asked for documentation to explain the difference.
Need help? Use this estimated income calculator to create your document.
Whose income is included in your estimate?
For most people, a household consists of
- the tax filer (You)
- your spouse (if you are legally married and plan to file a joint tax return)
- and your tax dependents, including those who don’t need coverage.
The Marketplace counts estimated income of all people in your “tax-household”, not your ACTUAL household.
So if you are not legally married then you are both a household of 1. And if you have an adult child or friend living with you and they are not claimed as dependents on your taxes, that person is not included in your tax-household because they may file their own tax return so do not include their income in your estimate.
What income is counted?
The Marketplace uses an income number called modified adjusted gross income (MAGI) to determine eligibility for savings.
The chart below shows common types of income and whether they count as part of MAGI. If you expect income types not shown or have additional questions, see details on what the IRS counts as income.
|Income type||Include as income?||Notes|
|Federal Taxable Wages (from your job)||Yes||If your pay stub lists “federal taxable wages,” use that. If not, use “gross income” and subtract the amounts your employer takes out of your pay for child care, health insurance, and retirement plans.|
|Self-employment income||Yes||Include “net self-employment income” you expect — what you’ll make from your business minus business expenses. Note: You’ll be asked to describe the type of work you do. If you have farming or fishing income, enter it as either “farming or fishing” income or “self-employment,” but not both.|
|Unemployment compensation||Yes||Include all unemployment compensation, including unemployment compensation as a result of the coronavirus disease 2019 (COVID-19) emergency.|
|Social Security||Yes||Include both taxable and non-taxable Social Security income. Enter the full amount before any deductions.|
|Social Security Disability Income (SSDI)||Yes||But do not include Supplemental Security Income (SSI).|
|Retirement or pension Income||Yes||Include most IRA and 401k withdrawals. (See details on retirement income in the instructions for IRS publication 1040). Note: Don’t include qualified distributions from a designated Roth account as income.|
|Alimony||Depends||Divorces and separations finalized before January 1, 2019: Include as income. Divorces and separations finalized on or after January 1, 2019: Don’t include as income.|
|Investment income||Yes||Include expected interest and dividends earned on investments, including tax-exempt interest.|
|Rental and royalty income||Yes||Use net rental and royalty income.|
|Excluded (untaxed) foreign income||Yes|
|Economic Impact/Stimulus Payments (come from the IRS as a result of the COVID-19 emergency)||No|
|Supplemental Security Income (SSI)||No||But do include Social Security Disability Income (SSDI).|
|Veterans’ disability payments||No|
|Proceeds from loans (like student loans, home equity loans, or bank loans)||No|