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Applying for ACA Coverage?
Understanding how small differences in projected income can have a large impact on your health plan costs can be key to obtaining affordable coverage.

modified adjusted gross income (MAGI)

What is MAGI or modified adjusted gross income?

healthinsurance.org health insurance glossary

Under the Affordable Care Act, eligibility for Medicaid, premium subsidies, and cost-sharing reductions is based on modified adjusted gross income (MAGI). But the calculation for that is specific to the ACA – it’s not the same as the MAGI that’s used for other tax purposes.

The details of the MAGI calculation are outlined here. For most enrollees, it’s the same as their adjusted gross income (AGI) from Form 1040. But there are three things that have to be added to AGI to get MAGI under the ACA. If you have them, you must add in these amounts:

  • Non-taxable Social Security benefits (this includes Social Security Disability Insurance benefits (SSDI), but Supplemental Security Income (SSI) does not get counted when the ACA-specific MAGI is determined)
  • Tax-exempt interest (typically earned on municipal bonds)
  • Foreign earned income and housing expenses for Americans living abroad

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Add ages of other family members to be insured.

Include yourself, your spouse, and children claimed as dependents on your taxes.

Modified Adjusted Gross Income (MAGI)

For most taxpayers, your MAGI is close to AGI (Line 11 of your Form 1040).

Estimated annual subsidy
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For Medicaid eligibility, some expenses can be subtracted, including scholarships and grants used for education, and certain American Indian/Native American income.

Income received as a lump sum is only counted as income in the month it’s received when determining eligibility for Medicaid (whereas it would be counted as part of an enrollee’s annual income for determining eligibility for premium subsidies), although there’s an exception for lottery and gambling winnings of $80,000 or more — those amounts can be counted as income spread out across up to 120 months.

If your MAGI is a little too high to qualify for health insurance premium subsidies, know that contributions to a pre-tax retirement account and/or a health savings account (HSA) will reduce your MAGI.

If you receive premium subsidies throughout the year (paid to your insurer on your behalf) based on your projected MAGI, the amount has to be reconciled on your tax return based on your actual MAGI for the year. But there’s no after-the-fact reconciliation process for Medicaid or cost-sharing reductions.

Calculate Yearly Income

Use this to calculate your household’s estimated yearly income. Consider including your income, your spouse’s income, and that of any tax dependents, all of which are usually counted by the Marketplace. After that, provide information about expenses that may be deducted.
Income
Add different income sources. If an individual gets an income from a source at different times during the year, enter it as multiple income sources.
Expenses
Add student loan interest, alimony, educator expenses, or IRA contribution this person pays, if any. Please note: these expenses are limited by IRS rules.

This calculator is for educational and illustrative purposes only and should not be construed as financial or tax advice. It uses the income and other information you provide. We included categories of income and expenses that the Marketplace commonly (but not always) uses. You should contact a tax advisor or other professional about any specific requirements or concerns.

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Your Estimated Yearly Income:

Click calculate to see updated yearly income

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