California offers Silver 73/87/94 for lower income people to reduce their deductible and out of pocket max. What happens if someone signs up for, say, a silver 94 plan which has very low deductible, and then gets a better job (or wins the lottery or whatever) so their actual income ends up higher than Silver 94 would allow? Is there a penalty? Does the person have to pay back the deductible that he/she would’ve had to pay had they chosen the normal Silver 70 plan?
Otherwise, it seems like there is a loophole — anyone can claim that they think their annual income is $19321 (which is the bottom cutoff for Silver 94), get very good coverage, and say at the end of the year “oops, I guess I earned more” and only pay for the extra premium (not the deductible they didn’t pay).
submitted by /u/gruntastics
[link] [comments]California offers Silver 73/87/94 for lower income people to reduce their deductible and out of pocket max. What happens if someone signs up for, say, a silver 94 plan which has very low deductible, and then gets a better job (or wins the lottery or whatever) so their actual income ends up higher than Silver 94 would allow? Is there a penalty? Does the person have to pay back the deductible that he/she would’ve had to pay had they chosen the normal Silver 70 plan? Otherwise, it seems like there is a loophole — anyone can claim that they think their annual income is $19321 (which is the bottom cutoff for Silver 94), get very good coverage, and say at the end of the year “oops, I guess I earned more” and only pay for the extra premium (not the deductible they didn’t pay). submitted by /u/gruntastics [link] [comments]Read Morer/HealthInsurance