Eligibility for financial assistance, like advance premium tax credits (APTC) and cost-sharing reductions (CSR), is based on the 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.
Whose income to include in your estimate
For most people, a household consists of the tax filer, their spouse if they have one, and their tax dependents, including those who don't need coverage.
Virginia's Insurance Marketplace counts estimated income for all household members who are required to file a tax return.
What income is counted
Virginia's Insurance Marketplace uses an income number called modified adjusted gross income (MAGI) to determine eligibility for APTC and CSR.
The chart below shows common types of income and whether they count as part of MAGI. If you expect to earn income types not shown or have additional questions, see details on what the IRS counts as income.
Types of income to include in your estimate
|
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. |
|
Tips |
Yes |
|
|
Self-employment income |
Yes |
Include "net self-employment income" you expect — what you'll make from your 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 |
This includes regular Unemployment Insurance (UI) and Pandemic Unemployment Insurance. |
|
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. |
|
Child support |
No |
|
|
Capital gains |
Yes |
|
|
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 |
|
|
Gifts |
No |
|
|
Supplemental Security Income (SSI) |
No |
But do include Social Security Disability Income (SSDI). |
|
Veterans' disability payments |
No |
|
|
Worker's Compensation |
No |
|
|
Proceeds from loans (like student loans, home equity loans, or bank loans) |
No |
|
Reporting changes to your income
It is important to report any changes to your income that your household experiences throughout the year, like additional wages as the result of a promotion or if a family member adds a new source of income, within 30 days of the change. If you don't report changes in income, you could miss out on financial assistance you may be eligible for or wind up having to pay money back when you file your federal tax return for the year.