Health Insurance After Quitting

Your Monthly Coverage Cost Worksheet

Companion to the lessons "How Subsidies Work Now" and "Three Worked Cases"

1. Calendar-Year MAGI Builder

The application wants household MAGI for the full calendar year. Net, always: self-employment income counts after business expenses ($30,000 of invoices with $12,000 of costs is $18,000 of income). The whole calendar counts; the tax household counts.

LineWorked case (Priya)Your numbers $
Wages through your last daycounted
Severance or payoutcounted
Unemployment benefitscounted
Interest and dividendscounted
Spouse's salary (if filing jointly)counted
Net profit from the business (after expenses)to $30,000 total
Estimated household MAGI, full year$30,000

2. FPL Placement

2026 coverage uses the 2025 federal guideline: $15,650 single (400% = $62,600); $84,600 for a household of two at 400%. Priya: $30,000 / $15,650 = 192% of poverty.

Your MAGI: $ / poverty line $ x 100 = % of poverty

3. Required-Contribution Calculation (2026 scale, IRS Rev. Proc. 2025-25)

Income as percent of povertyYou pay, as percent of incomeInterpolation note
Under 133%2.10%
133% to 150%3.14% to 4.19%
150% to 200%4.19% to 6.60%Priya at 192% lands about 6.2%
200% to 250%6.60% to 8.44%
250% to 300%8.44% to 9.96%
300% to 400%9.96%Marcus at 396%: full 9.96%
Above 400%No subsidy at any priceThe cliff

Annual share: MAGI $ x % = $ /yr   Monthly: $ /mo (Priya: $30,000 x 6.2% = $1,860/yr = $155/mo)

4. Benchmark Share and Subsidy

LineWorked caseYour numbers
Benchmark silver premium (second-lowest-cost silver in your area)$625/mo$  
Your required share (from section 3)$155/mo$  
Monthly subsidy (benchmark minus share)$470/mo$  
Apply it anywhere: a $456 bronze with a $470 subsidy$0/mo$  
Cost-sharing reductions (below 250% of poverty, silver only)deepest shrink the average silver deductible to $80 vs the standard $5,304☐ applies to me

5. The Cliff Check ($62,600 single / $84,600 for two)

At $62,600 a single 40-year-old pays no more than 9.96% for the benchmark, about $519/mo. At $62,601 the subsidy is zero and the benchmark costs its full price (national average $625/mo in 2026). One dollar of extra income can cost over a hundred dollars a month in premium. Marcus worked both sides: $62,000 = $515 benchmark share, $110 subsidy, $346 bronze; $63,000 = subsidy zero, $625 benchmark, $456 bronze, about $1,320/yr of damage from $1,000 of extra income.

Cliff distance: $62,600 (or $84,600 for two) minus my estimate = $

Since 2026 the repayment caps are gone: excess advance subsidy is repaid in full at tax time (a $60,000 estimate landing at $66,000 owes back roughly $1,500). The one surviving exception: if actual income would have made the household Medicaid/CHIP eligible, no repayment. Overestimating is the safe error: a $70,000 projection finishing at $45,000 collects the correct subsidy as a refundable credit.

6. December Correction Box

The cliff is measured on the calendar year, and by November you usually know. If the year is landing over the line: choose a cheaper metal, price the spouse plan, or hold the COBRA option differently, all inside open enrollment (November 1 to mid-January).

MonthUpdated MAGI estimate $Distance from cliff $Marketplace updated?
 
 
November