Beat the Squeeze: ACA Income Planning for Pre-Medicare Retirees

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Are you currently retired or planning on retiring before Medicare begins at age 65? If so, congratulations! If you have the ability to retire in your early 60s, chances are that you’ve saved aggressively over the years and have prepared well for retirement. In our experience, the top concern or area of stress for those retiring before 65 is the potential cost of health insurance and the impact it could have on their long-term financial plan.

Prior to the Affordable Care Act (ACA), private health care for those in their early 60s could be rigid and very expensive. Since the ACA was signed into law in 2010, a lot has changed. While certainly not perfect, the ACA now allows individuals to obtain private health insurance, the premiums of which are based on their current or projected income for the upcoming year.

If your income is within a certain percentage of the federal poverty level, you will receive a subsidy on your monthly health insurance premiums. Through recent legislation, these income parameters have substantially expanded, now benefiting individuals and couples with income levels that would previously disqualify them from receiving any subsidy on their health insurance premiums.

Open enrollment for ACA plans typically runs from early November until mid-January. When applying for coverage, you must estimate your income level for the upcoming year. From this information, your potential subsidy is determined.

If your actual income level is higher than projected, you will have to pay back a portion (or potentially all) of your subsidy. Your payback amount will depend on how much higher your income is as compared to your original projection. This determination occurs when you file your taxes for the year. On the flip side, if your income is lower than initially projected, you’ll be entitled to the higher subsidy amount you should have received all along (once again, determined when you file your taxes and received as a tax credit).

If you are someone who has saved very well in preparation for your retirement, you likely have various forms of retirement/investment accounts as well as future fixed income sources, which create retirement income flexibility for you. This flexibility makes it possible to structure a “retirement paycheck” that assures your spending needs are met but with significantly less income reported on your tax return. We call this “ACA income planning,” and it allows you to structure your income in a way that could help save you tens of thousands of dollars in reduced health insurance premiums! Read on as we dive into the details of the key elements of ACA income planning to see if this concept could make sense for you.

Overview of Income Sources

As discussed above, the premiums you pay for pre-65 health insurance are based on your projected modified adjusted gross income (MAGI) for the upcoming year. Because of this, it’s important to understand what constitutes as income in the first place:

  • Employment/Earned Income: Will generally be 100% included in your MAGI for the year.

  • Pension Income: Will generally be 100% included in your MAGI for the year.

  • Social SecurityWhile you may not pay tax on your full Social Security benefit, your ENTIRE monthly benefit (taxable and non-taxable component) is included in your MAGI for ACA income determination purposes.

  • Traditional IRA/401(k)/403(b) Distributions: Because these retirement accounts were funded with pre-tax income, distributions will generally be 100% taxable and included in MAGI.

  • Roth IRA Distributions: Because this retirement account was funded with after-tax dollars, distributions will NOT be taxable or included in MAGI (certain rules such as attaining age 59 ½ and having the Roth IRA open for at least five years will come into play, however).

  • After-Tax Investment or “Brokerage” Account: Unlike 401(k) or Roth IRAs, these accounts are not tax-deferred and were initially funded with after-tax dollars. Capital gains, dividends, and interest (even tax-free, municipal bond interest) produced by the investments within this account will be included in MAGI. However, funds withdrawn from this account that have previously been taxed (the cost basis) will NOT be included in MAGI.

  • Cash: Similar to an after-tax investment/brokerage account, funds initially deposited into a cash account, such as checking or savings, have already been taxed. Because of this, when funds are withdrawn from your checking/savings account for spending, these dollars are NOT included in MAGI.

  • For even more details on various income sources and how they can impact MAGI, please click HERE.

Intentional Distribution Strategy

Because drawing from different accounts will have drastically different tax consequences, it is imperative to have a sound retirement income plan in place while on an individual health care plan before Medicare.

Consider a retired married couple in their early 60s who have saved into other accounts besides 401(k)s or IRAs (e.g., Roth IRAs or after-tax brokerage accounts). Some significant tax and health insurance premium planning opportunities could exist. In many cases, it could be wise for them to spend less out of their pre-tax IRA or 401(k) accounts during this time and take more funds out of Roth IRAs or an after-tax brokerage account. By doing so, income hitting their tax return would likely be significantly less compared to drawing the majority of income from the IRA or 401(k). This, in turn, could qualify them for large health insurance premium subsidies that could save them tens of thousands in the years leading up to Medicare.

Conclusion

As with any retirement income planning strategy, multiple factors must be considered, and the above example is certainly not a one-size-fits-all approach. If you find yourself in this window, where you are on an individual plan before Medicare, I encourage you to discuss your retirement income plan with your adviser. Not doing so could end up costing you thousands in unnecessary tax and insurance premiums.

Nick Defenthaler, CFP®, RICP®, is a Partner and CERTIFIED FINANCIAL PLANNER™ professional at Center for Financial Planning, Inc.® Nick specializes in tax-efficient retirement income and distribution planning for clients and serves as a trusted source for local and national media publications, including WXYZ, PBS, CNBC, MSN Money, Financial Planning Magazine and OnWallStreet.com.

Securities offered through Raymond James Financial Services, Inc., member FINRA/SIPC. Investment advisory services are offered through Center for Financial Planning, Inc. Center for Financial Planning, Inc. is not a registered broker/dealer and is independent of Raymond James Financial Services.

The foregoing information has been obtained from sources considered to be reliable, but we do not guarantee that it is accurate or complete. Any opinions are those of Bob Ingram, CFP® and are not necessarily those of RJFS or Raymond James. Raymond James Financial Services, Inc. and its advisors do not provide advice on tax issues, these matters should be discussed with the appropriate professional.

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