What are the penalties for overestimating your income if it allows you to obtain a cost reduction marketplace plan if you end up not qualifying for the plan or to be on the marketplace?

What are the penalties for overestimating your income if it allows you to obtain a cost reduction marketplace plan if you end up not qualifying for the plan or to be on the marketplace?

I’m going to explain this as best I can. If you have any questions, please let me know. Sorry for the length.

I have zero income because I can’t work due to illness. I have not even started the disability application process and won’t for at least a year. I am in a state with no Medicaid expansion and I do not qualify for Medicaid where I am at this time.

I applied last year for a marketplace plan. I was waiting on settlements on a filed lawsuits (personal injury), a non-filed but prospected to have been filed this year lawsuit, and backpack (not related to the lawsuits) I was owed. I had zero idea what the exact amount would be at all, and my estimation based on what I thought it would be was an amount that got me a cost reduction plan. I decided not to take the subsidy I was owed and pay the entire monthly premium because I didn’t want to owe money at the end of the year if it came to that.

One of the lawsuits settled at the beginning of the year and would have put me just under the threshold of qualifying for marketplace coverage, a subsidy, and cost reduction plan. However, I was still anticipating the back pay and other lawsuit, so I thought it would go over the threshold and I would qualify based on my estimate. Every time I was due to submit documents proving my income, I changed my income on my account to a number close to what I had originally estimated and kept my plan. I have had to do this 3 times this year.

At this point at almost the end of the year, I have just found out that I most likely cannot use the settlement I received as income for the marketplace because it’s considered as not taxable income, although I have to consult with a professional about this. I also will not see any settlement for the other lawsuit until at least next year if not longer, and I really don’t know exactly when it’ll be. I am still waiting for the back pay and have no idea when I will get it, if at all because it’s proving much harder to get than I originally thought. I am due to submit documents proving my income soon to the marketplace, but I don’t know what to do.

I obviously have nothing to submit and I don’t want to change my income online to a number I can’t justify anymore. I don’t know whether to just not submit anything and not change my income online, to change my income online to zero, or put in the estimated income for the back pay even though it will be under the threshold to qualify for a marketplace plan.

Whatever I do, I will no longer qualify for my marketplace cost reduction plan because I didn’t make enough and I don’t know what will happen: will I lose my plan and be put on another plan with much higher co-pays, will I not lose my plan, will I just lose health coverage all together? And this isn’t even my biggest worry, my biggest worry is getting in trouble and/or getting a penalty for overestimating and qualifying for a cost reduction plan I don’t qualify for. Not knowing when I will get the back pay and other lawsuit settlement because I thought it would be filed this year and possibly settled until recently and making estimates based on that throughout the year to keep my coverage was not my fault, but I do feel that not realizing that I couldn’t use the income from the personal injury settlement as income until now was my fault and I’m worried about getting in trouble for it. Again, I’m not taking the subsidies and paying the full price of the monthly premiums to avoid having to pay them back, but I’m worried about getting in trouble for getting a cost reduction plan I didn’t qualify for.

And on top of it, I don’t know what to estimate my income for next year to get a marketplace or if I even should and should just go on a non cost reduction full price plan to avoid getting in potential trouble even if I will end up qualifying for the cost reduction plan? I am anticipating if I do get the back pay, it’ll be next year and I am anticipating that if I do file and settle the other lawsuit next year that it’ll earn me enough money to qualify for a marketplace plan, but I honestly don’t know what the settlement will be and how much of it will be taxable at this time. So if I estimate right at the threshold to get on the marketplace and get a cost reduction plan, I could get in trouble if I change my income throughout the year to a number close to it because these issues still aren’t resolved when it’s time for me to either submit documents or change my income.

I’m just lost. I cannot afford at this time to be on a non cost reduction plan because the deductibles and co pays are more than I can afford, I have zero idea how to estimate my income with my situation, but I also don’t want to get in trouble for all of this.