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Eligibility for Health Insurance Subsidies

eligibility for health insurance subsidies

Eligibility for health insurance subsidies is based on income and other factors that will be highlighted in this post. No less than 9.8 million Americans have been confirmed to qualify for premium subsidies in 2018. With each successive open enrollment period, there has been increase in the awareness of ACA’s premium tax credits, otherwise known as subsidies. This post will further explain the concept of health insurance subsidies, highlight the eligibility for health insurance subsidies and help you determine the amount of subsidy you can get.

What is a Health Insurance Subsidy?

What is a health insurance subsidy?” A health insurance subsidy is a financial assistance given by the government to enable people have access to affordable health care. It’s not a loan that is expected to be paid back. Subsidies offered by the federal government for individual health insurance plans are of two kinds. They are:

• The Advanced Premium Tax Credit which helps to reduce an individual’s monthly health insurance payment, or premium.
• Cost Sharing Reduction which helps to lower your out-of-pocket costs. It includes deductible, coinsurance and copays.
Typically, you apply for a subsidy when you buy your health plan.

How Health Insurance Subsidies Work

Having understood the concept of subsidies, it is a good idea to know how health insurance subsidies work. Health insurance subsidies are based on the Federal Poverty Level (FPL) as the government decides who and who is entitled to it based on some factors like income and family size. Note that it is not compulsory for you to be at the poverty level in order to receive health insurance subsidies. You will still be considered for subsidies even if your income is four times greater than the FPL. Here are the five subsidies levels:

i. Your income is 138% of the FPL, making you eligible for Medicaid.
ii. Your income is 150% of the FPL. Your subsidy becomes larger as you get closer to the poverty level.
iii. 200% of the FPL (twice the poverty level).
iv. Your income is 250% of the FPL
v. Your income is 400% of the FPL. This is four times the poverty level.

Eligibility for Health Insurance Subsidies

Your eligibility for health insurance subsidies depends on:

• Your income- in comparison with the Federal Poverty Level.
• The size of your family.
• The cost of health insurance where you reside.

Your income is the most critical factor. You will be eligible for a health insurance subsidy if you make up to four times the Federal Poverty Level. This amounts to $47,000 for an individual and $97,000 for a family of four. Assuming what you make is about $29,000 or less, or as a family of four, makes about $60,000 or less, you may be eligible for both subsidies.

How Much Of A Subsidy Can I Get?

Many people, having discovered their eligibility for health insurance subsidies keep asking “how much of a subsidy can I get?” Subsidies are calculated based on the cost of a silver insurance plan, which is among the four levels of insurance on the health insurance marketplace. It guarantees that an individual does not pay beyond 9.5% of his or her income for the second lowest Silver plan. You can calculate this by determining that cost and subtract 9.5 percent of your income from it. You don’t need to worry about calculations as the exchange figures it all out for you.

For more information please call ObamacareQuotes today at (800) 811-2640