Obamacare Subsidies – Income Limits to Qualify

Jenifer Dorsey
2018-11-29 October 22nd, 2018 |
Read time: 2 minutes

Could you reduce your monthly health insurance premium or what you pay out of pocket for healthcare expenses covered by your major medical insurance policy?

Perhaps.

Premium tax credits and cost-sharing reductions available through the Affordable Care Act (ACA), which is also known as Obamacare, help many Americans lower their health insurance premiums and out-of-pocket costs. However, to take advantage of these subsidies, you must both1:

  1. Buy your individual major medical health insurance plan from a state-based or federally facilitated exchange, and
  1. Meet household income guidelines related to the subsidy, or subsidies, for which you apply.

Premium tax credits may be applied to plans of all metal levels; however, cost-sharing reductions are only available with a silver plan.2

Learn more about ACA premium tax credits and cost sharing reductions.

Begin Coverage in 3 Easy Steps!

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Step 2: Compare multiple plans
Step 3: Finish application online

Obamacare subsidy income limits

Premium tax credits and cost-sharing reductions have different income limits based on the federal poverty level (i.e., poverty guidelines). They are as follows:

  • Premium tax credits: 100 – 400% of the federal poverty level3
  • Cost-sharing reductions: 100 – 200% of the federal poverty level4

Your health insurance subsidy for the current year is based on the previous year’s federal poverty guidelines. That means 2019 subsidies are based on the 2018 U.S. federal poverty guidelines, which are published in the Federal Register. Current information about poverty thresholds and poverty guidelines may also be found at https://aspe.hhs.gov/poverty-guidelines.

The 2018 poverty guidelines show that $12,140 is the poverty threshold for a one-person household.5 Based on these numbers alone, 100% to 400% of the federal poverty level for a single person would be $12,140 to $48,560. However, this person may or may not be eligible for a premium tax credit.

Learn more about the federal poverty level.

Other subsidy eligibility factors

You should be aware that your subsidy eligibility may be impacted by the state you live in due to Medicaid expansion decisions and other savings programs available there.6 Furthermore, state benchmark plans (i.e., the second lowest cost silver plan) can also impact subsidy amounts and eligibility.7 You can estimate your premium tax credit using online calculator tools such as the one available through www.healthedeals.com.

Summary + next steps

To verify your final eligibility, you’ll need to apply for health insurance coverage and subsidies through your state-based or federally facilitated Obamacare exchange—either on your own or with the help of a producer.

If you have questions about the subsidies available to you or need assistance shopping for health insurance, call 888-258-6270 to speak with an agent from Health eDeals.

Use Agent Finder to search for local assistance.

Current information about poverty thresholds and poverty guidelines may also be found at https://aspe.hhs.gov/poverty-guidelines.

2019 Health Insurance Open Enrollment:
Nov 1 - Dec 15

Blog

What's New for the ACA + Open Enrollment this Year?

Get the latest news and updates.

Go to the ACA Blog
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Do You Qualify For A Subsidy?

Use the Obamacare Calculator to find out.

Calculate Subsidy

Is Obamacare Mandatory in 2019?

The tax penalty is repealed beginning Jan. 1, 2019. That means you can explore alternative health insurance options without paying the individual mandate tax.

Obamacare Alternatives
FAQ

Got questions about the ACA (also known as Obamacare)? Get the answers here! 

Obamacare FAQ

Individual Health Insurance in Your State

When it comes to enrolling in Obamacare, or any individual health insurance plan like short-term medical or dental insurance, you'll have to validate the costs and options available in your state. 

Begin Coverage in 3 Easy Steps!

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Step 1: Get a quote within seconds
Step 2: Compare multiple plans
Step 3: Finish application online

Originally Published On December 5th, 2016

Footnotes