How to Calculate Your Obamacare Tax Subsidy

Jenifer Dorsey
2018-11-09 November 7th, 2018 |
Read time: 4 minutes

If you’re planning to buy health insurance from HealthCare.gov or a state-based exchange, you may wonder if you’re eligible for a subsidy that helps lower your monthly premium.

The HealtheDeals.com Obamacare Calculator will help you:

  • Determine if you might qualify for a premium subsidy
  • Estimate your subsidy amount
  • Shop for your 2019 health insurance plan

It’s simple: Just enter your info and get your results.

To use the calculator, you will need your estimated household income, ZIP code, date of birth and ages of any additional family members who will be covered by your health insurance policy.

Estimate your premium subsidy now.

You must apply for subsidies when you enroll in health insurance through HealthCare.gov or a state-based exchange. Your actual premium tax credit amount will be determined at that time.

Who qualifies for premium tax credit subsidies?

Under the Affordable Care Act (ACA), also known as Obamacare, premium tax credits are available to low- and moderate-income families as a way to help make health insurance more affordable.1

The eligibility criteria are generally as follows; if you do not meet both of these criteria, you are unlikely to qualify for a premium tax credit2:

1. Your household income must be within 100 and 400 percent of the federal poverty level for your family size.

The 2018 federal poverty guidelines used to calculate 2019 subsidies can be found here: aspe.hhs.gov/poverty-guidelines. Learn more about the income limits for Obamacare subsidies.

2. You must buy your health insurance plan from HealthCare.gov or a state-based exchange.

Additional factors that influence your tax credit eligibility and amount include the following:

  • Medicaid expansion — If you live in a state that expanded its Medicaid program and earn up to 138% of the federal poverty level, you may not be eligible for subsidies because you are instead eligible for Medicaid.
  • Your state’s benchmark plan — Premium tax credit subsidies are based on the second-lowest cost silver plan (i.e., the benchmark plan) in your area.3 Those who meet the guidelines for an ACA tax credit will pay no more than 2.01 percent to 9.56 percent of their income toward health insurance premiums.4 As such, a change in benchmark rates can impact the amount of subsidy for which you are eligible and how much you will pay for coverage.

With so many variables in the health insurance market, including fluctuating premium rates and their impact on tax credits, it is important to compare your coverage options and recalculate your estimated premium tax credit amount each year.

Learn more about how tax credits are calculated.

Not eligible for a tax credit to help pay your health insurance premium?

If you don’t qualify for an Obamacare subsidy, you can shop for coverage through HealthCare.gov, through a state-based exchange, and in the private market.

Individual health insurance policies sold in the private market may vary from those offered through HealthCare.gov or a state-based exchange since not all carriers sell exchange-based policies and some carriers offer different policies in the private market. Compare your exchange-based and private market options to find the rate, network and policy benefits that best meet your budget and healthcare needs.

You can buy ACA-compliant, off-exchange coverage from:

  • Health insurance agents
  • Health insurance carriers
  • Websites that sell health insurance from multiple carriers

Additionally, you may want to consider buying supplemental health insurance or add-ons to health insurance to help reduce what you pay out of pocket for covered medical expenses.

Another coverage option if you don’t get a subsidy

If you don’t qualify for a tax credit to help lower your monthly premium, you may also want to explore alternative health insurance options including short-term health insurance  and hospital indemnity insurance. Alternative health insurance premiums may be more affordable, but you will have to gather quotes and compare them to determine whether or not this is true for you—also factor in what you will pay out of pocket when you do seek medical care.

While they do provide some benefits to help pay for unexpected medical expenses that result from illness or injury, the alternative health insurance options mentioned above are not ACA compliant, which means they do not include essential health benefits and may deny you coverage based on health history. Short-term health insurance and hospital indemnity insurance do not qualify as minimum essential coverage, which means enrolling in them will not prevent you from owing a tax penalty for the 2018 tax year. In 2019, however, the tax penalty will be repealed—learn more here.

Summary + next steps

Premium subsidies can help reduce your monthly health insurance payments. It’s easy to estimate your tax credit using tools like the healthedeals.com Obamacare Calculator.

Find a local agent now with Agent Finder. Whether or not you qualify for a subsidy, a local producer can help you shop for ACA-compliant major medical insurance as well as non-ACA-compliant supplemental and alternative insurance.

Whether or not you qualify for a premium subsidy, you may want to read about additional coverage options to help pay for out-of-pocket medical expenses.

Explore supplemental insurance options.

Learn about alternative health insurance.

See how health insurance add-ons work.

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
tool

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

Alternative health insurance and supplemental health insurance options are underwritten by Independence American Insurance Company, Madison National Life Insurance Company, Inc. and/or Standard Security Life Insurance Company of New York.

Originally Published On December 21st, 2015

Footnotes