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What are Subsidies?

An important part of the Affordable Care Act was the creation of subsidies. Subsidies -- officially known as the “Advanced Premium Tax Credit” -- are like “discounts” that are applied directly to your health care costs.

The amount of the subsidy you may qualify for depends on several factors:

  • Your age
  • Your household income
  • Number of people in your household
  • Where you live
  • Whether or not you smoke

Any subsidy you receive can either be applied toward the monthly rate of the plan you choose, or you can take it as a lump sum credit on your federal income tax return. It can also be used to help you pay for out-of-pocket medical expenses like deductibles, co-pays, etc.

Qualifications for Subsidies

In general, the lower your household income, the greater the subsidy you will receive to help you pay for your health care costs. Please review the tables below to determine if you could qualify for a subsidy.

If you live in any one of the 48 Continental States:

You can qualify for a subsidy on both your premium and out-of-pocket costs if your income falls into one of the below ranges:

# of People in household Household Income Range
1 $11,670 to $46,680
2 $15,730 to $62,920
3 $19,790 to $79,160
4 $23,850 to $95,400
5 $27,910 to $111,640
6 $31,970 to $127,880
7 $36,040 to $144,120
8 $40,090 to $160,360

If you live in Alaska:

You can qualify for a subsidy on your premium if your income falls into one of the below ranges:

# of People in Household Household Income Range
1 $14,580 to $58,320
2 $19,660 to $78,640
3 $24,740 to $98,960
4 $29,820 to $119,280
5 $34,900 to $139,600
6 $39,980 to $159,920

If you live in Alaska:

You can qualify for a subsidy on your premiums and out-of-pocket expenses if your income falls into one of the below ranges:

# of People in Household Household Income Range
1 $14,580 to $36,450
2 $19,660 to $49,150
3 $24,740 to $61,850
4 $29,820 to $74,550
5 $34,900 to $87,250
6 $39,980 to $99,950

If you live in Hawaii:

You can qualify for a subsidy on your premium if your income falls into one of the below ranges:

# of People in Household Household Income Range
1 $13,420 to $53,680
2 $18,090 to $72,360
3 $22,760 to $91,040
4 $27,430 to $109,720
5 $32,100 to $128,400
6 $36,770 to $147,080

If you live in Hawaii:

You can qualify for a subsidy on your premiums and out-of-pocket expenses if your income falls into one of the below ranges:

# of People in Household Household Income Range
1 $13,420 to $33,550
2 $18,090 to $45,225
3 $22,760 to $56,900
4 $27,430 to $68,575
5 $32,100 to $80,250
6 $36,770 to $91,925

If your income is less than the numbers below, you may qualify for Medicaid or a Catastrophic Plan depending on which state you live in:

# of People in Household Household Income Range
1 Less than $16,243
2 Less than $21,983
3 Less than $27,724
4 Less than $33,465
5 Less than $39,206
6 Less than $44,497

For more information on Medicaid, please visit: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Eligibility.html

If you are unsure about subsidies, we can determine your eligibility during the application process. To get started please enter your zip code and fill-in the 1-page form. You can also call (855) 604-7061 to speak to an agent.

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[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

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HealthPlans.org is operated by QuoteLab, LLC, which is an independent broker and is not a federal or state insurance Marketplace or other website. It does not provide access to any federal or state marketplace or exchange. This website is owned and operated by QuoteLab, LLC, a licensed insurance agency, NPN #19911386. Invitations for application for health insurance are made through QuoteLab, LLC, only where licensed and appointed. License numbers are available upon request and are provided where required by law. QuoteLab's license information can be found at https://www.quotelab.com/licenses.html.

This website does not provide information about specific health plans, or enable visitors to obtain insurance quotes, on this website. However, if you provide your information and consent, we will transfer your information to insurance carriers and brokers that may contact you to offer Affordable Care Act (ACA) plans, short-term plans, medical indemnity plans and/or healthcare sharing ministry plans, and we will receive compensation for such transfer. The advertisements appearing on this website are placed by clients from which QuoteLab, LLC receives compensation, and such compensation may impact whether such advertisements appear on this website and the order in which they appear.

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Note that even with a $0 premium Medicare Advantage plan, you'll still pay a monthly premium for Part B, and a Part D premium if your Medicare Advantage plan does not include prescription drug coverage (MA-PD).

Allowance Disclaimer: Allowance amounts cannot be combined with other benefit allowances. Limitations and restrictions may apply.

** Members may receive a monthly or quarterly allowance in the form of a benefits prepaid card to pay for a wide range of approved groceries and utilities. Unused amounts will expire at the end of the month or quarter.

*The benefits mentioned are Special Supplemental Benefits for the Chronically Ill (SSBCI). You may qualify for SSBCI if you have a high risk for hospitalization and require intensive care coordination to manage chronic conditions such as Chronic Kidney Diseases, Chronic Lung Disorders, Cardiovascular Disorders, Chronic Heart Failure, or Diabetes. For a full list of chronic conditions or to learn more about other eligibility requirements needed to qualify for SSBCI benefits, please refer to Chapter 4 in the plan’s Evidence of Coverage.

Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.

1Transportation services are issued as one-way trips and provided on an annual basis. Benefits vary by plan.