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Who qualifies for a subsidy on health insurance under Obamacare (Affordable Care Act)?

  • do you qualify if you meet all these parameters mentioned so far, but, your overall wealth is over 400,000.00?
  • At this time, it  is income based only and not based on net worth. Most likly due to  the reporting being on an income tax return.
  • TurboTaxRic: so if people on Medicare aren't eligible for "tax credits" on their premiums, are they also not eligible for "subsidies" for co-insurance, co-payments, and deductibles???
  • People on Medicare aren't eligible for the Exchange plans (or their provisions) at all.

Under the Affordable Care Act (also known as Obamacare), you may be eligible for help paying for health insurance with the new premium tax credit, which many people are calling a subsidy.


You can qualify for financial assistance if:

•   Your income falls between 100% and 400% of the Federal Poverty Level; and

•   You are not eligible for Medicare, Medicaid, or the Children's Health Insurance Program (CHIP); and

•   Your employer does not offer affordable coverage.

 

Depending on your income and family size, the financial assistance can lower your health care premiums and/or lower your out-of-pocket costs, such as co-pays and deductibles.


When you apply through the online marketplace, which opened October 1, you'll find out your exact costs and savings. You can also find out if you qualify for Medicaid coverage under the new, expanded 2014 rules. Find your health insurance marketplace.


Want to get an idea of your future insurance costs and subsidy? You can get a quick estimate here.

  • Tax credit is given at the end of the year, right? And insurance premiums are monthly, correct? So, government won't be subsidizing it on a monthly basis but annually. This would make it difficult for many to afford.
  • The government will subsidize monthly in advance paid directly to the insurance company.   They are called Advance Premium Tax Credits.    At the end of the year you will have to reconcile, and if you made too much income, then you'll have to repay some/all of the subsidy.  If  you made less income than you expected, then you may get some additional refundable tax credit at the end of the year.   i.e., it's sort of an "honor system" based on what you anticipate your income will be for that year, and the govt. provides the tax credit in advance (if you choose) by paying the insurance company.     You can choose how much of your tax credit to apply each month, or you can choose to wait and get your tax credit back at the end of the year and not use the  monthly advance credit.

    Read more at:
    https://www.healthcare.gov/glossary/premium-tax-credit/
  • Though people are calling the tax credit a subsidy, there is a distinction.  Whereas the tax assistance credit applies to premiums, and may be applied ahead, subsidies are applied to coinsurance, copayments, and deductibles.  Credits offset premiums.  Subsidies offset costs other than premiums.
  • Here is a good resource by State that was just published:
    http://www.nytimes.com/interactive/2013/09/24/us/health-care-premiums.html?ref=politics
  • (I'm not sure which section I'm supposed to add my question)...
    TurboTaxRic: so if people on Medicare aren't eligible for "tax credits" on their premiums, are they also not eligible for "subsidies" for co-insurance, co-payments, and deductibles???
  • Sad but true, if you are on Medicare the ACA does  nothing for you.
  • AZ, that is correct.  The Cost-Sharing Subsidies are only available when you purchase a Silver-Level Plan.  That is, unless you are an Indian.  Then, those subsidies apply to any plan.  So if you have Medicare, you are not eligible for subsidies or a credit.