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The Affordable Care Act (Obamacare): If You Have Health Insurance

Premium And Cost-Sharing Subsidies For Individuals

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2/19

For health insurance purchased through an Exchange:

Premium Credits: There are refundable and advance-able premium credits to eligible individuals and families with incomes between 133-400% of the Federal Poverty Level offsite linkto purchase insurance through the Exchanges.

The amount of the premium credits are:

  • Tied to the second-lowest cost silver plan offered by an Exchange in the area.
  • Set on a sliding scale.
  • Adjust each year to reflect changes in the consumer price index. offsite link

Cost Sharing subsidies: There are cost-sharing subsidies to eligible individuals and families. NOTE: If you receive a health subsidy, it is required that you file a form 8962 to your individual income tax return. Failure to file this form could result in making you ineligible for subsidies next year.

Premium Credits and Cost Sharing Subsidies and Abortion: Neither federal premium or cost-sharing subsidies can be used to purchase coverage for abortion beyond saving the life of the woman or in cases of rape or incest.

Eligibility:

  • Eligibility is limited to U.S. citizens and legal immigrants who meet income limits.
  • Employees who are offered coverage by an employer are not eligible for premium credits unless the employer plan does not meet minimum standards or if the employee share of the premium exceeds 9.5% of the employee's income.
  • Legal immigrants who are barred from enrolling in Medicaid during their first five years in the U.S. will be eligible for premium credits.

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