Will I qualify for lower costs on monthly premiums?
When you get health insurance coverage in the Marketplace, you may be able to get lower costs on monthly premiums. This depends on your income and family size.
Pay lower costs for premiums each month
In the Health Insurance Marketplace you may be able to lower the costs of your health insurance coverage by paying lower monthly premiums. You'll see the amount of savings you’re eligible for when you fill out your Marketplace application. Prices shown for insurance plans will reflect the lower costs.
These lower costs are handled with a tax credit called the Advance Premium Tax Credit. But these tax credits can be applied directly to your monthly premiums, so you get the lower costs immediately.
Get an estimate of your costs and savings
You can get a rough estimate of your potential costs and savings by browsing plans and sample prices in your area or by using the Kaiser Family Foundation calculator.
Savings depends on income and family size
The amount you save depends on your family size and how much money your family earns. In general, if your income falls within the following ranges you'll qualify to save money on your premiums in 2014. The lower your income within these ranges, the more you'll save. (The amounts below are based on 2013 numbers and are likely to be slightly higher in 2014.)
- $11,490 to $45,960 for individuals
- $15,510 to $62,040 for a family of 2
- $19,530 to $78,120 for a family of 3
- $23,550 to $94,200 for a family of 4
- $27,570 to $110,280 for a family of 5
- $31,590 to $126,360 for a family of 6
- $35,610 to $142,440 for a family of 7
- $39,630 to $158,520 for a family of 8
If your income falls below the amounts shown, you may qualify for coverage under your state’s Medicaid program. But if your state is not expanding Medicaid in 2014--and you don't qualify for Medicaid under your state's rules--you can’t get lower costs on Marketplace coverage based on your income. You'd have to pay the entire cost of a Marketplace insurance plan.
Estimating your income and reporting your household makeup
Learn how to estimate your income and report on your household makeup for the Marketplace.
More answers
What if my income turns out to be different from what I estimate?
When you apply for coverage in the Marketplace, it's important to double-check the information you put on your application. If the amount of your expected 2014 income you report isn’t accurate, you may not get the right amount of savings. If you wind up making more money than you predicted on your application, you could have to pay back some or all of the savings you’ve received. You would do this on your next tax return.
What if my income qualifies me for Medicaid or CHIP?
Some people applying for coverage in the Health Insurance Marketplace will be eligible for free or low-cost coverage through Medicaid and the Children's Health Insurance Program (CHIP). You’ll learn if you qualify when you fill out a Marketplace application.
Can I appeal a decision about whether I qualify for lower costs?
If you think we made a mistake when you get your savings decision in the Marketplace, you have the right to appeal. The Marketplace application will explain how to do this.
