Are you eligible for a subsidy? 

Need help paying for health insurance?

Many people who buy individual insurance can get a subsidy to help pay premiums and out-of-pocket costs. There are two kinds of subsidies:

Premium tax credits

Tax credits can decrease how much money you pay for your health plan every month. These credits are available if your income is 100 to 400% of the federal poverty level. You can use this credit to buy any metal level (platinum, gold, silver, or bronze) plan.

Cost share reduction

Cost-share reduction (CSR) programs help lower your out-of-pocket costs. These programs give you a discount that decreases how much you pay before your insurance starts to pay. This discount lowers your deductibles, copays, and co-insurance. For the discount to apply, you must choose a silver metal level plan.

How it works

To figure out your tax credit, you’ll need to fill out an application on your state’s Health Insurance Marketplace. The Marketplace uses three pieces of information from your application to decide what you may qualify for:

• Your household size
• Your estimated household income
• The average price of plans in your area (benchmark plan)

Using this information, your state’s Health Insurance Marketplace will do this calculation:
Benchmark Plan Cost  -  Premium Contribution  =  Your Premium Tax Credit

Why it changes each year

Your state’s Health Insurance Marketplace selects a new benchmark plan each year. This plan is always the second-lowest cost silver plan available where you live. How much you’ll pay your health plan every month will change every year, and so will your tax credit. Changes to your income and household size may also affect your tax credit.

How to get your tax credit

If you qualify, you have two ways to get money back:

• Add the tax credit to your monthly premium
  Use some or all of this tax credit to pay your monthly premium. The Marketplace will send it directly to your insurance company, so you’ll only pay what is left.


• Claim the credit when you file your tax return
  You can wait to claim your tax credit until you file your tax return. If you only applied part of the credit to help pay your monthly health insurance plan than you can claim the rest when you file, too. 

Keep in mind, if you take more money in advance than you’re due, you’ll have to pay the extra money back when you file your taxes. If you’ve taken less money than you qualify for, you’ll get that money back in a tax return.

Do you qualify?

Here are general guidelines:

Individuals: with an income below $51,520

Couples: with a household income below $69,680

A four-person family: with a household income below $106,000

Additional savings in 2022

American Rescue Plan Act (ARPA)

You usually wouldn’t get premium subsidies if you make more than 400% of the federal poverty level. But that’s not the case for 2021 and 2022. Instead, your income is compared to the cost of the benchmark plan. If the plan costs more than 8.5% of your income then you’ll probably get help paying for your health insurance.

See if you qualify

To qualify, you must buy your plan through your state's Health Insurance Marketplace. Your income and other household information will help figure out how much assistance you’ll get. If you need help with your application, reach out your state's Health Insurance Marketplace.