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Health Plans

Health insurance subsidies

Health insurance can be expensive. Fortunately, the federal government offers health insurance subsidies to help cut the cost for individuals and families who qualify.1

Health insurance subsidies

If you don’t have health coverage through an employer and you’re not eligible for Medicare or Medicaid, you may qualify for a health care subsidy. Established by the Affordable Care Act (ACA), this federal assistance covers some of the premium and out-of-pocket costs of health coverage. There are two types of subsidies offered: 

Advanced Premium Tax Credit (APTC): This subsidy helps lower your monthly insurance premiums. It’s based on the cost of health coverage in your state, your estimated income and your household size, which includes you, your spouse and any tax dependents.  

Cost-Sharing Reductions (CSRs): This subsidy offers extra savings that reduce out-of-pocket costs by decreasing deductibles, coinsurance, copays and out-of-pocket max. If you qualify for CSRs based on your income, you must enroll in a plan that falls in the Silver ACA level to enjoy these extra health insurance savings. 

The best part is you may be eligible for both types of subsidies, which can dramatically lower your annual health insurance costs. 

Estimate your health care subsidy

How much will you save? Use our online calculator to estimate the subsidy amount you could potentially qualify for from the federal government. 

Go to Subsidy Calculator

Will you qualify for a subsidy?

To qualify for a subsidy under health care reform, you must meet a few requirements: 

  • Income above 100% Federal Poverty Level (FPL) 
  • Not be eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program (CHIP), Medicare or coverage through the Armed Services 
  • Not have affordable access to insurance through an employer (“affordable” is defined yearly by the federal Marketplace based on the percentage of premium an employee is responsible for) 

A household income between 100% and 250% of FPL could qualify you for both the APTC and CSRs. If you have a household income more than 250% of FPL, you could still qualify for the APTC, and you may pay no more than 8.5% of your expected annual income toward premiums. 

Metallic levels and APTC coverage

The percentage of premium coverage your APTC offers is dependent on the Metallic Level / Plan Category you select. Our plans are available in three metallic levels and were created by the ACA to show the value of the health care coverage and help you easily compare plans. Learn more about metallic levels on Healthcare.gov.

Bronze

Bronze plans pay 60% of medical costs on average, and you pay 40%.

  • Protects against worst-case medical scenarios 
  • Has lowest monthly premium  
  • You pay for most routine care 

Silver

Silver plans pay 70% of medical costs on average, and you pay 30%.

  • Higher monthly premium  
  • More routine care is covered than a Bronze plan 

Gold

Gold plans pay 80% of medical costs on average, and you pay 20%.

  • Ideal if you use a lot of care and are willing to pay more in monthly premiums 
  • Cover more costs when you get medical treatment