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): With this subsidy, the federal government pays part of your monthly insurance premium. The subsidy you receive is based on the cost of health coverage in your state, your estimated income and your household size. Household size 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 Silver plan 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. 

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

• Income above 138% and below 400% of the 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 138% and 250% of FPL could qualify you for both the APTC and CSRs. 

The percentage of premium coverage your APTC offers is dependent on the metallic level 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.