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.
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.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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