Health Insurance Subsidy

Health Insurance Subsidy is a government assistance to help pay for health insurance provided by insurers such as Blue Cross, Humana or UnitedHealthCare. There are two types of subsidies: one lowers the insurance premium and the other, out-of-pocket expenses. Thanks to the subsidized insurance brought by Obamacare, low and middle-income households will only have to pay part of their insurance expenses, and the remainder will be covered by the government.

Who is eligible for the Subsidy?

In order to qualify for the subsidy, most importantly, you have to meet three requirements:

  1. You have to be either a United States citizen or be in the United States with legal immigration status (green card holder, valid visa holder such as student or employment based visa),
  2. Your income may not exceed the income requirements set out below, and
  3. You must purchase a new health plan with "built-in" subsidy

See further requirements set out in Health Insurance Subsidy Eligibility Requirements.

Subsidy Income Requirements

The entire household’s income is taken into consideration, of all the family members who file their taxes on the same tax return. In the case of self-employed individuals, net income is considered (after deducing business expenses).

There are two types of the subsidies:

  1. Premium Subsidy (also known as Advanced Premium Tax Credit - APTC) - lowers your monthly premium, and
  2. Cost-Sharing Subsidy (also known as Cost-Sharing Reduction - CSR) - you can get plans with lower deductible, co-insurance and the copayment.

Household
Size
Maximum Income for
Premium Subsidy
Maximum Income for
Cost-Sharing Subsidy
1 $48,560 $30,350
2 $65,840 $41,150
3 $83,120 $51,950
4 $100,400 $62,750
5 $117,680 $73,550
6 $134,960 $84,350
7 i wiecej* $17,280 $10,800

*Last updated: 10/22/2018. To each additional person, please add the indicated amount. Individuals eligible for Medicaid don't qualify for the subsidies.

Example: 1 person with an annual income of $35,000 will qualify only for Premium Subsidy. A family of 4 with an annual income of $40,000 will get both subsidies.

What will be the amount of my Subsidy?

The amount of subsidy depends not only on income but also on the number of family members and their ages. In some situations, the amount of subsidy may reach as high as 100% of the total insurance premium. In order to accurately calculate the amount of your subsidy, please call at (773) 789-7233 or stop by our office.

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