Health Insurance for Low-Income Families

You Have Options for Health Insurance for Low-Income Families

Under the Affordable Care Act (ACA), families with a modest income can qualify for subsidies that help make the cost of healthcare better fit their budget.

Levels of Coverage Within Health Insurance for Low-Income Families

When you enroll in a health insurance plan, you can choose the level of coverage, or "metal level," that works for your medical and financial needs. Your monthly premium cost can affect the amount of coverage offered by your plan. 

In general, there are four types of health insurance plans:¹

1. Bronze: 60% of costs are covered by your health insurance provider; 40% are covered by you.
2. Silver: 70% of costs are covered by your health insurance provider; 30% are covered by you.
3. Gold: 80% of costs are covered by your health insurance provider; 20% are covered by you.
4. Platinum: 90% of costs are covered by your health insurance provider; 10% are covered by you.

The 10 Essential Health Benefits

No matter which plan you purchase or how much you pay for it, the ACA guarantees 10 essential health benefits to those covered under health insurance, including those who have health insurance for low-income families. These benefits are considered necessary services to maintain good overall health. Your insurance provider must cover these services when you receive care from an in-network provider. 

These 10 essential health benefits include:²

1. Prescription drugs
2. Pediatric services
3. Preventive and wellness services, and chronic disease management
4. Emergency services
5. Hospitalization
6. Mental health and addiction services
7. Pregnancy, maternity, and newborn care
8. Ambulatory patient services
9. Laboratory services
10. Rehabilitative and habilitative services and devices

Subsidies Can Offer Lower Monthly Premiums and Reduced Costs

There is a subsidy program that helps make healthcare more affordable for families with a low income. There are two subsidies you may qualify for:

1. Premium Tax Credit: Families making between 100% and 400% of the Federal Poverty Line ($26,500 - $106,000 a year for a family of four³) can get some – or all – of their monthly premium covered by either direct payments from the government to your health insurance provider or by filing a tax return at the end of the year.⁴
2. Cost-Sharing Reduction: Families making between 100% and 250% of the Federal Poverty Line ($26,500 - $66,250 a year for a family of four³) can get some – or all – of their out-of-pocket costs (e.g. coinsurance, copayments, deductibles) covered by requiring your health insurance provider to cover a larger percentage of costs than your metal level indicates.^5,6

What Is the Best Health Insurance for Low-Income Families?

The best health insurance for low-income families depends on what’s important to you. It's easy to compare plans with the innovative HealthMarkets FitScore^®. Just answer a few quick questions about your insurance needs, and we can rank health plans that best fit your needs – all at no cost to you.

Start comparing plans today!

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References:
1.HealthCare.gov. Retrieved from https://www.healthcare.gov/choose-a-plan/plans-categories/. Accessed February 25, 2021. 2.HealthCare.gov. Retrieved from https://www.healthcare.gov/coverage/what-marketplace-plans-cover/. Accessed February 25, 2021. 
3.HHS. Retrieved from https://aspe.hhs.gov/system/files/aspe-files/107166/2021-percentage-poverty-tool.xlsx. Accessed March 19, 2021. 4.HealthCare.gov. Retrieved from https://www.healthcare.gov/glossary/premium-tax-credit/. Accessed February 25, 2021. 
5.HealthCare.gov. Retrieved from https://www.healthcare.gov/glossary/cost-sharing-reduction/. Accessed February 25, 2021. 
6.KFF. October 2020. Retrieved from https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health-insurance-subsidies/ 

HealthMarkets’ FitScore intends to identify plans that fit your needs. You should carefully review official plan materials.