Hispanic family realizes they are eligible for a premium subsidy

Many people who buy health insurance on the federal and state exchanges receive premium subsidies that reduce the cost of their monthly payment. But who benefits? And how is this tax credit amount determined? It’s all based on the federal poverty level (FPL).

In the 2019 and 2020 Open Enrollment Periods, approximately 87% of people who bought an Affordable Care Act (ACA) health insurance policy from the federal or state exchanges received a premium tax credit.1 Each year, the FPL is issued by the U.S. Department of Health and Human Services (HHS) to determine eligibility for certain programs, including ACA coverage.

Who Qualifies for the Premium Tax Credit?

You can qualify for a premium tax credit if your individual income falls between $12,880 and $51,520, or 100% and 400% of the FPL.2,3 In March 2021, the federal government enacted the American Rescue Plan Act, which expanded the eligibility requirements for subsidies. This means that more people may be eligible for reduced premiums or premium subsidies.4 You might also qualify for $0 premium health insurance!

What Is the Income Limit for ACA Subsidies in 2021?3

The income limit for ACA subsidies in 2021 for individuals is between $12,880 and $51,520.2,3 Families of four with a household income between $26,500 and $106,000 can also qualify for premium subsidies. How do you know if you qualify for a premium subsidy on your ACA policy? We’ll make it easy.

The chart below provides the qualifying income ranges in 2021 for the 48 contiguous U.S. states and the District of Columbia, effective January 2021.5 The income ranges for Alaska and Hawaii can be found on the U.S. Department of Health and Human Services (HHS).

Income Limits for ACA Premium Subsidies3

Household Size Minimum Income –
100% Federal Poverty Level
Maximum Income –
400% Federal Poverty Level
One individual $12,880 $51,520
Family of 2 $17,420 $69,680
Family of 3 $21,960 $87,840
Family of 4 $26,500 $106,000
Family of 5 $31,040 $124,160
Family of 6 $35,580 $142,320
Family of 7 $40,120 $160,480
Family of 8 $44,660 $178,640

For families/households with more than eight people, add $4,540 for each additional person.5

Find Subsidies and Shop for a Subsidized ACA Plan Now

Are you still eligible for the same ACA subsidies or possibly new premium subsidies? HealthMarkets can help determine whether you qualify for a subsidy. The innovative HealthMarkets FitScore® can help you review your options and compare plans that fit your needs.

Simply answer a few quick questions about what’s important to you, and the FitScore will use your responses to rank plans accordingly.

Start comparing plans with HealthMarkets today.

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References

1. Centers for Medicare & Medicaid Services. April 2020. Retrieved from https://www.cms.gov/files/document/4120-health-insurance-exchanges-2020-open-enrollment-report-final.pdf
2. Premium Tax Credit, HealthCare.gov. Retrieved from https://www.healthcare.gov/glossary/premium-tax-credit/. Accessed on April 12, 2021.
3. Department of Health and Human Services. January 2021. Retrieved from https://aspe.hhs.gov/system/files/aspe-files/107166/2021-percentage-poverty-tool.xlsx
4. KFF. March 2021. Retrieved from https://www.kff.org/health-reform/issue-brief/impact-of-key-provisions-of-the-american-rescue-plan-act-of-2021-covid-19-relief-on-marketplace-premiums/
5. Department of Health and Human Services. January 2021. Retrieved from https://aspe.hhs.gov/poverty-guidelines

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