Individuals and families may get help paying the bill. The amount depends on your eligibility, income and number of people in your household.
(Information based on a paper published by
the Congressional Research service)
Health Insurance Premium Credits in the
Patient Protection and Affordable Care Act
Premium Credit Eligibility
Premium credits can only be obtained by qualifying individuals who file tax returns.
Premium credits will only be available to individuals enrolled in a plan offered through an
Only lawful residents may obtain exchange coverage.
To be eligible for credits, an individual cannot be
for other acceptable coverage—that is,
“minimum essential coverage,” defined as Medicare, Medicaid, the Children’s Health Insurance
Program (CHIP), coverage related to military service, an employer-sponsored plan, a
and other coverage recognized by the Secretary
An individual eligible for,
but not enrolled in, an employer-sponsored plan may still be eligible for premium credits if the
employer’s coverage is not “affordable”— that is, the employee’s contribution toward the
employer’s lowest-cost self-only premiums would exceed 9.5% of household income
or if the
plan’s payments cover less than 60% of total allowed costs.
If an individual is enrolled in an exchange
through an employer who contributed toward that coverage, the individual will be ineligible for
To be eligible for a premium credit, individuals must have “household income”
of less than 400% FPL
400% of FPL
48 Contiguous States and DC
for AK and HI see ACA Bill
PPACA says premium credits are available to those whose income “exceeds 100 percent [FPL]
but does not exceed 400 percent [FPL]....” PPACA then provides for lawfully present noncitizens
who are at or below 100% FPL and who are not eligible for Medicaid to obtain premium credits.
Non-aged citizens and legal permanent residents at or below 138% FPL will be eligible for
Medicaid (state participation required) and therefore ineligible for premium credits
Other Eligibility requirements may apply. (for complete details read the Affordable Care Act Bill)
There is no question that many families will benefit from the discounted health premiums. The tax credit is paid directly to the insurance company so your premiums are reduced automatically when applying for coverage. Upon application you will be required to fill out comprehensive information pertaing to your income and family size. This information will be verified by the IRS. The amount of the premium will then be calculated and the discounted monthly premiums will be shown.
Agents and Brokers are required to be trained to assist consumers with the application and decision making process. Using an Agent to enroll in an ObamaCare Health Plan will be the primary choice of many americans. After all agents have the inside track on companies and their promptness to handle claims and pay benefits in a timely fashion.
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*ExploreObamacare.com is not affiliated with any government agency. All information provided is for informational purposes only and no guarantee of the accuracy is hereby implied. The information was the product of researching the Affordable Care Act Bill and is subject to change.