Your source for health insurance quotes and plans.

Health Insurance Subsidy Calculator

Premium Assistance Under Affordable Care Act

About the Subsidy Calculator

Estimated premiums in 2014 were calculated using actual health insurance rates generated by the GoHealth Quote Engine. Using quotes from GoHealth, the calculator determines an average premium for most ZIP codes in the United States for 2013. The calculator then uses that average to estimate 2014-level rates. For a small set of states, GoHealth uses the Congressional Budget Office’s estimates, rather than actual health insurance quotes to calculate 2014 premium estimates. Those states include: HI, ME and RI.

Rates used in the calculator for a single individual were based on a 40 year old female who is healthy and a non-smoker. Rates used in the calculator for families were made using a healthy 40 year old woman as the primary applicant with a 40 year old spouse, and children under the ages of 18.

The actual premium payment is a reflection of how much an eligible individual/family can expect to pay after their tax subsidy has been applied. The highest amount that a household will be expected to pay for health insurance coverage is 9.5 percent of their annual income.

The calculated out-of-pocket costs is the maximum dollar amount an individual/family would have to pay for health care services, not including premiums, in 2014. An individual/family may or may not reach this maximum level, depending on how much they utilize health care services in a year.

FAQs


What is a health insurance subsidy?
The Patient Protection and Affordable Care Act aims to encourage broad participation and provide affordable coverage for all Americans by offering tax credits to qualifying individuals and families that purchase coverage through a public health insurance exchange (marketplace). Some families, making under 250% of the federal poverty level are also eligible for reduced cost sharing (lower deductibles and payments) paid for by the federal government.
Am I eligible for a subsidy?
You are eligible for the premium tax credit if:
  • You are a U.S. citizen or legal immigrant
  • You purchase coverage through the new health insurance exchanges
  • Your yearly household income is no more than 400% of the federal poverty level
  • You are not eligible for Medicaid, the Children’s Health Insurance Program, Medicare, or military coverage
  • You are not offered health insurance through your employer (Exceptions are made to this rule if your employer’s plan does not cover at least 60 percent of covered benefits on average or the employee share of the premium exceeds 9.5 percent of the employee’s income.)
When will the subsidy be available?
The premium tax credits and cost-sharing assistance will begin in 2014.
Can I get the subsidy if I have health insurance through my employer?
Typically, no. The only exception would be if your employer’s plan does not cover at least 60 percent of covered benefits on average or the employee share of the premium exceeds 9.5 percent of the employee’s income.
What is the Federal poverty line?
As of 2013, the federal poverty level is an annual income of under $11,490 for an individual and $23,550 for a family of four.
  Return to Subsidy Calculator