Health care subsidies help to lower premiums or out of pocket costs to save you money on health care. Many people are eligible for a subsidy, but few know if they qualify.
What is a Health Plan Subsidy?
A health plan subsidy is financial assistance from the government that is intended to reduce the cost of health care payments or premiums, making it more affordable for you and your family.
There are two types of subsidies available to consumers. The first is a premium tax credit, which reduces monthly premium payments for health care coverage. The second is a cost-sharing subsidy designed to minimize out-of-pocket costs for doctor and hospital visits.
Health Plan Subsidy Eligibility
Subsidy eligibility depends on your household income, your household size and where you live. Depending on your eligibility factors, you may qualify for a premium tax credit or a cost-sharing reduction — or both.
What is the Income Limit for a Health Plan Subsidy?
Income limits for health plan subsidies are tied to the federal poverty level and are adjusted each year. You can find a subsidy calculator to see if you qualify here.
Can I Get a Subsidy for Employer Health Coverage?
Unfortunately, if you are offered health coverage through an employer that meets the Affordable Care Act minimum standards or are eligible for other government sponsored health plans such as Medicare or Medicaid, you won’t qualify for a subsidy. You also can’t get a subsidy if you are claimed as a dependent on someone’s federal income taxes.
Can I Get a Subsidy with Private Health Coverage?
Yes, you may be eligible for a health plan subsidy if your plan is through a private health insurance company.
How do Health Plan Subsidies Work?
If you qualify, the health plan subsidy is paid directly to your health benefits provider to lower your monthly premiums or health insurance payments. To receive a health plan subsidy, you can apply through your state’s health care marketplace.
Do I Have to Pay Back a Health Plan Subsidy?
No, you typically do not have to pay back a health plan subsidy. The only circumstance that would require you to pay back the subsidy is if your income increases during the year. In this situation, you would likely have to pay back a fraction of your health care costs to make up the difference.
Is a Health Plan Subsidy Taxable?
No, a health plan subsidy is not taxable.
An essential investment
Health care is a necessary investment, but it doesn’t have to break the bank. Health care protects you from the unplanned — and helps to maintain your health through preventative care. See if you qualify for a health care subsidy to reduce your cost and get yourself, and your family, covered. Comparing plans and prices, as well as confirming your subsidy eligibility, will ensure that you get the best care at a cost you can afford. Learn more about Priority Health’s plans here.
