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 coverage Subsidy?
A health care 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 insurance coverage. The second is a cost-sharing subsidy designed to minimize out-of-pocket costs for doctor and hospital visits.
Health Insurance 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 Insurance Subsidy?
Income limits for health insurance subsidies are tied to the federal poverty level and are adjusted each year. For 2021, those making between $12,760- $51,040 as an individual, or $26,200-$104,800 as a family of 4, qualify. Priority Health has a subsidy calculator tool that allows you to easily check if you qualify for the premium tax credit.
Can I Get a Subsidy for Employer Health Insurance?
Unfortunately, if you are offered health insurance through an employer or are eligible for other government sponsored health insurance 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 Insurance?
Yes, you may be eligible for a health insurance subsidy if your plan is through a private health insurance company.
How do Health Insurance Subsidies Work?
If you qualify, the health insurance subsidy is paid directly to your health insurance provider to lower your monthly premiums or health insurance payments. To receive a health insurance subsidy, you must apply through your state’s health insurance marketplace.
Do I Have to Pay Back a Health Insurance Subsidy?
No, you typically do not have to pay back a health insurance 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 Insurance Subsidy Taxable?
No, a health insurance 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.