Eligibility for Coverage Programs

Eligibility for Coverage Programs

Key Facts

Key Facts: Premium Tax Credits | Key Facts

Key Facts: Employer-Sponsored Coverage and Premium Tax Credit Eligibility | Key Facts

Key Facts: Immigrant Eligibility for Health Insurance Affordability Programs | Key Facts

Key Facts: Helping Families that Include Immigrants Apply for Health Coverage | Key Facts

View all key facts

Premium Tax Credits

Webinar: 2018 Coverage | Slide Deck PDF | Presented September 19, 2017

Part I of a four-part series on key elements of eligibility and enrollment 

Topics include:

  • Premium tax credit (PTC) eligibility
  • Calculation of the PTC


Immigrant Eligibility for Health Coverage Programs

Webinar: 2018 Coverage | Slide Deck PDF | Presented October 4 and 24, 2017

Presented in partnership with the National Immigration Law Center 

Topics include:

  • Eligibility for Medicaid and Marketplace coverage based on immigration status
  • Understanding and addressing concerns immigrants may have when applying for health programs
  • Navigating the application process


OE4 Webinars:
Complex Eligibility Scenarios

Archived Webinar: 2017 Coverage | Slide Deck PDF | Presented November 10, 2016

Topics include:

  • Scenario 1: Affordability
  • Scenario 2: Noncustodial parents
  • Scenario 3: Increased household income
  • Scenario 4: Change in household size

View all webinars

Additional Resources

Health Assister’s Guide to Tax Rules | Guide
A guide on the basic tax rules that are applied in determining eligibility for premium tax credits and Medicaid

Yearly Guidelines and Thresholds | Reference Guide
Resource guide that lists all the indexed guidelines and thresholds that change each enrollment year

Minimum Essential Coverage Reference Chart | Chart
Reference tool that lists whether various types of coverage are considered MEC, and whether eligibility for that coverage makes an individual ineligible for premium tax credits

Frequently Asked Questions | FAQs
Collection of FAQs on many of the common issues encountered since the implementation of health reform