Most people who enroll in health insurance through the marketplace are eligible for financial help. Premium tax credits lower up-front monthly premiums and cost-sharing reductions lower deductibles, copayments, and other costs when people use their insurance.
Determining household size and accurately calculating income are key to determining whether someone is eligible for Medicaid or financial help in the marketplace. Tools to calculate income and self-employment earnings can help people complete their applications.
Certain circumstances, like having an offer of employer-sponsored insurance, might disqualify someone from financial help.
In this Beyond the Basics webinar presented on September 8, 2022, Jenny Sullivan, Director of Health Coverage Access, covers the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits and Medicaid.
Updated October 2024 We have created a tool to help you estimate the income and expenses a self-employed client needs to include on their HealthCare.gov application to project their income for the enrollment year. This tool will give the client a ballpark estimate of their projected net self-employment income. There’s…
This worksheet will help individuals add up their current monthly income and estimate their annual income for the following year. It will be particularly useful for people with multiple sources of income. This is a fillable worksheet, which means you can fill it out on your computer and email it…
In this Beyond the Basics webinar presented in partnership with the National Immigration Law Center (NILC) on September 24, 2024, Gabrielle Lessard, Senior Policy Attorney at NILC, and Shelby Gonzales, Vice President for Immigration Policy at the Center on Budget and Policy Priorities, provide an overview of barriers to enrollment…
Financial eligibility for most categories of Medicaid and the Children’s Health Insurance Program (CHIP) is determined using a tax-based measure of income called modified adjusted gross income (MAGI). The MAGI methodology includes rules prescribing who must be included in a household when determining eligibility. The following FAQ explains MAGI and…
In this Beyond the Basics webinar presented in partnership with the National Immigration Law Center (NILC) on September 17, 2024, Gabrielle Lessard, Senior Policy Attorney at NILC, and Shelby Gonzales, Vice President for Immigration Policy at the Center on Budget and Policy Priorities, cover immigration-related eligibility requirements for Medicaid, the…
In this Beyond the Basics office hours session hosted on September 10, 2024, CBPP’s Jenny Sullivan was joined by Lynn Cowles, Health and Food Justice Programs Manager at Every Texan and former Navigator program manager. The session provided a quick review of premium tax credit eligibility rules and how premium…
Updated September 2024 Millions of uninsured Americans are eligible for a premium tax credit to help them pay for health coverage. The premium tax credit is only available to people without another offer of affordable and adequate coverage; in most cases, this will mean that people with an offer of…
Updated September 2024 ↓ Download PDF In general, an individual must not be eligible for minimum essential coverage (MEC) to be eligible for premium tax credits (PTC) in the marketplace, although there are a few exceptions. Being eligible for MEC means the insurance is available to the individual, even if they…
Updated September 2024 This Employer Coverage & Premium Tax Credit Eligibility Guide explains eligibility rules for individuals with offers of employer-sponsored coverage. It covers how to determine whether employer-sponsored coverage is affordable and minimum value, as well as special rules that reduce an employee’s required contribution. The guide also offers…
In this Beyond the Basics office hours session hosted on September 3, 2024, CBPP’s Jenny Sullivan and Allison Orris were joined by Lynn Cowles, Health and Food Justice Programs Manager at Every Texan and former Navigator program manager. They provided a brief refresher on the rules used to determine household…
