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.
In Part III of this Beyond the Basics OE10 webinar series presented in partnership with the National Immigration Law Center (NILC) on September 20, 2022, Gabrielle Lessard, Senior Policy Attorney at NILC, and Shelby Gonzales, Vice President for Immigration Policy at Center on Budget and Policy Priorities, provide an overview…
In Part II of this Beyond the Basics OE10 webinar series presented on September 15, 2022, Jenny Sullivan, Director of Health Coverage Access, provides an in-depth review of eligibility rules for premium tax credits—including how offers of employer-sponsored insurance can affect eligibility—as well as how premium tax credits are calculated.…
In Part I of this Beyond the Basics OE10 webinar series presented on September 8, 2022, Jenny Sullivan, Director of Health Coverage Access, and Allison Orris, Senior Fellow on the Health Policy Team, cover the rules used to determine household size and explain what counts as income when determining eligibility…
Eligibility for subsidies in the Marketplace is determined in part by using specific percentages and thresholds that are indexed and change each enrollment year. In addition, people who received advance premium tax credits (APTC) in the prior enrollment year will need to complete a tax return for that year and…
Household size is a key factor in determining eligibility for the premium tax credit. The following Q&A explains the rules on household size and how it affects eligibility for and the amount of the premium tax credit. Note that many guidelines and thresholds are indexed and change each enrollment year.…
In 2014, a Supreme Court decision gave states the choice whether to expand Medicaid to cover adults with incomes below 138 percent of the poverty line. As a result, individuals earning between 100 and 138 percent of poverty can qualify for a premium tax credit in states that do not…
Updated August 2022 Financial eligibility for the premium tax credit, 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 following Q&A explains what income is included in MAGI. Note that many guidelines and…
Generally, people can only enroll in a marketplace plan or switch plans on HealthCare.gov during the annual open enrollment period, which begins on November 1st each year. But people who experience certain life events during the year (such as getting married, losing job-based insurance, etc.) are able to newly enroll…
In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on October 12, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, brings together all of the policies covered in our webinar series by walking through the HealthCare.gov application step-by-step. ↓ View Presentation Slides…
In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 24, 2021, in partnership with the National Immigration Law Center, Shelby Gonzales, Vice President for Immigration Policy, and Gabrielle Lessard, Senior Policy Attorney at the National Immigration Law Center, provide an overview of…
