Eligibility for Coverage Programs

Eligibility for Coverage Programs

Tools and Resources

Health Assister’s Guide to Tax Rules | Guide
Explains the basic tax rules that are applied in determining eligibility for the premium tax credit and Medicaid


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


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


Reference Guide: Documents Used to Verify Immigration Status | Reference Guide
Walks through examples of the different immigration document types that can be used in Healthcare. gov to verify immigration status and notes where different document numbers are located


Key Facts: Detailed Q&As on various topics related to eligibility and enrollment

  • The Premium Tax Credit | Key Facts
  • Employer-Sponsored Coverage and Premium Tax Credit Eligibility | Key Facts
  • Immigrant Eligibility for Health Insurance Affordability Programs | Key Facts
  • Helping Families that Include Immigrants Apply for Health Coverage | Key Facts


The Premium Tax Credit

Webinar OE6: 2019 Coverage | Presentation Slides (PDF) | September 13, 2018

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

Immigrant Eligibility for Health Coverage Programs

Webinar OE6: 2019 Coverage | Presentation Slides (PDF) |October 23, 2018

  • Eligibility for Medicaid and CHIP based on immigration status
  • Eligibility for marketplace coverage based on immigration status
  • Special marketplace and PTC eligibility
  • Understanding and addressing concerns
  • Navigating the application process


Resources by Subtopic

Premium Tax Credit Eligibility | View all

Offers of Employer Coverage | View all

Premium Tax Credit Calculation | View all

Medicaid Eligibility | View all

Immigrant Eligibility | View all

Special Populations | View all


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

View all webinars and resources related to eligibility rules

View all webinars

View all key facts

View all other resources