Affordable Care Act Subsidy Calculator
Trợ cấp hoặc thuế suất trả tiền bảo hiểm sức khỏe theo ACA được xác định bằng sự kết hợp của nhiều yếu tố, bao gồm thu nhập của bạn, kích thước gia đình, chi phí bảo hiểm sức khỏe trong khu vực của bạn và kế hoạch bảo hiểm sức khỏe cụ thể bạn chọn.
Để tính toán trợ cấp ACA của bạn, bạn có thể sử dụng máy tính trợ cấp chính thức trên trang web HealthCare.gov hoặc các máy tính trợ cấp được cung cấp bởi thị trường bảo hiểm sức khỏe của tiểu bang của bạn nếu tiểu bang của bạn điều hành thị trường của riêng mình (ví dụ: Covered California cho cư dân California).
Dưới đây là cách bạn có thể ước tính trợ cấp ACA của mình một cách tổng quan:
Hãy lưu ý rằng tính toán trợ cấp có thể phức tạp và quan trọng là cung cấp thông tin chính xác. Nếu thu nhập hoặc tình hình gia đình của bạn thay đổi trong năm, quan trọng là bạn cập nhật thông tin của mình trên thị trường để đảm bảo bạn nhận được số tiền trợ cấp chính xác.
Để có tính toán trợ cấp chính xác và mới nhất, nên sử dụng các công cụ chính thức được cung cấp bởi thị trường bảo hiểm sức khỏe của tiểu bang của bạn hoặc trang web HealthCare.gov của liên bang. Các công cụ này sẽ tính đến các hướng dẫn và quy định mới nhất về thuế suất trả tiền bảo hiểm dưới Đạo luật Chăm sóc Sức khỏe Hợp lý (ACA).
The Affordable Care Act (ACA) subsidy or premium tax credit is determined by a combination of factors, including your income, family size, the cost of health insurance in your area, and the specific health insurance plan you choose.
To calculate your potential ACA subsidy, you can use the official HealthCare.gov subsidy calculator or the subsidy calculators provided by your state’s health insurance marketplace if it operates its own marketplace (such as Covered California for California residents).
Here’s how you can generally estimate your subsidy:
Keep in mind that the subsidy calculation can be complex, and it’s essential to provide accurate information. If your income or family circumstances change during the year, it’s important to update your information on the marketplace to ensure that you receive the correct subsidy amount.
For the most accurate and up-to-date subsidy calculation, it’s advisable to use the official tools provided by the health insurance marketplace in your state or the federal HealthCare.gov website. These tools will take into account the latest guidelines and regulations regarding premium tax credits under the ACA.
https://www.valuepenguin.com/aca-subsidy-calculator
updated Sep 23, 2022
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Our Affordable Care Act (ACA) subsidy calculator can help you determine the amount your household can save on health insurance purchased through your state exchange. After you enter your ZIP code, age, household size and income, you’ll learn your estimated subsidy for the current policy year and how much you’ll pay for health insurance.
The amount of the subsidy your household may receive depends on the number of people in your household and your household income as it relates to the federal poverty level.
Health Insurance Subsidy Calculator
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Your health insurance estimated subsidy
$122/month
More information about your subsidy:
Income vs. federal poverty level
388.2%
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Your cost for a Silver plan
$354/month
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Your cost without the subsidy
$476/month
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What is the Affordable Care Act (ACA) subsidy?
The Affordable Care Act (ACA) subsidies are tax credits that allow you to pay less for marketplace health insurance.
Essentially, the cost of health insurance is reduced based on your family size and household income. Subsidies can be applied throughout the year to lower your monthly bill, or the lump sum can be taken as a deduction when you file income taxes.
Your ACA subsidy can be used to lower your cost for any metal-level plan. , but you must buy your insurance through a health insurance exchange to qualify for help.
Subsidies don’t apply to Medicaid, the Children’s Health Insurance Program (CHIP) or employer insurance.
When can you sign up for ACA subsidies?
You can sign up for a subsidized health insurance plan each year during the annual open enrollment period. However, if you have a qualifying life event. , you may be eligible for a special enrollment period, which would give you one-time access to purchase coverage mid-year.
Examples of qualifying events include:
Who is eligible for health insurance subsidies?
ACA subsidies are available for low- to middle-income households enrolled in individual or family health insurance plans. Keep in mind that if you get the very cheap Catastrophic plan, you aren’t eligible for subsides.
For most people, health insurance subsidies are available if your income is between 100% and 400% of the federal poverty level (FPL). For the 2023 policy year, that’s between $13,590 and $54,360 for an individual. For a family of four, it’s between $27,750 and $111,000.
How much you save on health insurance will vary based on your income, and the cost for coverage can be as low as $0 per month. The low prices that are available are due to an increase in the size of discounts implemented in 2021 as a part of the American Rescue Plan. This larger discount will continue through 2025 as a part of the Inflation Reduction Act.
For the 2023 policy year, the federal poverty level (FPL) income numbers below show the typical income limits to qualify for ACA health insurance subsidies.
| Household/family size | Min. income to qualify | Typical max. income to qualify |
| 1 | $13,590 | $54,360 |
| 2 | $18,310 | $73,240 |
| 3 | $23,030 | $92,120 |
| 4 | $27,750 | $111,000 |
| 5 | $32,470 | $129,880 |
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How much does health insurance cost after ACA subsidies?
Among those who qualify for subsidies, the average cost of health insurance in the U.S. is $77 per month after the subsidies are applied.
| Location | Average health insurance cost after subsidies |
| United States | $77 |
| Alabama | $66 |
| Alaska | $77 |
| Arizona | $120 |
| Arkansas | $97 |
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Calculating your subsidies
Before shopping for an ACA health insurance plan, you can estimate your health insurance costs by using a subsidy calculator or doing the math yourself. Knowing if you qualify for subsidies and the approximate amount should help you choose a plan that best fits your needs.
How much you might save depends on your income, your family size and the cost of a benchmark Silver plan where you live.
Subsidies are calculated in two ways:
1. COMPARE YOUR INCOME TO THE FEDERAL POVERTY LEVEL
You’ll start by figuring out your income percentage compared to the federal poverty level. For 2023 health insurance plans, you’ll use your estimated 2023 income and compare that to the 2022 federal poverty level amounts. For example, if you’re single with an income of $27,180 per year, you’re earning 200% of the federal poverty level.
| Household size | Federal poverty level 2022 |
| 1 | $13,590 |
| 2 | $18,310 |
| 3 | $23,030 |
| 4 | $27,750 |
| 5 | $32,470 |
| 6 | $37,190 |
| 7 | $41,910 |
| 8 | $46,630 |
For a family of nine or more, add $4,720 for each extra person. Poverty levels are higher in Alaska and Hawaii.
2. DETERMINE THE MOST YOU’LL PAY FOR INSURANCE
2. DETERMINE THE MOST YOU’LL PAY FOR INSURANCE
The ACA limits the amount of money you must spend on premiums based on a percentage of income. Higher-income households pay higher rates as a percentage of income.
The percent of your income you pay for insurance, listed below, is based on recent federal legislation and will be used from 2021 through 2025.
| Your income as a % of federal poverty level | Min. % of income paid for insurance | Max. % of income paid for insurance |
| 0%-150% | 0% | 0% |
| 150%-200% | 0% | 2% |
| 200%-250% | 2% | 4% |
| 250%-300% | 4% | 6% |
| 300%-350% | 6% | 8.5% |
| 400% or higher | 8.5% | 8.5% |
Expected premium contributions based on earnings as a percentage of the federal poverty level. A benchmark plan is free if your income is at or below 150% of the federal poverty level.
3. FIND OUT THE COST OF A BENCHMARK SILVER PLAN
Your health insurance discount is calculated based on the cost of the second-cheapest Silver plan in your area, called a benchmark Silver plan. You can view available quotes in the federal or state insurance exchange to find the benchmark plan, or you can call the exchange.
4. SUBTRACT HOW MUCH YOU’RE EXPECTED TO PAY FROM THE BENCHMARK RATE
If the amount you’re expected to pay for health insurance is less than the cost of a benchmark plan, the difference between the two is the subsidy you’ll receive. For example, if the benchmark Silver plan costs $3,000 a year and you’re expected to pay $1,000 for a plan, according to your income calculations, then you will receive a subsidy of $2,000.
If your expected contribution for health insurance is more than the cost of a benchmark plan, you won’t receive any health insurance subsidies. However, you can still enroll in full-priced plans
EXAMPLE: INCOME IS TWO TIMES THE POVERTY LEVEL
In this example, a single person’s income is $27,180, two times the federal poverty level. Their expected contribution is 2% of their annual income, which amounts to about $544 for the year or $45 per month.
If the cost of a benchmark Silver plan in the area is $433 per month, they would receive a $388 per month subsidy to cover the difference. The consumer can use the $388 subsidy toward the cost of any plan they choose, whether it be Bronze, Silver, Gold or Platinum.
EXAMPLE: INCOME IS FOUR TIMES THE POVERTY LEVEL
For those who earn more than 400% of the federal poverty level, subsidies limit insurance payments to 8.5% of your annual income, regardless of what you earn. As part of the Inflation Reduction Act, these subsidies are available through 2025.
For example, a family of four with an income of $150,000, well over four times the federal poverty level, would pay no more than 8.5% of their income — or $12,750 per year — for an ACA benchmark plan. That’s a monthly rate of about $1,063 per month, which saves $262 compared to an average nonsubsidized ACA plan, costing $1,325.
Do I have to pay back subsidies if my income changes?
Most consumers receive premium subsidies in the form of an advanced tax credit, with the subsidy applied directly to the cost of their monthly insurance bill. Since these amounts are based on your projected income for the year, the actual amount of subsidies you are eligible for may differ once you determine your actual income earned at the end of the year.
If you qualify for more subsidies than you received, the difference is paid back to you in the form of a tax credit when you file income tax.
In some cases, households may receive higher subsidies than they were ultimately eligible for based on their final income for the year. Those households must repay the portion of subsidies they didn’t qualify for, up to the repayment cap.
IF YOUR INCOME IS BELOW FOUR TIMES OF THE FEDERAL POVERTY LEVEL
For the 2021 tax year, households with final incomes under 400% of the federal poverty level would have repayments set at the following amounts:
| Income range | Repayment cap |
| Under 200% of federal poverty level | $650 ($325 individual) |
| 200% to 299% of federal poverty level | $1,600 ($800 individual) |
| 300% to 399% of federal poverty level | $2,700 ($1,350 individual) |
IF YOUR INCOME IS ABOVE FOUR TIMES OF THE FEDERAL POVERTY LEVEL
Households with a final income over 400% of the federal poverty level will be required to pay back the premium subsidy overpayment. Here’s an example of how that would work when a family of four is paying 8.5% of their income for health insurance:
| Your estimated annual income | Actual | |
| Income | $150,000 | $160,000 |
| Annual cost based on income | $12,750 | $13,600 |
| Subsidy amount owed back at tax time | $850 |
The final rate is based on 8.5% of the consumer’s final income. Rates reflect annual amounts.
If you qualify for a premium subsidy, you may also be eligible for another type of discount called cost-sharing reductions. These programs help to reduce out-of-pocket medical costs like deductibles and copays.
Frequently asked questions
Is Obamacare free?
Obamacare health insurance may be free for those earning close to the federal poverty level. That’s because of a subsidy program that reduces the cost of insurance based on income. However, those who receive subsidies typically pay a higher amount, averaging $77 per month.
What are the income limits for health insurance subsidies?
To qualify for health insurance subsidies, you need to earn at least $13,590 as an individual or $27,750 for a family of four, which is the current federal poverty limit. Those who earn less can apply for low-income health insurance programs such as Medicaid or CHIP.
Who is eligible for Obamacare?
Most people who don’t have health insurance through their job can purchase an insurance plan through HealthCare.gov or their state health insurance marketplace. However, your income will determine if you’re eligible for health insurance subsidies. Use our subsidy calculator to estimate your final cost for health insurance.
How much is Obamacare insurance?
The average cost of health insurance through Obamacare is $541 per month. For those with low to moderate incomes, subsidies can reduce the cost of health insurance, and those who qualify pay an average of $77 per month.
Sources and methodology
Costs and calculations are based on aggregated data from Public Use Files (PUF) on the Centers for Medicare & Medicaid Services (CMS) government website. Plans and providers for which county-level data was included in the CMS’ Crosswalk file were used in our analysis; those excluded from this dataset may not appear.
Additional sources include HealthCare.gov, the U.S. Department of Health and Human Services and the Kaiser Family Foundation.
Editorial Note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.
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