ACA Health Insurance Subsidy Calculator
See if you qualify for a subsidy and estimate your total annual costs.
Official ACA Health Insurance Subsidy and Premium Tax Credit Calculator 2024
Calculate Affordable Care Act (ACA) marketplace premiums and determine subsidy eligibility with our comprehensive calculator. Input Modified Adjusted Gross Income (MAGI - includes wages, self-employment income, interest, dividends, IRA distributions, social security), household size (yourself, spouse, dependents under 26, other tax dependents), age, tobacco use (up to 50% surcharge), and location (ZIP code - premiums vary by rating area).
Related Insurance Calculator Keywords and Topics:
- ACA subsidy calculator
- premium tax credit
- healthcare marketplace calculator
- Obamacare calculator
- Federal Poverty Level calculator
- MAGI calculator
- cost-sharing reductions
- Bronze Silver Gold Platinum plans
- health insurance subsidy
- marketplace premium estimator
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Estimate your health insurance premium and find out if you qualify for subsidies under the Affordable Care Act.
❓Frequently Asked Questions
How do I calculate my Modified Adjusted Gross Income (MAGI) for ACA subsidies?
MAGI for ACA subsidies equals your Adjusted Gross Income (AGI) from your tax return plus tax-exempt foreign income, tax-exempt Social Security benefits, and tax-exempt interest. It includes wages, self-employment income, investment income, rental income, alimony received, IRA distributions, and Social Security benefits. It does not include gifts, inheritances, or child support received.
What percentage of the Federal Poverty Level qualifies me for subsidies?
You qualify for premium tax credits if your household income is between 100-400% of the Federal Poverty Level (FPL). For 2024, that's approximately $15,060-$60,240 for an individual or $31,200-$124,800 for a family of four. Those earning 100-250% FPL may also qualify for cost-sharing reductions that lower deductibles and out-of-pocket costs.
What's the difference between Bronze, Silver, Gold, and Platinum plans?
Plan metal tiers indicate how costs are shared between you and insurance: Bronze plans have lowest premiums but highest out-of-pocket costs (40% you pay, 60% plan pays), Silver (30%/70%), Gold (20%/80%), and Platinum (10%/90%) have highest premiums but lowest out-of-pocket costs. Silver plans are best for subsidy recipients as they're the only tier offering cost-sharing reductions.
What are cost-sharing reductions and who qualifies?
Cost-sharing reductions (CSRs) lower your deductibles, copayments, and out-of-pocket maximums. You qualify if your income is 100-250% FPL and you enroll in a Silver plan through the marketplace. CSRs can reduce your out-of-pocket maximum from $9,200 to $2,900 or less, making Silver plans with subsidies often better value than Gold or Platinum plans.
Can I get ACA subsidies if my employer offers health insurance?
You cannot get premium tax credits if your employer offers affordable coverage that meets minimum value standards. Coverage is considered affordable if the employee-only premium costs less than 9.12% of household income (2024). If employer coverage is unaffordable or doesn't meet minimum value, you may qualify for marketplace subsidies.
How does household size affect my subsidy eligibility?
Household size directly impacts subsidy eligibility because the Federal Poverty Level increases with more people. Include yourself, your spouse if married filing jointly, and all tax dependents (children under 26, elderly parents you support). Larger households qualify for subsidies at higher income levels. A family of four can earn significantly more than a single person and still receive assistance.
Do I have to repay premium tax credits if my income changes?
Yes, if your actual income exceeds your estimated income, you may need to repay some or all of the advance premium tax credits received. Repayment caps apply ($325-$2,800 depending on income and filing status) for those under 400% FPL. Report income changes to the marketplace immediately to avoid large tax bill surprises. Underestimating income results in a tax credit you can claim when filing.
What is the second-lowest-cost Silver plan (SLCSP)?
The SLCSP is the benchmark plan used to calculate your premium tax credit amount. Your subsidy is determined by the difference between the SLCSP premium in your area and the maximum you're expected to pay based on income. You can apply this subsidy to any metal tier plan, but the subsidy amount is always based on the SLCSP cost.
Can I change my health insurance plan during the year?
You can only enroll or change plans during open enrollment (November 1 - January 15 annually) or if you qualify for a special enrollment period. Special enrollment triggers include: losing other coverage, marriage, divorce, birth or adoption of a child, moving to a new rating area, or significant income changes. You typically have 60 days from the qualifying event to enroll.
Are dental and vision covered by ACA marketplace plans?
Adult dental and vision coverage are not essential health benefits under the ACA, though pediatric dental and vision are included. Adults must purchase separate dental and vision plans if desired. Marketplace offers standalone dental plans that you can purchase alongside your health plan, with separate premiums that may not be subsidized.
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