Health insurance savings: Are you eligible?
Financial assistance and subsidies explained.
As healthcare costs continue to rise, it’s valuable to know where you can save money. Many people qualify for financial assistance but don’t even know it.
The Congressional Budget Office reports 4.4 million uninsured Americans were eligible for premium tax credit subsidies in 2023, not including those eligible for Medicare Part B or employment-based coverage.
Financial assistance programs exist to help make health insurance affordable. The most common types of help include tax credits and cost-sharing reductions.
Who is eligible?
Generally, your eligibility depends on your household income and family size (or if you are an Alaska Native or American Indian).
The Federal Poverty Guidelines (FPG) are the largest factor in determining whether you can receive financial assistance. If your income is between 100% and 400% of the FPG, you may be eligible for subsidies that can lower your health insurance costs.
What are tax credits?
Premium tax credits help lower your monthly premium payments. These credits are determined based on a sliding scale related to your income, the cost of available insurance, where you live, and your family size.
Access to premium tax credits may be available for those who meet designated requirements from the government.
If you qualify, those credits will be paid directly to your insurer to help lower your premium. This is known as an advanced credit payment. If you’d rather get the credit amount all at once, you must wait until you file your tax return.
If your income or life circumstances change from the time you enroll through the end of the year, you may be required to pay back some of the credits you received.
What are cost-sharing reductions?
Another type of assistance you may qualify for is cost-sharing reductions (CSRs). While tax credits lower your monthly premium, CSRs help reduce the out-of-pocket costs you pay when you get care. These include deductibles, copays, and coinsurance costs.
CSRs only apply to Silver-level health plans. When you find out if you qualify for premium tax credits, you’ll also find out if you’re eligible for CSRs.
How do I find out if I qualify?
Finding out if you qualify for financial assistance is easy. When you apply for a Select Health plan through the Marketplace, you’ll enter your income and family size. The system will identify potential eligibility.
Find out if you’re eligible for savings and review Select Health plans available through the Marketplace at selecthealth.org.