The Affordable Care Act, also known as "Obamacare" or the ACA, is the comprehensive health law passed in 2010 under that name.
If you have an illness or injury, having health insurance through an Affordable Care Act marketplace plan can assist shield you from suffering financially. For those without access to employer-based insurance or government insurance like Medicaid and Medicare, ACA plans serve as a safety net option.
Based on the size and income of your household, you might be eligible for a premium tax credit or premium subsidy under the ACA. You will be able to lower the monthly premium for your health insurance plan as a result.
By continuing to read, find out if you might be eligible for an ACA plan subsidy.
What are the income restrictions for financial aid under the Affordable Care Act?
In the 2023 coverage year, the Affordable Care Act provides new financial assistance to increase health plan access. 4 out of 5 Americans, according to the Centers for Medicare & Medicaid Services (CMS), will be able to select a plan for $10 or less each month.
Your household's income determines how much you pay and how much you save. You may be eligible for a subsidy based on how your household income stacks up against the federal poverty level.
The ACA uses your modified adjusted gross income (MAGI) to calculate savings. The adjusted gross income that appears on your tax return is distinct from this. Your tax return does not include a MAGI number.
Additionally, a projected household income for the year in which you desire health insurance will be used to determine your savings.
You will generally be eligible for a premium subsidy if your household income is between 100% and 400% of the federal poverty line. This implies that in order to be eligible for the tax credit in 2022, a single person must earn between $13,590 and $54,360. (The federal government's website will be updated; federal poverty figures for 2023 were not yet accessible.)
In 2022, a family of three would be eligible with an income ranging from $23,030 to $92,120. For a family of four, the range would be $27,750 to $111,000 in 2022. (Income limitations may be higher in Hawaii since those states have higher federal poverty levels.
You can use the calculator on Healthcare.gov to see if you're eligible for discounts. The website also lists the many types of income you should include in your estimate.
You can be eligible for Medicaid based simply on your income if your income is below 138% of the federal poverty threshold and you reside in a state with extended Medicaid coverage. You can enrol in Medicaid through the Affordable Care Act enrollment process in your state.
You probably won't qualify for Medicaid or savings on an ACA plan if your income is less than 100% of the federal poverty line.
What is covered by the Affordable Care Act?
The Affordable Care Act seeks to increase access to healthcare in a number of ways.
Families who earn between 100% and 400% of the federal poverty line are eligible for subsidies that lower the cost of their health insurance.
States can choose to extend Medicaid coverage to those whose household earnings are less than $38,295 for a family of four in 2022, or 138% of the federal poverty threshold.
Consumers are not required to pay for preventive care services.
Customers with pre-existing medical issues are eligible for coverage.
Up until age 26, young individuals are still eligible for their parents' health insurance policies.
These 10 fundamental health benefits are also covered by ACA health insurance plans:
emergency assistance
Hospitalization
testing services
Services for substance use disorders and mental health
ambulatory care
Pediatric healthcare, including child dental and vision care
infant, maternity, and pregnancy care
medicines on prescription
Services for wellness and prevention
therapeutic services
How does my income impact the cost of my insurance?
For people and families with low and middle incomes, the ACA offers savings opportunities. Generally speaking, the more financial assistance you are eligible for under the law, the less money you make.
Families will be eligible for discounts on monthly premiums if their income is between 100% and 400% of the federal poverty line, and occasionally even more. The plan you choose will also affect how much you pay each month.
The four metal tiers of the Affordable Care Act are bronze, silver, gold, and platinum. Bronze plans feature the highest out-of-pocket expenses for medical care but the lowest monthly premiums. Platinum plans feature the most expensive monthly premiums but the cheapest out-of-pocket payments for healthcare.
How does the ACA lower the cost of individual health insurance?
The ACA lowers the cost of health insurance by:
imposing restrictions on the prices insurance companies can charge customers. Insurance companies are not allowed to charge customers additional premiums because they have a pre-existing disease like diabetes or cancer.
giving low- and moderate-income individuals rebates to lower their overall health insurance costs
ensuring that individuals with ACA health insurance receive a range of preventative health treatments free of charge, such as wellness exams, mammograms, and other screenings, as well as some immunisations.
providing further cost-sharing discounts to those who meet the requirements and select a silver plan. These are "additional savings" on out-of-pocket costs like your deductible, coinsurance, and copayment.
enabling states to broaden Medicaid coverage to those with marginally higher incomes than previously qualified.
How can I sign up for the ACA?
There are numerous ways to register:
Register online at Healthcare.gov.
To find local assistance with a navigator as well as with an agent or broker, use the Find Local Help feature. They are all skilled at guiding you through the market procedure, and their services are offered without charge.
Use the website of a qualified enrollment partner, such as a private health insurance provider, to submit your application.
Call the Marketplace Call Center at 800-318-2596 to enrol over the phone. This line offers service in English and other languages around-the-clock, seven days a week (except holidays).