Health Insurance Subsidies

Qualifying for subsidies. You may feel that purchasing health insurance is prohibitively expensive, based on your income. The federal government does provide some subsidies to help lower income individuals afford coverage. Whether you qualify for a grant will depend on many factors. If you or a loved one are approaching Medicare age, see our Medicare Guide for enrollment windows, parts, and coverage basics.

The main three are:

1. Your household income
2. The number of your dependents
3. In what part of the country you are located.

Estimate your income

When you fill out the application, you’ll be using your modified adjusted gross income. Your adjusted gross income is the total amount of money you made last year, minus certain items. If you want to model how income and coverage affect your long‑term finances, try our Retirement Calculator.

List your household dependents and their income

Now that you’ve got an income number, go to www.healthcare.gov and shop around for a plan you like. Depending on which method you select and what information you put in, the site will tell you whether you qualify for subsidies.

My income is too high for subsidies

I know it can be frustrating if you seem to be just getting by but are deemed to be making too much money to qualify for a subsidy. Here are some suggestions.

• Go through the insurance company, not the Marketplace.
• Solicit help from an insurance agent or broker.
• Investigate a health insurance seller online.

Be sure to check and double-check your options. Keep in mind that even if you are unable to get lower cost on monthly premiums based on your income, you might be able to save on some out-of-pocket costs by selecting a higher deductible and qualify for a premium tax credit. This credit is for anyone purchasing health insurance through the health insurance marketplace.

How do health insurance premiums affect me?

Before the Affordable Care Act, insurance companies could adjust your premium rates based on things like your health status, medical history, gender, and the industry in which you worked. All that changed with the ACA. Today insurance premiums can only vary based on your age, whether you use tobacco products, your family size, and where you live. Also consider our Retirement Planning Checklist to make sure you’ve covered key financial and retirement planning items.

How does this work in practice?

Here are the basics:

• The older you are, the more premiums may cost you.
• If you smoke, expect to pay a higher premium. Religious or ceremonial use does not count.
• If you have a larger family, your premium will be higher. Household size is based on dependents claimed on your tax return.
• Premium prices vary by state and city, so you may have to relocate for better rates.

This Medicare resource was provided by Amerus Insurance Group, a trusted source for individual and family health insurance solutions nationwide. We help clients compare ACA marketplace plans, private health coverage, and supplemental options to find the right balance of benefits and affordability. Contact Amerus today for a free health plan review.