Affordability Programs For Purchasing Coverage Through An Exchange
Certain individuals who are applying for coverage will also be eligible for the ACA’s insurance affordability programs—health insurance subsidies in the form of premium tax credits and cost-sharing reductions—to help cover the cost of coverage through the Exchange. An additional set of eligibility criteria applies to these individuals. In addition to the eligibility requirements for purchasing coverage through an Exchange, these individuals:
- Generally must have household income for the year between 100 percent and 400 percent of the federal poverty line (FPL) for the taxpayer’s family size;
- May not be claimed as a tax dependent of another taxpayer; and
- Must file a joint return, if married.
In addition, the individual must enroll in one or more qualified health plans (QHPs) through an Exchange and cannot be eligible for minimum essential coverage (such as coverage under a government-sponsored program or an eligible employer-sponsored plan that is affordable and provides minimum value).
Regardless of whether an individual is eligible for the insurance affordability programs, he or she will still be eligible to enroll in a QHP through the Exchange as long as the basic eligibility requirements are met.
Material posted on this website is for informational purposes only and does not constitute a legal opinion or medical advice. Contact your legal representative or medical professional for information specific to your legal or medical needs.