Understanding Income Levels and Savings

Explore how your income impacts potential savings on Marketplace premiums and eligibility for Medicaid or the Children’s Health Insurance Program (CHIP). You can also determine who should be included in your household and how to estimate your income accurately before applying.

Steps to Determine Your Savings:

1.State of Residence:
Select your state from the list provided.

2,Household Size:
Include yourself, your spouse if married, and any dependents you claim on your tax return, even if they do not need coverage.

3.Estimated Household Income:
Choose the income range that best represents your household’s anticipated earnings for the year.

Next Steps:

• Estimating Income:
  Begin with your adjusted gross income and adjust for any expected changes throughout the year. Savings are based on your income estimate for the coverage year, not the previous year.

• Special Enrollment Periods:
  You might qualify to enroll or modify your Marketplace coverage based on your income estimate. Discover if you’re eligible for a Special Enrollment Period.

• Income Calculator:
  Use our tool to estimate your income and determine potential savings.

• Household Composition:
  Ensure you include all necessary members in your household count, such as your spouse and tax dependents.

For further assistance and detailed information, learn more about estimating income and identifying who to include in your household.

Cost-Sharing Reductions: Lower Your Out-of-Pocket Costs

When you apply for Marketplace coverage and provide your household and income information, you'll discover if you qualify for a "premium tax credit" to reduce your monthly insurance premium. Additionally, you may be eligible for "cost-sharing reductions" that further lower your out-of-pocket expenses for medical services.

Key Points:

1.Eligibility for Extra Savings:
Cost-sharing reductions are available for individuals whose income qualifies. These reductions decrease the amount you pay for out-of-pocket expenses, such as deductibles, copayments, and coinsurance.

2.Silver Plan Requirement:
To benefit from cost-sharing reductions, you must enroll in a Silver plan. While you can still use the premium tax credit with plans in other categories, you won't receive cost-sharing reductions unless you choose a Silver plan.

3.Adjustments for Income Changes:
If your income or household size changes, your eligibility for cost-sharing reductions may also change. If you lose cost-sharing reductions while enrolled in a Silver plan, you may qualify for a Special Enrollment Period to switch plans that better suit your needs.

4.How Cost-Sharing Reductions Work:

• • Lower Deductibles: Your deductible in a Silver plan may be reduced significantly, depending on your income. For instance, a plan with a $750 deductible might be lowered to $300 or $500 for those who qualify.
  • Reduced Copayments and Coinsurance: Costs for medical visits and services could be lower. For example, a $30 copayment could be reduced to $15 or $20.
  • Lower Out-of-Pocket Maximums: The total amount you would pay out-of-pocket annually could decrease. Instead of a $5,000 maximum, it might be reduced to $3,000.

Note: The exact savings depend on your specific income and the Silver plan you choose. Shop for Silver plans in the Marketplace to see your precise savings.

Additional Information:
For American Indians and Alaska Natives, special provisions may apply.