Please use these Resources for Determining Your Estimated Premium Subsidy
Federal Poverty Level (FPL)
A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.
The 2020 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children's Health Insurance Program (CHIP). 2019 numbers are slightly lower, and are used to calculate savings on Marketplace insurance plans for 2020
A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.
The 2020 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children's Health Insurance Program (CHIP). 2019 numbers are slightly lower, and are used to calculate savings on Marketplace insurance plans for 2020
2020 Poverty Guidelines Income Chart
How federal poverty levels are used to determine eligibility for reduced-cost health coverage:
- Income between 100% and 400% FPL: If your income is in this range, in all states you qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.
- Income below 138% FPL: If your income is below 138% FPL and your state has expanded Medicaid coverage, you qualify for Medicaid based only on your income.
- Income below 100% FPL: If your income falls below 100% FPL, you probably won’t qualify for savings on a Marketplace health insurance plan or for income-based Medicaid.
Estimate Your Income for 2021
To determine the premium subsidy–the Marketplace uses your "MAGI" (Modified Adjusted Gross Income). NOW on Line 8b of your 2019 tax return 1040. PLUS the full value of any Social Security Income. This is your total income.
We will use this estimate to determine your APTC ( Advance Premium Tax Credit ) or the premium discount subsidy to reduce your insurance premium.
In thinking about your income for 2021, we suggest going a little higher rather than lower. Your income estimate is reconciled with your actual income when you do your taxes for 2020 tax year (in 2021). It'll be nice to get some dollars back at that point rather than pay more.
As the premium of the benchmark Silver plan has decreased–so too the premium subsidy has decreased as well. If you have similar income estimate in 2021 as 2020 - the actual subsidy will decrease for 2021.
In thinking about your income for 2021, we suggest going a little higher rather than lower. Your income estimate is reconciled with your actual income when you do your taxes for 2020 tax year (in 2021). It'll be nice to get some dollars back at that point rather than pay more.
As the premium of the benchmark Silver plan has decreased–so too the premium subsidy has decreased as well. If you have similar income estimate in 2021 as 2020 - the actual subsidy will decrease for 2021.
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