Here’s how to find out if you can get ACA marketplace health insurance with premium tax credits during open enrollment before Dec 15. Includes links to federal and state web sites that let you browse before applying.

by wijwijwij

I’ve seen some posts that indicate some people have had trouble figuring out if they’re eligible for help paying for health insurance coverage on the ACA marketplace, aka Obamacare. Because the user interfaces may be hard to navigate, here is a quick guide. Open enrollment runs Nov 1 – Dec 15 for 2019 plan selection.

Federal ACA Marketplace

First find out if you can get Medicaid or ACA marketplace coverage with premium tax credits based on your state and your income. Your projected 2019 household income needs to be between 100% and 400% federal poverty level for your tax household size to be eligible for the premium tax credits.

Next, browse anonymously to preview plans and prices before creating an account.

Step 1: Enter ZIP code

Step 2: Are you enrolled in ACA plan this year?

Step 3: Who’s in your tax household? (just you, or others)

Step 4: Enter age, sex, and other info

On this screen, leave “Eligible for health coverage through job” box unchecked if your job offers insurance but the self-only coverage would cost more than 9.56% of your household income.

Step 5: Confirm

Step 6: Predict 2019 household income

This is next year’s MAGI. It’s AGI plus tax-exempt interest, nontaxable Social Security, and tax-exempt foreign earned income. It includes the AGI of your dependents only if they are required to file. Make sure you adjust this based on your anticipated 2019 adjusted gross income from all sources and your tax family composition. more info

Result: Estimated savings overview

This tells you the estimated premium tax credit monthly. This is calculated by taking second lowest cost Silver plan price for someone your age in your area and subtracting a required payment on your part that is calculated between 2.08% and 9.56% of your household income on a sliding scale. See IRS Form 8962 instructions Table 2 for details.

This premium tax credit amount will be subtracted from the prices shown on the plan browsing screen. The tax credit does not change based on what plan you pick. Exception: The tax credit will never be more than the actual cost of the plan you pick.

Hit Continue, Next, See all plans.

The list of plans may run several pages and will be a mix of all the plans, organized by premium from lowest to highest.

I recommend you look first at the Silver plans. You can quickly filter to do that.

Use Refine Results. Check Silver plans box. Apply Filters.

You can later Clear All Filters and then look just at Bronze plans.

The results screen shows the estimated monthly premium after the tax credit (with the original price in parentheses), the deductible, and out-of-pocket maximum.

For a particular plan, use Quick View to see page with more info and links to Summary of Benefits. Use Details for more information about plan.

When you are ready to actually enroll, go to the page to create an account.

Other States

Some states have their own ACA marketplace web sites.

Here are links to the main page and the browsing page that lets you research if you’re eligible for tax credits and cost sharing reductions that affect the cost of insurance if you choose ACA marketplace coverage.



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