Eligible Health Plans for Public Subsidies

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Citizens and legal residents in family households with income between 100% and 400% of the Federal Poverty Level who purchase coverage through a Government Marketplace Exchange are eligible for an Advance Premium (subsidy) Tax Credit to reduce the cost of health insurance coverage.  

 

In states without expanded Medicaid coverage, like Texas with incomes less than 100% of poverty will NOT be eligible for exchange subsidies, while those with incomes at or above the Federal Poverty Level of 100% will be.    People offered coverage through an employer are also NOT eligible for Advanced Premium (subsidy) Tax Credits unless the employer plan does not have an actuarial value of at least 60% or unless the person’s share of the premium for employer-sponsored health insurance exceeds 9.5% of their income.   People who meet these thresholds for unaffordable employer-sponsored insurance are eligible to enroll in a Government Health Exchange and may receive Advance Premium (subsidy) Tax credit to reduce the cost of coverage purchased through the Government Exchange.