Qualify for Premium Tax Credits 2017-11-01T01:43:49+00:00

Qualify for Premium Tax Credits

In the Health Insurance Marketplace you may be able to lower the costs of your health insurance coverage by paying lower monthly premiums. You’ll see the amount of savings you’re eligible for when you fill out your Marketplace application. Prices shown for insurance plans will reflect the lower costs.

These lower costs are handled with a tax credit called the Advance Premium Tax Credit. These tax credits can be applied directly to your monthly premiums, so you get the lower costs immediately.

Savings depend on income and family size

The amount you save depends on your household size and how much money your household earns. The Marketplace generally considers your household to be you, your spouse if you’re married, and your tax dependents. Your eligibility for savings is generally based on the income of all household members, even those who don’t need insurance. If your income falls within the following ranges you’ll qualify to save money on your premiums in 2018. The lower your income within these ranges, the more you’ll save.

  • $12,060 to $48,240 for individuals
  • $16,240 to $64,960 for a family of 2
  • $20,420 to $81,680 for a family of 3
  • $24,600 to $98,400 for a family of 4
  • $28,780to $115,120 for a family of 5
  • $32,960 to $131,840 for a family of 6
  • $37,140 to $148,560 for a family of 7
  • $41,320 to $165,280 for a family of 8

PLEASE NOTE: If your income falls below the lowest income level for each family size shown above (which is 100% of the federal poverty line), you can’t get lower costs on Marketplace coverage. (There is a limited exception for very low income legal immigrants.) You would have to pay the full cost of a Marketplace insurance plan. While you or family members might qualify for free coverage through Virginia’s current Medicaid program, thousands of low-income Virginians will not qualify for Medicaid because the state has not expanded Medicaid eligibility for adults.

Modified adjusted gross income

When you fill out the Marketplace application, a number called “modified adjusted gross income” (MAGI) will be used.

Modified adjusted gross income is generally your household’s adjusted gross income plus any tax-exempt Social Security, interest, and foreign income you have. It’s used to determine your eligibility for lower costs on Marketplace coverage, and for Medicaid and the FAMIS health insurance program (for uninsured children).

You don’t have to figure out this income yourself. The math will be done for you when you apply through the Marketplace.

How to estimate your income

When you apply for lower costs in the Marketplace, you’ll need to estimate your household income for 2018.

For most people, you can use your household’s adjusted gross income for this estimate. If you know your 2017 adjusted gross income, use that and take into account any changes you expect in 2018.

Another way to estimate your income is to add up the following items for all the people in your household, based on what you think they’ll receive in 2018:

  • Wages
  • Salaries
  • Tips
  • Net income from any self-employment or business
  • Unemployment compensation
  • Social Security payments

Other kinds of income to include when estimating your 2016 income are: rental income, interest, dividends, capital gains, annuities, alimony, and some retirement and pensions.