You may be eligible to save money on your health insurance premium and lower your monthly bill.

What is a Premium Tax Credit?

It’s a type of financial assistance from the government that can help you save on your monthly premium payment. The tax credit, if you’re eligible, will go towards reducing your monthly premium. Your premium payment is what you pay each month for your monthly bill.

Do You Qualify?

Your eligibility is based on household size and estimated income along with other factors.

The amount of premium tax credit you may be eligible for is based on how your household income compares to Federal Poverty Levels. Federal Poverty Level (FPL) is the minimum income a family requires for basic needs like food or shelter. The government decides these FPL levels. You can check the levels on the Department of Health and Human Services website. The FPL range may change based on the state you live in.

FAQs

On March 11, 2021, President Biden signed the American Rescue Plan (ARP) with immediate impacts on Marketplace. Three sections of the new law impact current and prospective Marketplace members:

  1. Enhanced APTC: Marketplace advance
    premium tax credits (APTC) subsidies will be enhanced for 2021 and 2022, allowing eligible consumers to receive more APTC than under the ACA and eliminating the subsidy cap at 400% Federal Poverty Level (FPL). Premiums are capped at 8.5% of income regardless of income, and individuals earning 100-150% FPL may be eligible for fully subsidized coverage ($0 premiums).
  2. Unemployment Income: People receiving unemployment in 2021 will be treated as earning no more than 133% FPL, unless they are otherwise eligible for Medicaid. This means they could be eligible for fully subsidized coverage.
  3. APTC overpayment: APTC subsidy overpayment in the 2020 tax year will not need to be repaid.

It depends on the state you live in.

  • For members in HealthCare.gov states: You will need to return to HealthCare.gov or enrollambetter.com beginning April 1 and update your application to receive a new eligibility determination and reselect your current plan. You may also choose to take no action and any additional tax subsidies you’re eligible for will be “reconciled” when you file your 2021 taxes next year. You may receive communication regarding updates to your APTC eligibility from your health plan and/or HealthCare.gov. In the meantime, we encourage you to keep paying your monthly premium to avoid any gaps in coverage.
  • For members in State-based Marketplaces (NV, PA, WA): This will depend on what state you live in. You may visit your State-based Marketplace website for more information on your eligibility for increased APTC. You may receive communication regarding updates to your APTC eligibility from your health plan and/or State-based Marketplace. In the meantime, we encourage you to keep paying your monthly premium to avoid
    any gaps in coverage.

If you received or were approved to receive unemployment compensation for any week in 2021, you may be eligible for an increase in APTC or be newly eligible for APTC, which
may lower your monthly premium amount. The functionality to determine eligibility and apply for this enhanced APTC will not be available until around July 2021. You may receive communication regarding updates to your APTC eligibility from your health plan and/or HealthCare.gov/State-based Marketplace. In the meantime, we encourage you to keep paying your monthly premium to avoid any gaps in coverage.

There are a number of helpful resources regarding the new law and the impacts for your particular states.

Calculate Your Savings

Thanks to the American Rescue Plan, more people than ever before are now able to save. Even if you've checked your eligibility in previous years, look again now. See what savings you may be eligible for

 And if you're already saving as an Ambetter member, you may be able to save more. Log in to your member portal

Understanding Premium Tax Credits

Watch how premium tax credits may help you save money on health insurance premiums. View the Video.


What is a subsidy? A subsidy is financial assistance provided by the federal government that helps lower what you pay for health insurance each month (your premium). The size of your family, where you live, and your income are the three things that determine your subsidy.  See if you qualify: Enroll.Ambetterhealth.com