The Problem: Higher Health Insurance Prices
Health insurance costs are going up. And now you’ll be legally required to purchase a policy. So what can we do about it?
The good news is there is a solution that will help millions of people. Under the Affordable Care Act, anyone making 100-400% of the federal poverty limit will be eligible for subsidies from the government to help them pay their premiums. These are called “Premium Tax Credits.”
A Solution for Many: Premium Tax Credits
If you make between 100% and 400% of the federal poverty level, you’ll be eligible for some level of subsidy (these are called “premium tax credits”). Obviously, the higher your income, the less your subsidy amount.
These premium tax credits are designed to make health insurance more affordable for many consumers, and most people will likely qualify.
Who Is Eligible for Premium Tax Credits
So the next logical question is… what is the federal poverty limit? Check it out:
2013 Federal Poverty Guidelines for 48 Contiguous States and DC
Federal Poverty Guidelines Used to Calculate Premiums, Cost-Assistance and Taxes in 2013 – 2014:
Household Size | 100% | 133% | 138% | 150% | 200% | 300% | 400% |
1 | $11,490 | $15,282 | $15,856 | $17,235 | $22,980 | $34,470 | $45,960 |
2 | 15,510 | 20,628 | $21,404 | 23,265 | 31,020 | 46,530 | 62,040 |
3 | 19,530 | 25,975 | $26,951 | 29,295 | 39,060 | 58,590 | 78,120 |
4 | 23,550 | 31,322 | $32,499 | 35,325 | 47,100 | 70,650 | 94,200 |
5 | 27,570 | 36,668 | $38,047 | 41,355 | 55,140 | 82,710 | 110,280 |
6 | 31,590 | 42,015 | $43,594 | 47,385 | 63,180 | 94,770 | 126,360 |
7 | 35,610 | 47,361 | $49,142 | 53,415 | 71,220 | 106,830 | 142,440 |
8 | 39,630 | 52,708 | $54,689 | 59,445 | 79,260 | 118,890 | 158,520 |
For each additional person, add | $4,020 | $5,347 | $5,548 | $6,030 | $8,040 | $12,060 | $16,080 |
So figure out your family size and your annual income. If you make less than the number in red for your household size, then you will qualify for a premium tax credit of some amount.
How Do You Get a Premium Tax Credit?
In order to get a premium tax credit to help pay for your health insurance plan, you’ll have to purchase a qualified plan available on the government-run health insurance marketplace (sometimes called an “exchange”). AC Forrest is certified to help clients purchase qualified coverage in the federal health insurance marketplace, so we can help you do that.
The application process will involve verifying your income to assess your eligibility for these subsidies.
[button url=”https://www.healthsherpa.com/?_agent_id=1278″]Apply for Premium Tax Credits and Enroll in a Plan[/button]
How Premium Tax Credits Work
You can opt to receive your payment in one of two ways (but at least 99% will probably opt for option 2):
1. Get a lump sum when you file taxes.
You can opt to get your premium subsidy in the form of a credit on your 2014 taxes. If the premium tax credit amount is greater than the amount of tax you owe, you’d get the rest on your tax return. Otherwise it would simply reduce the amount you pay.
2. Have it applied to the monthly bill for your health insurance plan.
You can opt to have your estimated premium tax credit paid upfront directly to your health insurance company. The amount of your subsidy would simply be paid by the government directly to the insurance company, resulting in a lower monthly bill for you.
We think almost everyone will opt for the monthly reduction in premiums. Just know that the government will reconcile these numbers at the end of the year. In other words, if your income were to change (or if your income is varies a bit and you have a good year), and it winds up that you’ve received more premium subsidy than you qualified for, you could get hit with the difference on your taxes.
The Marketplaces will provide documentation to the tax filer and to the IRS that will support the reconciliation process, in the same way that an employer or bank provides a Form W-2 or Form 1099.
Conclusion
A whole lot of people will be eligible for a premium tax payment on their health insurance premiums. If you are among them, you’ll want to be careful if your income changes for the better during the year.
As always, we hope you’ll trust us to help you navigate Obamacare.
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