Many individuals will qualify for financial help with their health insurance premiums, but here are some considerations.
First, go to www.healthcare.gov to be sure that the modified adjusted gross income for your whole taxable family unit falls within the income range. Be sure to include all family members who will be included in the tax return when determining family size. Also, be careful to add everyone’s income, even the little bit of money teenagers may earn in part time jobs.
Second, be sure that you intend to file a joint tax return with your spouse. This is one of the qualifying questions you will need to answer when you ultimately apply for subsidy help.
Third, look carefully at any health insurance offered to ANYONE in your taxable family for which the rest of the family members could qualify. This is another qualifier in the subsidy application. There is wording in the rules that require the employer plan premiums to pass an “affordability” test. Do not confuse that with whether these premiums are “affordable” in your family budget! If employer coverage is offered and the premiums fall within the percentage of income range predetermined by the rules, you will not qualify for financial subsidy.
Fourth, check to verify that your providers not only participate in the network for the coverage you are considering, but that they will also accept you as a patient once you are a Marketplace client. There has been tremendous confusion with this and many patients have been turned away even when providers appear in network listings as participating providers.
Fifth, if you would like to apply for the tax credit offered through the Marketplace you must still go through the application process. There is a spot where you will make notification that you intend to take the tax credit at the end of the year rather than taking a monthly subsidy against your premiums.
The income range for subsidy qualification is large and there are many Americans who will benefit from the premium subsidy which is a part of the Affordable Care Act. If you do apply, be sure to answer all questions carefully so that you won’t face problems at the end of the year as you file your taxes.