What Are Health Insurance Marketplace Subsidies?

Health Insurance Marketplace subsidies are financial assistance programs that help lower the cost of health insurance for eligible individuals and families. These subsidies, established under the Affordable Care Act (ACA), reduce monthly premiums and out-of-pocket costs for those who qualify based on income.

Types of Marketplace subsidies

• Premium Tax Credits: Reduce the monthly cost of a Marketplace health plan.
• Cost-Sharing Reductions (CSRs): Lower out-of-pocket expenses, such as deductibles and copays, for eligible individuals on Silver-tier plans.

Who qualifies for subsidies?

• Income-based eligibility: Available for individuals and families earning between 100% and 400% of the federal poverty level (FPL).
• Medicare recipients are not eligible: Subsidies only apply to Marketplace plans, not Medicare. However, Medicare beneficiaries with low income may qualify for Extra Help or Medicaid instead.

How Solace can help

A Solace advocate can help you determine eligibility for Marketplace subsidies or alternative financial assistance programs, such as Medicare Savings Programs or Extra Help for prescription drugs. If you're transitioning from employer coverage or approaching Medicare eligibility, an advocate can also guide you through your coverage options.

What to do next

Not sure if you qualify for Marketplace subsidies, or need help exploring other cost-saving programs? Find a Solace advocate today.