Your income and number of family members is used to determine if you qualify for a subsidy or tax credit. Please refer to this chart to determine your Federal Poverty Level (FPL).
If you are below 150% FPL, the word MEDICAID will appear in the Subsidy column since you are close to the 138% FPL limit. Check with the state to see if you qualify for Medicaid and/or other government programs.
If you are between 150% FPL and 300% FPL, the maximum premium you will pay for health insurance is calculated for the whole family first.
• Any of your children 18 and under will then be enrolled in the CHIP program on a mandatory basis at no cost and are not included in calculating the premium for the family.
• The full premium will be calculated for the parent or parents and all children 18 and older. In no case will you be charged for more than three children in the 0 to 20 age range, but will be charged for all children 21 and older. If the full premium is greater than the maximum premium, your subsidy will equal the difference. If not, there will be no subsidy shown.
• Your subsidy is the difference between the maximum premium for your income and family size and the second lowest cost Silver plan in your area.
This amount will be shown in the Subsidy column and is subtracted from the full premium to determine the Exchange premium.
If you are between 300% FPL and 400% FPL, the full family is used in all calculations and children will be included on your policy. The subsidy amount will be shown in the subsidy column and the amount remaining for you to pay is shown in the Exchange Premium column.
If you are at or above 400% FPL, the Subsidy column will be blank or show a zero indicating you do not qualify for a subsidy and can purchase directly from your agent.
Catastrophic plans are only for those under age 30 or certified as exempt from the mandate by an exchange. They are shown as Agent Only since there are no subsidies or other advantages in using the exchange.