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Frequently Asked QuestionsTax Credits/Subsidies
1. What if I can’t afford monthly premiums?
You may be eligible for tax credits and/or subsidies from the federal government. Many single people and working families will get money from the government to help pay their health care costs. This includes many people who the government does not help now. Beginning in 2014, these credits and subsidies will be available to U.S. citizens and legal immigrants who purchase coverage in the new health insurance Marketplace and who have income up to 400 percent of the federal poverty level (FPL).
To be eligible for the premium tax credits and/or subsidies, individuals must not be eligible for public coverage — including Medicaid, CHIP, Medicare, or military coverage — and must not have access to health insurance through an employer. (There is an exception in cases where the employer plan does not cover at least 60 percent of covered benefits on average, or the employee share of the premium exceeds 9.5 percent of the employee's income.)
2. What if I can’t afford my out-of-pocket costs?
You may be eligible for additional tax credits and/or subsides. People with incomes up to 250 percent of the FPL are also eligible for reduced cost-sharing (for example, coverage with deductibles and copayments) paid for by the federal government. Both the premium and cost-sharing reductions will vary by income and are structured so the amount that eligible people have to pay will not exceed a specified percentage of their income.