► MA - What is a Subsidy?

Kaiser Family Foundation - Health Insurance Marketplace Calculator



Massachusetts Subsidy Info
When you buy health insurance coverage through the Massachusetts Health Connector, you may be able to get help from the government with paying for your coverage if you meet certain income criteria.  This financial assistance from the government is often referred to as a “subsidy.”  In order to obtain any subsidy, you must shop and apply for coverage through the Health Connector and supply the required information on your income and household size.  

Households with income between 100% and 400% of the federal poverty level qualify for a subsidy known as a “Premium Tax Credit” (sometimes Advanced Premium Tax Credit or APTC) which helps reduce the amount you pay each month for your health plan premiums should you choose a Platinum, Gold, Silver or Bronze plan. (Health Connector plans are grouped into 5 categories: Platinum, Gold, Silver, Bronze, and Catastrophic.  However, Catastrophic plans are not eligible for subsidy.)  Federal poverty level is determined by both income and family size. You can apply part or all of this tax credit to your premium payments. The Health Connector will send your tax credit directly to Minuteman Health, so you pay less for your premiums each month. It is important to keep in mind that the IRS will reconcile your estimated income at the time of plan selection with the actual income that you submit on your tax returns, and if your income is higher than estimated, you may be responsible for paying back some or all of the Premium Tax Credit that you received.

In addition to a premium tax credit, households with income between 100% and 300% of the federal poverty level also qualify for savings on out-of-pocket costs available through a special program in Massachusetts called ConnectorCare.  Minuteman Health offers three ConnectorCare plans that have low monthly premiums and low out-of-pocket costs for things like prescription drugs and copays when you visit a Minuteman Health doctor.  Again, to qualify for a low-cost ConnectorCare plan, you must complete an application through the Health Connector either online, over the phone or in person.

The Kaiser Family Foundation has created a handy Health Insurance Marketplace Calculator which you can use to obtain estimates of health insurance premiums and subsidies you could qualify for using 2015 premium data. You will need to enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use this tool to estimate your eligibility for Medicaid.  You can find the tool online here: http://kff.org/interactive/subsidy-calculator/