► NH - What is a Subsidy?

Kaiser Family Foundation - Health Insurance Marketplace Calculator


 

WHAT IS A SUBSIDY

New Hampshire Subsidy Info
When you buy health insurance coverage through the Marketplace, 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 Marketplace 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. (Marketplace plans are grouped into 5 categories: Platinum, Gold, Silver, Bronze, and Catastrophic.  However, Catastrophic plans do not qualify 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 Marketplace 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 250% of the federal poverty level also qualify for savings on out-of-pocket costs on Silver level plansIf your income qualifies you for out-of-pocket savings, you must choose a Silver plan to get the savings. You can choose any category of plan you want, but you'll get the out-of-pocket savings only if you enroll in a Silver plan. (The Advance Premium Tax Credit described above is available for all plan types except Catastrophic plans.)

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 in the Marketplace 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 above, or at http://kff.org/interactive/subsidy-calculator/.

When you shop for a Minuteman Health plan through the Marketplace, you will enter your zip code and answer a few brief questions about your estimated income and household members for 2016.  You can preview health plans before you apply, and you’ll see premium estimates based on your income.  The estimated quotes use only the basic 2016 income information you provided. The Marketplace application itself asks for more details.

After you pick a plan you like, you can start a Marketplace application. Once you finish your application, the Marketplace will show you all the plans you’re eligible for, with subsidy-adjusted (if applicable) price quotes based on the detailed information in your application.

Beginning in January 2016, many low-income adults in New Hampshire who are ages 19-64 with incomes up to 138% of the federal poverty level and who do not qualify for Medicaid or Medicare, will be eligible to select a Minuteman Health plan with no monthly premiums and low or no copays through the New Hampshire Premium Assistance Program (PAP).
 
The PAP program is administered by the New Hampshire Department of Health and Human Services (DHHS). For more information, please visit http://www.dhhs.nh.gov/ombp/pap/index.htm

 


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