The Health Insurance Marketplace Calculator is based on the Affordable Care Act (ACA) as signed into law in 2010, and subsequent regulations issued by Health and Human Services (HHS) and the Internal Revenue Service (IRS).
The premium is adjusted for family size and age of the user. Premiums in the calculator vary by age within the three to one limit specified in the law, using age factors from proposed regulations issued by HHS (or, state specific age factors where states have adopted them). The calculator does not display a tobacco surcharge. However, in most states, insurers can charge a tobacco surcharge of up to 50% of your total premium, and tax credits do not apply to the surcharge. Actual tobacco surcharges will vary by plan and some states do not permit insurers to vary premiums by tobacco status.
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KFF is not able to provide individual advice on your insurance options. However, we do provide answers to a number of frequently asked questions below, along with more detailed questions and answers in our Health Reform FAQ page.
It could be that you are using an older version of Microsoft Edge or Firefox. Try updating to a newer version of your web browser. Not sure which browser version you are running? Check here for Microsoft Edge or here for Firefox. If you continue to have technical problems with the Calculator after updating your browser, please contact KFF.
Yes, the calculator estimates how much you may pay and the amount of financial assistance you will receive under the Inflation Reduction Act (IRA), which continued expanded amounts and eligibility for Marketplace subsidies.
Subsidies are financial assistance from the Federal government to help you pay for health coverage or care. The amount of assistance you get is determined by your income and family size. There are two types of health insurance subsidies available through the Marketplace: the premium tax credit and the cost-sharing subsidy.
Medicaid is a comprehensive, free health insurance program (offered through a partnership between states and the Federal government) for people when they have limited income. Eligibility for Medicaid is based on your current income (vs eligibility for marketplace subsidies, which is based on your estimated total annual income for 2024). Medicaid programs vary from state to state, but most health care services are covered at little or no cost and no premium is charged. If you are eligible for Medicaid, then you would not be eligible for subsidies in the Marketplace and would instead need to sign up for Medicaid.
When using the Health Insurance Marketplace Calculator, if some members of your household are eligible for Medicare and others are not, you should enter your full household size (including those who are eligible for Medicare) in Question #4. For the following question (#5), please enter only those family members who are signing up for Marketplace coverage (do not enter adults who are eligible for Medicare in Question #6).
If you are over the age of 65 but not yet eligible for Medicare due to immigration status or your work history, you may be eligible for Marketplace coverage and subsidies. You can use the Health Insurance Marketplace Calculator by entering your age as 64.
In most states, older people will still pay more for health insurance than a younger person. The ACA requires that people aged 64 and older can be charged no more than 3 times that of a 21-year-old. Children under age 21 have slightly lower premiums and families with more than three children under the age of 21 will be charged premiums for no more than three children.
Yes. The cost of health insurance (your monthly premium) varies quite a bit by state, and even within regions of a state. This is because of several factors, such as the cost of living and cost of health care services in your area.
Under the ACA, private insurers can charge tobacco users no more than 50% more per month than those who do not use tobacco. The health law also makes clear that financial help through the Health Insurance Marketplace cannot be used to cover the portion of the premium that is due to a tobacco surcharge.
When you buy coverage through the Health Insurance Marketplace you can choose between four levels of coverage: Bronze, Silver, Gold, and Platinum. The levels are based on how much financial protection the plans offer you when you get sick or need medical care and how much you will have to pay out-of-pocket for care subject to the plan deductible and other cost sharing.
Bronze plans will have the lowest monthly premiums, but have the highest deductibles, copayments, and other cost sharing. If you get sick or have an accident, your share of covered medical bills that you will have to pay out-of-pocket will be higher because of the higher cost sharing. Silver plans are more protective and will have higher monthly premiums, but generally have somewhat lower deductibles and other cost sharing, meaning you would likely spend less out of pocket when you get medical care. Gold and platinum plans have the highest monthly payments, but the lowest cost sharing, leaving you with fewer additional costs to pay for covered services.
With most job-based health plans, an employer pays part of your monthly or yearly costs (premiums). In general, people who qualify for health insurance through their job are not able to get financial assistance through the Marketplaces.
States have the option to expand Medicaid coverage to everyone under 138% of the poverty level. If a state expands Medicaid, most of the costs are covered by the federal government under the health reform law. If your state decides to expand Medicaid, your income will make you eligible for the program. Medicaid coverage varies from state to state, but out-of-pocket costs are generally very low. Tobacco use is not taken into account in Medicaid eligibility.
Your income (which is of the poverty level) makes you eligible for Wisconsin's Medicaid Program. Medicaid coverage varies from state to state, but out-of-pocket costs are generally very low. Tobacco use is not taken into account in Medicaid eligibility.
Based on the information you provided, you are likely eligible for Medicaid. Medicaid is a health coverage program run by states and the Federal government. Under the health law, states have the option to expand Medicaid coverage to everyone under 138% of the poverty level. (The federal government pays nearly all of the costs of Medicaid expansion).
Because your state decided to expand Medicaid, your income (which is of the poverty level) means you are likely eligible for the program. Medicaid coverage varies from state to state, but out-of-pocket costs are generally very low. Tobacco use is not taken into account in Medicaid eligibility.
You may be eligible for financial assistance through the Health Insurance Marketplace. Financial assistance is only available to people who make at least 100% of the poverty level. The information below is an estimate of what you would pay for subsidized Marketplace coverage in 2024:
Based on the information you provided, you or some members of your family may be eligible for Medicaid. Medicaid is a health coverage program run by states and the Federal government. Under the health reform law, states have the option to expand Medicaid coverage to everyone under 138% of the poverty level. (The federal government pays nearly all of the costs of Medicaid expansion).
Idaho voters approved a ballot measure in November 2018 that requires the state to submit a state plan amendment to the Centers for Medicare and Medicaid Services (CMS) to implement the Medicaid expansion within 90 days of approval of the measure.
At this time, your state has not decided to expand Medicaid. This means that you or members of your family may need to meet special criteria set by your state in order to qualify for Medicaid. 0 ) { %> Children under the age of 19 at this income are likely eligible for coverage under Medicaid or the Children's Health Insurance Program (CHIP).
In addition to Medicaid, the Federal government provides financial help to some people who qualify through the Health Insurance Marketplace. However, based on the information you provided, you would not be eligible for this type of help. Because your income is equal to of the poverty level, you are not likely eligible for tax credits in the Marketplace. This financial help is only available to people who make at least 100% of the poverty level.
Under the American Rescue Plan Act of 2021, if a person qualifies to purchase insurance on the Marketplace and has received or was approved to receive unemployment compensation at any point in 2021, they and any eligible dependents can get a silver plan with a $0 premium. Because you indicated that you had received or were approved to receive unemployment income this year, you qualify for a premium tax credit that covers the full cost of the premium for the second-lowest cost silver plan in your area. You also qualify for cost-sharing reductions that significantly lower the maximum amount you and any eligible dependents would have to spend out-of-pocket in 2021. Below is an estimate of your cost for coverage and amount of financial help in 2024. For more information on how unemployment income is factored into your 2024 Marketplace costs, see the FAQs below. 152ee80cbc
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