Help Center – How do I get help paying for health insurance in 2014?

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Health Care Reform

Who is this for?

If you’re shopping for individual health insurance, this information will explain how health care reform can help you pay for it.

In January 2014, almost everyone will be required to have a health insurance plan. But a lot of people are already struggling to stay financially afloat. How will you be able to afford health insurance in 2014 if you can’t afford it now?

The answer is simple. While health care reform will require you to buy health insurance, it’s also creating ways to help you pay for it.

Medicaid

Medicaid already helps people with lower incomes or disabilities pay for their health care. And in 2014, it’s expanding to help even more people. That means if you’ve applied for Medicaid before and were turned down, or if you’re struggling to pay for health insurance, you might qualify in the near future.

In 2014, if you earn up to 138 percent of the poverty level (approximately $15,000 for an individual and $32,000 for a family of four), you’ll be eligible to enroll in Medicaid.

What’s the poverty level? The Census Bureau gathers information on the nation’s people and economy and uses it to calculate the total cost of essential resources used by an average person in a year. That’s why families can have higher incomes and qualify for Medicaid—the poverty level changes based on the number of people in a family.

If you don’t qualify for Medicaid, don’t worry. You still might be eligible for a subsidy from the government to help you pay for your health insurance.

Premium assistance credits

Beginning in 2014, if your income is less than 400 percent of the poverty level (approximately $45,000 for an individual and $92,000 for a family of four), you could qualify for a premium assistance credit. It helps you pay your premiums, the monthly amount you pay for your health insurance.

Here’s what you need to know:

Premium assistance credits only work with individual coverage purchased through the Exchange. For example, you can’t get the credit if you’re eligible for Medicaid or Medicare. In most cases, you can’t get the credit if you’re eligible for insurance from your employer.
The size of your credit depends on your family size, income and benchmark option. For more information, please read our benchmark option reform alert.
Premium assistance credits will be paid directly to the health insurance plan or company. You’ll be responsible for the remainder of your premium.
If you qualify for a premium assistance credit, you might also qualify for reduced cost sharing. Cost sharing is all of the ways you share the cost of your health care with your health insurance company—things like deductibles, copays and coinsurance.

To learn more about health care reform in general and what it means for you, check out our health care reform site.