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Health care solutions for all

Getting hurt or sick isn’t something a person wants to happen, but unexpected medical events do occur. Having a health insurance plan helps pay for some of those unexpected costs, and provides financial protection against ongoing large medical bills. Speak to one of our licensed healthcare agents who can help find a program that will fit both your needs and your budget.

Cost assistance is available to help lower monthly expense of health insurance in the form of prremium tax credts.

Who is eligible for the premium tax credit?

In order to receive the premium tax credit for coverage starting in 2020, a marketplace enrollee must meet the following criteria:

Have a household income from one to four times the Federal Poverty Level (FPL), which for the 2020 benefit year will be determined based on 2019 poverty guidelines (In 2020, the subsidy range in the continental U.S. is from $12,490 for an individual and $25,750 for a family of four at 100% FPL, to $49,960 for an individual and $103,000 for a family of four at 400% FPL.)
Not have access to affordable coverage through an employer (including a family member’s employer)
Not eligible for coverage through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or other forms of public assistance
Have U.S. citizenship or proof of legal residency (Lawfully present immigrants whose household income is below 100% FPL and are not otherwise eligible for Medicaid are eligible for tax subsidies through the Marketplace if they meet all other eligibility requirements.)
If married, must file taxes jointly in order to qualify

For the purposes of the premium tax credit, household income is defined as the Modified Adjusted Gross Income (MAGI) of the taxpayer, spouse, and dependents. The MAGI calculation includes income sources such as wages, salary, foreign income, interest, dividends, and Social Security.

How will premium tax credit be provided?

To receive the premium tax credit, an individual or family must purchase insurance coverage through the Marketplace. When they apply for Marketplace coverage, enrollees will receive a subsidy determination, letting them know whether they are eligible for a premium tax credit and the amount they may receive. The person or family then has the option to receive the tax credit in advance, claim it later when they file their tax return, or some combination of the two options.

The advanced payment option allows consumers to receive their tax credit at the time of purchase and choose how much advance credit payments to apply toward their premiums each month. If the enrollee chooses the advanced payment option, then the IRS will pay insurers directly such that the cost of the premium is reduced upfront. With this option, the enrollee would need to reconcile their premium tax credit at tax time the following year. (For people receiving an advanced payment of the premium tax credit in 2020, the reconciliation would occur when they file their 2020 tax return in 2021). If the individual or family had a significant change in their income from the time they first applied for Marketplace coverage, they may be asked to repay some or all of the tax credit; or conversely, they may be owed an additional amount when they do their taxes. The table below indicates the maximum repayment limits for an individual and family, which varies depending on income level