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Health Care Reform:

Health Insurance & Affordable Care Act

Financial Aid Part II: Cost-Sharing Subsidies

Have to buy your own health insurance? You can get financial help if you buy a health plan through your state's health insurance Marketplace, also called an Exchange. When you go to the Marketplace to enroll in a plan, you'll find out if you qualify for financial aid. It's based on how much money your family makes in 2013, how many people you will cover with health insurance, your age, and where you live. If you can get a tax credit (see Financial Aid Part I: Tax Credits) and you are buying a silver-level plan, you may be able to get a second type of financial aid. This money from the government is called a cost-sharing subsidy.

What Is a Cost-Sharing Subsidy?

A cost-sharing subsidy lowers your out-of-pocket costs -- the amount you spend whenever you get health care. You can only get this type of subsidy if you purchase a silver-level plan.

Who Qualifies for a Tax Credit or Cost-Sharing Subsidy?

You may be eligible for a cost-sharing subsidy if the amount of money you and your spouse make for all of 2013 is near the following income ranges:

  • $28,725 for one adult
  • $38,775 for a family of 2
  • $48,825 for a family of 3
  • $58,875 for a family of 4

Note that these are 2013 amounts, so they may be higher in 2014. If you live in Alaska or Hawaii, the amount you can make and still qualify will be different.

How Do I Get the Money From a Cost-Sharing Subsidy?

You won't directly get the money from your cost-sharing subsidy. Instead, the government gives the money to your health insurance company directly. That lets you pay less when you see a doctor or get a prescription.

If your employer offers health insurance but it’s too expensive, you may be able to buy health insurance through your state's Marketplace and get financial help through a tax credit. If your income falls within the ranges mentioned above, you will also qualify for a cost-sharing subsidy.

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