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Health Care Reform:

Health Insurance & Affordable Care Act

West Virginia Health Insurance Marketplace

Financial Aid and Medicaid continued...

Premium Subsidies (also known as  Tax Credits ): You may qualify for a federal subsidy to help lower your monthly premium. The subsidy is available only if you buy your insurance in the Marketplace. In general, you'll be eligible if you're single and make between $11,770 and $47,080 a year, or if you have a family of four and make between $24,250 and $97,000 a year. Subsidies are based on your estimated household income for 2016 and the cost of the health plans in your area. The lower your income the more assistance you will receive. You can use your 2015 tax return to estimate your 2016 income. When you file taxes for 2016, the IRS will adjust your subsidy based on your actual income.

You also may be eligible for cost-sharing subsidies if your income is below $29,425 for an individual or $60,625 for a family of four. Cost-sharing subsidies will lower your out-of-pocket costs when you get medical care. Cost-sharing subsidies are available only if you buy a silver-level plan.

Medicaid Expansion : Some states expanded their Medicaid programs so more people can get health insurance coverage. Because West Virginia is one of them, you may be eligible if your annual income is no more than about $16,243 for one person and $33,465 for a family of four.

CHIP: The Children's Health Insurance Program, called CHIP in West Virginia, provides coverage for children of some families who have a low income but are not eligible for Medicaid.

Check with to see if you are eligible for these programs.

Available Resources

In addition to, there are several ways you can get help with your insurance decisions:

  • Call Center: You can call the federal government's help line, 800-318-2596, 24 hours a day, 7 days a week, for information, help, and to buy insurance.
  • Navigators and Assisters: They can teach you about the Marketplace and guide you through your insurance decisions. Here are the organizations approved to operate Navigator programs, or find a list at
  • Local, State, and Federal Organizations: Many health and community organizations, public libraries, and hospitals are offering help. Find a list at or a calendar of local events at
  • Insurance Brokers and Agents: People in the insurance business who are specially trained also can help you buy insurance through the Marketplace, and they may have policies that are not offered on the Marketplace. You can find a list of brokers and agents in West Virginia through You can only get tax credits or subsidies if you buy through the Marketplace, though.


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