Are you eligible for health insurance premium tax credits (subsidies)?
In 2010, the federal government passed the Affordable Care Act (ACA) to help make health care more accessible and affordable. One way the ACA does this is by offering federal health insurance premium tax credits (subsidies) to help individuals and families who purchase their insurance through the Health Insurance Marketplace® pay their monthly premiums.
So, who is eligible for ACA premium tax credits? And how can you see if you qualify? Here’s what you need to know about health insurance premium tax credits, how they work and other ways you may be able to save on your ACA plan.
What financial assistance is available through the Health Insurance Marketplace?
The federal government offers two financial resources to help lower the cost of coverage for qualified individuals and families with health plans from the Health Insurance Marketplace. Depending on your situation, that assistance may help lower your monthly premium, your out-of-pocket health care costs or both.
Save on your monthly premium with a health insurance tax credit (subsidy)
The advance premium tax credit applies to your health insurance premiums, helping to lower the amount you pay each month. You apply for this credit through the ACA marketplace at Healthcare.gov. If you qualify, you can have all or some of your credit paid in advance to help lower your monthly premium.
Save on health care costs with cost sharing reductions
Cost sharing reductions (CSR) reduce the amount you pay for deductibles, coinsurance and copays, up to the amount of your out-of-pocket maximum. You must enroll in a silver tier ACA plan and meet other eligibility requirements to qualify for CSR.
Learn more about premium tax credits
See how premium tax credits can help you save on your health insurance premiums. Find out who is eligible and see if you qualify.
How do advance premium tax credits (subsidies) work?
Your insurance company is notified of the credit amount and paid directly by the ACA marketplace; your premium is then adjusted accordingly. You can also wait to claim all or a portion of the credit on your taxes. The amount of your premium tax credit is based on your Marketplace application, including your estimated household income and the number of people in your household. The amount may change if your income or household changes during the year.
Who is eligible for ACA health insurance premium tax credits?
Your eligibility will depend on where you live, your family size (spouse and/or dependents) and your annual household income.
You will most likely be eligible for a premium tax credit if:
- You file federal income tax returns.
- You enroll in an eligible ACA health insurance plan.
- Your annual household income is at or above 100 percent of the federal poverty level for 2026.
- You are not enrolled in Medicare, Medicaid or health insurance through your employer.
The primary factor for qualifying is income. If you make up to four times the 2026 federal poverty level, you will most likely qualify. For an individual in the continental United States, that’s about $63,800. For a family of four, that’s about $132,000. If you’re unsure about your eligibility, you can put your annual household income into our calculator to see if you qualify for any health insurance premium tax credits. Keep in mind, the ACA marketplace will determine the exact amount you qualify for when you officially apply.
If you are eligible for health insurance premium tax credit, it’s important to keep your ACA marketplace application current. If your income or household changes, update your information as soon as possible. This can help you receive a more accurate tax credit amount and avoid an unexpected difference when you file your federal tax return.
What ACA marketplace plans are eligible for a premium tax credit?
To receive a premium tax credit, your health plan must be purchased through the Health Insurance Marketplace. All Wellmark individual and family ACA plans are eligible for premium tax credits.
Explore your Wellmark individual or family plan options
When you’re ready, see what Wellmark individual and family plan options are available in your area. With Wellmark’s online shopping platform, you can estimate your tax credit amounts and compare plan features, costs and network access at the same time. See if you qualify and what plan options are available in your area.
Prefer personalized guidance? Find a local Wellmark agent near you.