Help Paying Marketplace Premiums: The Basics

I thought people who earn more than 4 times the federal poverty level are not eligible for Marketplace subsidies. Has that changed?

Yes, it has changed. Beginning in 2021 and through the 2022 plan year, there is no income cap on marketplace premium subsidies. Instead, premium tax credits are now set so that people are not required to pay more than 8.5% of household income for the benchmark silver plan. This is especially beneficial for older consumers whose age-rated premiums can otherwise be very expensive. For example, the national average premium for the benchmark silver plan is nearly $1,000 per month for a 60-year-old. Previously, someone who earned must above 4 times the poverty level had to pay that entire premium; but now tax credits will reduce what they pay to roughly $365 per month.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.