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Individual Subsidies

Subsidies: Making Coverage More Affordable

If you purchase health coverage through NY State of Health, you may be eligible for subsidies that can assist with the cost of health coverage. There are two types of subsidies: the Advanced Premium Tax Credit, also known as an individual subsidy, which lowers the monthly premium, and cost-sharing assistance, which limits the maximum out-of-pocket costs.

Are You Eligible For A Subsidy?
This calculator from NY State of Health should be used to estimate eligibility. It does not guarantee subsidy benefits.

Use a calculator to see if you may be eligible for a subsidy.

 

The Individual Subsidy
If you enroll through the NY State of Health Marketplace, you may be eligible for an Advanced Premium Tax Credit, also known as an individual subsidy, that can be used to lower what you pay for your monthly health plan premiums. The amount of the subsidy you are eligible for is based on the cost of plans offered in the Marketplace and is set on a sliding scale according to your income. You will be able to apply this subsidy to reduce the premium amount you pay each month, or you can choose to receive the subsidy when you file your federal tax return.

Eligibility Requirements
Individuals and families with incomes between 133 percent and 400 percent of the federal poverty level are eligible for federal subsidies that will offset the cost of health insurance premiums in a health insurance marketplace (see chart).

Cost-Sharing Subsidy
Individuals and families under 250 percent of the federal poverty level (FPL) may be eligible for a subsidy that lowers the cap on their out-of-pocket maximums when they purchase a silver plan. To find out if you qualify for this type of subsidy, visit NY State of Health.