2022 Obamacare Subsidy Chart and Calculator
Answer a few easy questions to calculate your subsidy eligibility in seconds.
How do you get help paying for health insurance and health coverage? It depends on how much you earn. In 2022, you’re eligible for Obamacare subsidies if the cost of the “benchmark plan” (the second-lowest-cost silver plan on the exchange) costs more than a given percent of your income, up to a maximum of 8.5%. The cut-off threshold increases on a sliding scale depending on your income. The discount on your monthly health insurance payment is also known as a Premium Tax Credit (or PTC), also known as an Advance Premium Tax Credit (APTC).
2022 health plans are measured against your projected income for 2022 and the benchmark plan cost. You qualify for subsidies if you pay more than 8.5% of your household income toward health insurance.
In 2021, premiums for new enrollees have averaged about $30 less per person per month, or 25%. For subsidized enrollees, the median deductible has dropped by 90% from $450/yr to just $50. If you already enrolled in an ACA plan and got a subsidy, you can change your plan and get the added savings through August 15th in most states.
If you decide to keep your current plan, you will receive a refund for the subsidy difference at tax time next year for the first 8 months of the year; for September – December, those enrolled via the federal exchange will see their additional subsidies automatically subtracted from their premium due amount.
Bottom line – it pays to check your eligibility level no matter what your income is. You can check resources like HealthCareInsider.com or the calculator above to figure out your subsidy rate or to see if switching is the right choice for you.
Learn More About Obamacare Subsidies
How Do You Figure Out Your 2022 Obamacare Subsidy?
Subsidies, or premium tax credits, are based on three things: Your income, the list price of the benchmark plan, and how much the Affordable Care Act requires you to pay toward your health insurance.
The actual subsidy is the difference between the benchmark plan and your expected contribution.
You have to make a reasonable estimate of how much you’ll make in advance since you generally apply for coverage before the year starts.
You also have to compare the total plan premium and your household income before coverage starts.
Prior to 2021, you were expected to chip in anywhere from 2% to 9.83% of your income. And prior to 2021, you could earn up to 400% of the federal poverty level to qualify for subsidies (also known as the subsidy cliff). For a family of four, that number equaled $104,800 a year.
Previous 2021 Total Household Income for Maximum ACA Subsidy
|Household Size||Household Income|
What’s Different in 2022 for Obamacare Subsidies?
The American Rescue Plan changed everything for 2022 (with the possibility of this change being made permanent in the near future).
The American Rescue Plan Act (ARP) of 2021 improved the affordability of the Affordable Care Act (ACA).
How? In three major ways:
First: It removed the Federal Poverty Level (FPL) income cap requirement. Previously, if you earned more than 400% FPL, you didn’t qualify for any subsidies no matter how much the benchmark Silver plan cost.
Under the ARP, the benchmark Silver plan will cost no more than 8.5% of your annual household income no matter how high that income is. The subsidies still eventually drop off to nothing, but they taper off gradually now instead of being cut off immediately the moment your income hits 400% FPL.
Second: It also increased the amount of subsidies those who earn less than 400% FPL are eligible for.
Prior to 2021, you were expected to spend from around 2% to 9.83% of your household income toward health insurance.
That range has dropped to 0% to 8.5% for two years.
Third: As of July 1, 2021, anyone who received or was approved for unemployment benefits can enroll in a free- (or low-cost), low-deductible health plan after the enhanced federal subsidies.
The American Rescue Plan also opened a Special Enrollment Period on the federal Health Insurance Marketplace. Every state with its own exchanges has also followed suit, although the deadline has expired in several of them. Even if you’ve already enrolled in a health plan, in most states you can go back and get a different plan (or reenroll in the same one).
The federal government has stated that average premiums have dropped on average about $30 per person per month and median deductibles have dropped by 90%, from $450 to just $50/year.
How Much You Pay for a Benchmark Silver Plan
|Income (by federal poverty level)||% of Your Income (before 2021)||% of Your Income (in 2021)|
|100% – 138%||2.07%||0%|
|138% – 150%||3.10% – 4.14%||0%|
|150% – 200%||4.14% – 6.52%||0.0% – 2.0%|
|200% – 250%||6.52% – 8.33%||2.0% – 4.0%|
|250% – 300%||8.33% – 9.83%||4.0% – 6.0%|
|300% – 400%||9.83%||6.0% – 8.5%|
|Over 400%||Not eligible||8.50%|
Households with more than 8 people should add $4,480 per person.
What About Medicaid Instead of Subsidies?
In most states, those who make up to 138% of the federal poverty level qualify for Medicaid eligibility instead of ACA exchange subsidies.
In 2021, for a single person, 138% of the poverty level equates to $17,774; for a family of four, that amount equals $36,570.
Alaska and Hawaii are unique states with higher income guidelines – those can be found here.
What Are These Subsidies For?
This information – and these household income amounts – apply to health insurance plans that cover you and your family during 2022.
ACA subsidies are available to reduce your monthly payments or as a credit for next year’s tax filing with the IRS.
New federal poverty level income levels are released annually in January. Those numbers are used immediately to determine eligibility for Medicaid and the Children’s Health Insurance Program (also known as CHIP). They are also used in November when the ACA Open Enrollment Period begins.
What Counts As Income?
The right income to submit is your modified adjusted gross income or MAGI (basically, the annual income you report on your tax return, with a few tweaks).
What If You Earn Too Much or Too Little to Qualify for Subsidies?
You can still “get Obamacare” no matter how much you make per year. You simply won’t qualify for monthly premium assistance if you make more than the income limit.
Less Than 100% of FPL: If your household makes less than 100% of the federal poverty level, you don’t qualify for premium tax credits (“Obamacare subsidies”). However, in most states, you’re probably eligible for Medicaid. To learn more, it’s important to apply directly to your state’s Medicaid program.
2021 Total Household Income for Minimum ACA Subsidy
|Household Size||Household Income|
If You Don’t Qualify: If your household makes too much to qualify for a subsidy, you can also consider off-Marketplace insurance.
These plans are generally identical to subsidy-eligible plans, generally cost the same, and follow ACA rules.
In some states, you’ll be able to find off-exchange ACA-compliant Silver plans which are identical to their on-exchange counterparts but which have a lower unsubsidized price, via a pricing strategy called “Silver Loading”. There’s a long, strange story behind why this is the case, but the bottom line is that those who don’t qualify for financial subsidies might find some Silver plans off-exchange which cost less than their on-exchange counterparts.
Depending on the area, you may also find that different insurers offer plans outside the exchange, giving you more options from which to choose.
What About Expanded Marketplace Subsidies?
Under the 2021 American Rescue Plan, individuals earning up to 150% FPL can enroll in a Silver benchmark plan for $0 with dramatically reduced deductibles and other out-of pocket expenses. Previously, no matter how low-income you were, people had to contribute something toward the cost of the benchmark Silver plan.
If you received unemployment benefits or were approved for them at any point during 2021, you also qualify for the expanded subsidies through the federal Health Insurance Marketplace.
On the other end of the spectrum, people who make more than 400% FPL can also qualify for a premium subsidy. In the past anyone making more than the income cap was unable to qualify and would have to pay full-price whether on or off the exchange.