Getting help with costs

The Affordable Care Act introduced various forms of financial assistance to help US citizens and legal residents pay for individual health insurance each month. (For help with Medicare costs click here.) More than half of Americans who apply for individual coverage are eligible for financial help.

A few guidelines about receiving financial help:

  • Not available if you can get health insurance from an employer that meets minimum coverage and/or affordability standards.

  • Not available if you are eligible for Medicare or certain other government programs.

  • Your financial eligibility will be verified each year when renewing your health plan.

  • WA residents must purchase and renew individual coverage through the WA Healthplanfinder.

Tax Credits & Cost-sharing Subsidies

The Health Insurance Premium Tax Credit (HIPTC) is the main form of help that can immediately lower what you pay in monthly premiums. Cost-sharing reductions (CSR) lowers the amount you pay when receiving care (e.g., lower deductibles, copays, etc.).

What income ranges qualify for assistance?

The government measures household income in relation to the annual Federal Poverty Level (FPL).

  • Households under 138% FPL may qualify for coverage through WA Apple Health (Medicaid).

  • Households 138-250% FPL may qualify for both tax credits and cost-sharing reductions.

  • Households 250-400% FPL may qualify for tax credits to purchase a Qualified Health Plan.

How much is my tax credit worth?

The amount of tax credit you receive depends on your household size and income. Try out this calculator to see a quick estimate.

What if I don't qualify for assistance?

WA residents who do not qualify for tax credits or subsidies based on household income can still buy a health plan through the WA Healthplanfinder or directly from an insurance company.

How do I apply for a tax credit and cost-sharing reductions?

You must apply for coverage through the WA Healthplanfinder. We can help you determine if you qualify, submit an application, and select a plan. Call us at (425) 353-9763 or contact us.