Health Insurance Subsidy Estimator
Most people who buy their own health insurance qualify for help paying for it. Estimate how much of your premium the government could cover before you shop.
This estimator shows the premium tax credit you may qualify for on a Marketplace (ACA) health plan, based on your income, household size, and location. The credit lowers what you pay each month. Enter a few details to see your likely subsidy and what a benchmark plan might cost you after it.
Calculator by KFF, embedded here. It reflects current federal rules; state Marketplaces may vary.
How subsidies work
The Marketplace caps what you are expected to pay for a benchmark plan at a percentage of your income. The government makes up the difference between that cap and the actual premium, and pays it as a premium tax credit. You can take the credit in advance, applied straight to your monthly bill, so you pay less up front rather than waiting for tax time.
The credit is pegged to the second-lowest-cost silver plan in your area (the "benchmark"). You can apply it to any metal level: put it toward a cheaper bronze plan to lower your premium further, or a richer gold plan to lower your out-of-pocket costs.
Who qualifies
Eligibility depends on your projected household income relative to the federal poverty level (FPL), your household size, and not having access to other affordable coverage (like a job-based plan or Medicaid). As a rule of thumb:
- Below about 138% of FPL, you may qualify for Medicaid instead in states that expanded it.
- Between roughly 100% and 400% of FPL is the core range for premium tax credits.
- Above 400% of FPL, eligibility depends on current law. Temporary enhanced subsidies removed that upper cliff through 2025; under current rules the cliff has returned, so higher earners may get little or no credit. This is an active policy question, so treat the estimate as current-law and confirm at enrollment.
The silver-plan bonus (CSR)
If your income is under about 250% of FPL, choosing a silver plan unlocks cost-sharing reductions (CSR): lower deductibles, copays, and out-of-pocket maximums, on top of the premium credit. For lower-income households a silver plan is often the best value even though bronze looks cheaper on premium alone. The estimator focuses on the premium credit; keep CSR in mind when you compare plans.
How to use the result
- Estimate income carefully. Subsidies use projected annual income. If you under- or over-estimate, you may owe money back or get a refund at tax time.
- Compare after the credit, not before. The sticker premium matters less than what you pay after the subsidy is applied.
- Do not stop at premium. A subsidy lowers the monthly cost, but a plan’s deductible and out-of-pocket max decide what a sick year costs. Weigh total cost, not just premium.
- Enroll on the Marketplace. This is a planning estimate; your official credit is set when you apply on HealthCare.gov or your state Marketplace.
Frequently asked questions
What is a premium tax credit?
A premium tax credit (also called an APTC, or advance premium tax credit) is a government subsidy that lowers what you pay each month for a Marketplace health plan. The amount is based on your household income, size, and where you live, and it can be applied directly to your premium so you pay less up front.
Why does the estimate differ from what I see on HealthCare.gov?
This is a planning estimate based on your inputs and the benchmark plan in your area. Your official eligibility and exact credit are determined when you apply on HealthCare.gov or your state Marketplace, using verified income and household details. Use this to plan; use the Marketplace to enroll.
What income should I enter?
Use your best estimate of next year’s household Modified Adjusted Gross Income (MAGI): roughly your adjusted gross income plus any tax-exempt income, for everyone on your tax return. Subsidies are based on projected annual income, not last year’s.
This estimator is for education and planning, not a quote, tax, or legal advice. Your official eligibility is determined by the Marketplace when you apply.