Qualifying For The Affordable Care Act.

What you need to qualify for individual insurance through the Affordable Care Act.
  • You , your spouse, and ALL your dependants Full Name, birth date, address, phone number, and social security number.
  • Email address for the primary person if you have one.
  • Copy of your Green Card if you do not have citizenship. If you have been naturalized then we will need a copy of your Certificate of Naturalization.

 Household Size

 100%

 133%

 150%

200%

250%

 300%

400%

 1

$11,880

$15,800

$17,820

$23,760

$29,700

$35,640

$47,520

 2

16,020

 21,307

23,030

  32,040

40,050

48,060

64,080

 3

20,160

 26,813

30,240

  40,320

50,400

60,480

80,640

 4

24,300

 32,319

36,450

  48,600

60,750

72,900

97,200

 5

28,440

 37,825

42,660

  56,880

71,100

85,320

113,760

 6

32,580

 43,331

48,870

  65,160

81,450

97,740

130,320

 7

36,730

 48,851

55,095

  73,460

91,825

110,190

146,920

 8

40,890

 54,384

61,335

  81,780

102,225

122,670

163,560

  1. Your Modified Adjusted gross income must be between these numbers to qualify for subsidyModified Adjusted Gross income is your income BEFORE taxes but after deductions. Your adjusted Gross income is usually found on line 37 of your 1040 tax returns.
  2. You AND your spouse must not be offered insurance through your place of employment.  If EITHER of you have a plan offered through your place of employment, then you do not qualify for subsidy, UNLESS the group plan specifically does not allow for family coverage. You can still purchase a policy for yourself, but there will be no federal subsidy.  Please note that even if your spouse has a plan and you believe it is too expensive to add you to your spouse’s work plan, you still do not qualify based on the fact that your spouse has a qualified group health plan offered to them at work if that plan is considered affordable for your spouse.
  3. The numbers above are based off of your 2015 estimates, we realize that 2015 has not happened, which is why it is a best estimate scenario. It is suggested that you use your latest tax returns and make fair estimates off of those numbers. You can adjust your income throughout the year to change your subsidy amount to the appropriate level.
  4. You will need to know your HOUSEHOLD income, not your individual income. Please ask your spouse prior to the appointment for this data.
  5. Child support does NOT count as income, but Alimony does.
  6. Even if your kids have Medicaid, we still have to have their information for the application.
  7. You can purchase insurance for anyone that is on your taxes. If they are not on your taxes, they cannot be on the same policy as you if you are applying for subsidy.
  8. You CAN purchase a policy for your elderly parents IF you claim them, or plan to claim them, on your 2015 taxes and they do NOT have Medicare.
  9. If you are currently on Medicaid/Medicare, you do not qualify for subsidy from PPACA.
  10. If your children or spouse are on Medicare/Medicaid, it does NOT disqualify you from getting coverage for yourself.
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