2025

ACA Subsidies And Partial Years

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ACA Subsidies and Partial Years

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ACA Subsidies and Partial Years

2020 ACA Subsidy Chart

The Affordable Care Act (ACA) provides subsidies to help low- and moderate-income individuals and families afford health insurance. These subsidies are available through the Health Insurance Marketplace, and they can significantly reduce the cost of health insurance premiums.

How ACA Subsidies Work

ACA subsidies are calculated based on the following factors:

  • Income: Subsidies are available to individuals and families with incomes up to 400% of the federal poverty level (FPL).
  • Family size: Subsidies are higher for larger families.
  • Age: Subsidies are higher for older individuals.
  • State of residence: Subsidies vary by state.

The amount of the subsidy is determined by comparing the cost of the second-lowest-cost silver plan in the Marketplace to the applicant’s income. If the cost of the silver plan exceeds a certain percentage of the applicant’s income, the applicant is eligible for a subsidy.

Partial Years

The ACA subsidies are available for full calendar years. However, there are some circumstances in which individuals may only be eligible for subsidies for a partial year. These circumstances include:

  • Losing health insurance coverage: If you lose health insurance coverage during the year, you may be eligible for subsidies to purchase a new plan through the Marketplace.
  • Gaining health insurance coverage: If you gain health insurance coverage during the year, your subsidies may be reduced or eliminated.
  • Changing income: If your income changes during the year, your subsidies may be adjusted.
  • Moving to a new state: If you move to a new state during the year, your subsidies may change.

How to Apply for ACA Subsidies

To apply for ACA subsidies, you must enroll in a health insurance plan through the Health Insurance Marketplace. You can apply online, by phone, or through a paper application.

When you apply for a Marketplace plan, you will be asked to provide information about your income, family size, and other factors. This information will be used to determine your eligibility for subsidies.

If You Are Eligible for a Partial Year of Subsidies

If you are eligible for a partial year of subsidies, the Marketplace will prorate your subsidies based on the number of months you are eligible for coverage. For example, if you are eligible for subsidies for six months of the year, you will receive half of the annual subsidy amount.

Repaying ACA Subsidies

If you receive ACA subsidies and your income is later determined to be higher than you reported, you may have to repay some or all of the subsidies. You will receive a notice from the Marketplace if you are required to repay subsidies.

Conclusion

ACA subsidies can significantly reduce the cost of health insurance for low- and moderate-income individuals and families. If you are eligible for subsidies, it is important to apply for them when you enroll in a health insurance plan through the Health Insurance Marketplace.

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