The ACA provides two main forms of financial assistance that can dramatically reduce what you pay for health insurance. Millions of Americans qualify — and many don’t realize it. Understanding how these programs work can save you thousands of dollars per year.
Premium Tax Credit (PTC)
The Premium Tax Credit reduces your monthly health insurance premium. You can apply it in advance (reducing what you pay each month) or claim it when you file your federal taxes. The credit is calculated based on your household income relative to the Federal Poverty Level (FPL) and the cost of the benchmark Silver plan in your area.
Who Qualifies for the PTC
- Household income between 100% and 400% FPL — enhanced subsidies extend above 400% FPL through 2025 under current law
- Not eligible for Medicare, Medicaid, or affordable employer-sponsored coverage
- U.S. citizen or lawfully present resident
- Enrolled through the ACA marketplace (Healthcare.gov or a state marketplace)
Cost-Sharing Reductions (CSR)
CSRs reduce your deductible, copays, and out-of-pocket maximum — effectively upgrading your Silver plan to Gold or Platinum-level cost-sharing at Silver prices. CSRs are only available on Silver-tier plans, which is why Silver is often the best value for subsidy-eligible buyers.
CSR Income Thresholds
- 100%–150% FPL: Highest CSR — plan performs like Platinum (very low deductibles and copays)
- 150%–200% FPL: Mid-range CSR — plan performs like Gold
- 200%–250% FPL: Basic CSR — enhanced Silver cost-sharing
2025 Federal Poverty Level Reference (Contiguous US)
- 1 person: $15,060
- 2 people: $20,440
- 3 people: $25,820
- 4 people: $31,200
Income thresholds for subsidies are a multiple of these figures. For example, 400% FPL for a single person is approximately $60,240.
Avoiding Subsidy Repayment
If you take advance premium tax credits and your actual income ends up higher than estimated, you may owe some or all of the credit back at tax time. Reporting income changes to the marketplace promptly helps avoid large repayments.
Call us at 1-888-972-0024 to find out exactly how much subsidy you qualify for and which plan gives you the best value after assistance.