The income amounts to get 2023 Obamacare subsidies are based on – but higher than – last year’s federal poverty level (FPL). These discounts on your monthly health insurance payment are also known as premium tax credits.
What’s the Minimum Income for 2023 Obamacare Subsidies?
To get Obamacare subsidies in 2023, your household must earn (in 2022) at least 100% of the 2021 federal poverty level. Subsidy eligibility is based on your income for the year you’re going to have coverage.
What does that mean? You have to project how much you’ll make in advance since you generally apply for coverage before the year starts.
But it’s compared with the poverty level guidelines from the year before the coverage starts.
Why? There are two reasons:
- Open enrollment takes place before the start of each year.
- Federal poverty level numbers for each year aren’t published until open enrollment for that year’s coverage has already ended.
What You Need to Know
Subsidy eligibility is based on your income for the year you’re going to have coverage.
You qualify for federal aid for 2023 if you make one to four times the 2022 federal poverty level for your household size. For a family of four, that range is from $26,200 to $104,800.
You don’t qualify for federal aid for 2022 if you make more than four times the 2020 federal poverty level for your household size. For a couple that amount is $68,960.Households with more than 8 people should add $4,480 per person.
In most states, those who make under 139% of the federal poverty level are offered Medicaid instead of subsidies. So for a single person, that amounts to $18,754; for a family of four, that amount equals $38,295.
What’s the Maximum Income for 2023 Obamacare Subsidies?
To get Obamacare subsidies, your household cannot make more than 400% of the federal poverty level. The cutoff amounts for 2022 plans are below.
2023 Total Minimum & Max Household Income for ACA Subsidy
What Year Are These Subsidies For?
This information – and these household income amounts – apply to health insurance plans that cover you and your family during 2023.
Affordable Care Act subsidies are still available, despite the ongoing debate over the law in Washington.
New federal poverty level income levels are released annually in January. Those numbers are used immediately to determine Medicaid and CHIP eligibility, and in November, when open enrollment begins, they’ll be used to determine eligibility for premium subsidies for the coming year.
What Counts As Income?
The right income to submit is your modified adjusted gross income (basically, the income you report on your tax return, with a few tweaks).
What If You Earn Too Much or Too Little to Qualify for Subsidies?
You can still “get Obamacare” no matter how much you make per year. You simply won’t be eligible for monthly premium discounts if your income is out of the subsidy range.
Minimum and maximum levels change every year, based on how the poverty level numbers change.
|Persons in household||2023 Federal Poverty Level Threshold - 138% FPL|
|*Medicaid eligibility is different in states that did not expand Medicaid. Federal Poverty Guidelines are different in Hawaii and Alaska.|
NOTE: If your family contained more than 8 people, add $4,480 for each additional person. Note that Hawaii and Alaska use different guidelines.
Quick Reference For Assistance Program Thresholds
Each assistance program may use different percentages of the Federal poverty level as thresholds. here is a quick overview of which programs use what.
100% = Baseline Eligibility for Community Service Block Grant (CSBG) funded Programs
125% = Maximum Eligibility for Community Service Block Grant (CSBG) funded Programs
138% = Maximum Eligibility for Medicaid and CHIP in states that expanded Medicaid
150% = Maximum Eligibility for United Way Rent and Utility Assistance programs, and the Employee Profit Sharing Plan (EPSP) and Emergency Shelter Grant (ESG) programs.
100% – 250% = Eligibility for cost sharing reduction subsidies on Silver plans bought on the Marketplace. (see 2020 guidelines further down the page).
100% – 400% = Eligibility for Premium tax credits on Health Insurance Marketplace plans (see 2020 guidelines further down the page).
How to Find a Percentage of the Federal Poverty Level (FPL)
The 100% Federal Poverty Threshold Guidelines above are a quick and easy way to look at what dollar amount each year’s poverty level is by family size. If you want to see what 400% of the poverty level is, you can multiply The Federal Poverty Level figures by 4 (300% FPL multiply by 3, 250% FPL multiply by 2.5, 138% FPL multiply by 1.38 etc. TIP: Always round up to the nearest dollar for poverty levels and taxes).
If you are looking for the monthly poverty levels – for determining Medicaid eligibility for instance – divide the annual number by the number of months you are trying to calculate (or see our 6 month and monthly charts below). (ie. for 2013 100% of the FPL for one person was $11,490. If you divide this number by 12 you get a figure of $957.50 per month)
If you want more details, or the want to use a pre-calculated table instead of doing the math yourself, we suggest using additional FPL Guidelines found further down the page. The more detailed Federal Poverty Level Guidelines below will be helpful for calculating assistance amounts for the Premium Tax Credit Form 8962 (NOTE: Alaska and Hawaii use different guidelines which are also provided below).
How to Use the Guidelines for Different Assistance Programs
Medicaid and CHIP use the current years guidelines, or technically the guidelines that are current at the “time of application” (ie. use 2020 guidelines for 2021, use 2020 guidelines when the new ones are released somewhere between January and February and are printed in the Federal register, typically around January 20th).
TIP: If you are applying for Medicaid or CHIP during or around the change over date, and are close to an eligibility threshold, take extra care of how you are reporting your income. Notice that poverty level dollar amounts increase every year.
For ACA subsidies you should use the guidelines from the year before (ie. use 2022 guidelines for coverage starting in 2023; use 2022 guidelines for coverage starting after January 1st).
TIP: If your state expanded Medicaid, and you make between 100% – 138% FPL, you may have to take Medicaid or CHIP. Keep this in mind if your goal is to get a private plan with subsidies rather than public state insurance.
Depending upon what assistance program you are applying for, you may need to look at income for a full 12 month year (like ObamaCare) or, in some cases monthly income, (like Medicaid and CHIP). The guidelines on this page show dollars amounts for 12 months. Either divide any dollar amount in the charts by the number of months you are looking for or see our monthly guidelines below.
For example, a household of four had to earn no more than $94,200 to qualify for premium subsidies in 2014, whereas a household of four will be able to earn up to $104,800 in 2021 and still qualify for subsidies.
Less Than 100% of FPL: If your household makes less than 100% of the federal poverty level, you don’t qualify for premium tax credits (“Obamacare subsidies”). For a family of three, this amount is less than $21,720.
However, you’re probably eligible for Medicaid, depending on your state’s rules. To learn more, it’s important to apply directly to your state’s Medicaid program.
More Than 400% of FPL: If your household makes more than 400% of the federal poverty level, you can also consider off-Marketplace insurance through independent web brokers like Independent Health Agents. For a couple, this amount exceeds $68,960.
These plans are generally identical to subsidy-eligible plans, generally cost the same, and follow ACA rules. But depending on the area, you may find that different insurers offer plans outside the exchange, giving you more options from which to choose.
Please sign in to leave a comment.