NC Health Insurance Subsidies

Over the years health care costs have continued to rise drastically.  The government realizes that if North Carolinian’s are required to purchase health insurance then the government must also step up to the plate to help those that can’t afford to purchase the coverage on their own.

Because of this the Affordable Care Act outlines two types of NC health insurance subsidies available to folks that meet certain eligibility criteria.:

  1. Premium subsidies will be provided to individuals and families to lower the amount of monthly premium they pay.  This will be available for folks whose income is less than 400% Federal Poverty Limit (FPL).
  2. Cost-sharing assistance are additionally available for individuals or families that are less than or equal to 250% FPL and they purchase a silver plan.  This limits the out of pocket costs for deductibles, coinsurance, copayments, etc.  Basically a plan upgrade without a premium upgrade.

In order to qualify for an ACA health insurance subsidy an individual/family must:

  • Be a citizen or national of the US or a lawfully present immigrant that files a tax return
  • Must purchase a plan inside the health insurance exchange
  • Household income must be below 400% FPL.  Click here for a chart.
  • Cannot be eligible for “other acceptable coverage
    • Medicaid or Medicare
    • “Affordable” employer sponsored health coverage (may be eligible for subsidy if employee (self only) premium costs is greater than 9.5% of household income OR if the plan offered has an actuarial value of less than 60%)

 

Below is the 2013 Federal Poverty Level (FPL) Chart

Household Size

100% FPL

133% FPL

150% FPL

200% FPL

300% FPL

400% FPL

1

$11,490

$15,282

$17,235

$22,980

$34,470

$45,960

2

$15,510

$20,628

$23,265

$31,020

$46,530

$62,040

3

$19,530

$25,975

$29,295

$39,060

$58,590

$78,120

4

$23,550

$31,322

$35,325

$47,100

$70,650

$94,200

5

$27,570

$36,668

$41,355

$55,140

$82,710

$110,280

6

$31,590

$42,015

$47,385

$63,180

$94,770

$126,360

7

$35,610

$47,361

$53,415

$71,220

$106,830

$142,440

8

$39,630

$52,708

$59,445

$79,260

$118,890

$158,520

For each additional person, add

$4,020

$5,347

$6,030

$8,040

$12,060

$16,080

 

Please note....At time of publication, this information is accurate. There is no guarantee
Federal interpretations of ACA will not change prior to full implementation after 1/1/14.  We are not connected with or
endorsed by the US Government or the PPACA.  Click our About Us page to learn about why we created this website.

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