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A subsidy is financial assistance that helps you pay for something. It's not a loan. You don't pay it back. There are two kinds of subsidies available from the federal government for individual health insurance plans. The Advanced Premium Tax Credit lowers your monthly health insurance payment, or premium.
Your subsidy amount is the difference between your expected contribution and the cost of the benchmark plan in your area. See an example of how to calculate your monthly costs and your subsidy amount at the bottom of the page.
You can qualify for a subsidy if you make up to four times the Federal Poverty Level. That's about $47,000 for an individual and $97,000 for a family of four. If you're an individual who makes about $29,000 or less, or a family of four that makes about $60,000 or less, you may qualify for both subsidies.
Put simply, a health insurance subsidy helps you to pay for your health insurance. Subsidies lower your monthly premium, which is the amount you pay for health insurance coverage every month. Some subsidies also help by lowering other costs, like your copay. A subsidy is not a loan.
The subsidy is based on the guarantee that you pay no more than 9.5 percent of your income for the second lowest Silver plan. It's calculated by taking that cost and subtracting 9.5 percent of your income. You can then apply this amount to the plan you choose.
If you earned more than you estimated, and you got a subsidy for your health insurance, you may have to pay back some subsidy. The maximum amount of payback is tied to your actual income.
The subsidies (both premium assistance tax credits and cost-sharing) are not considered income and are not taxed. Either way, the subsidy is a tax credit, and is not considered income. Cost-sharing reductions (CSR, also known as cost-sharing subsidies) are also not considered income.
Courts in some cases9 have held such subsidies are capital in nature and hence not taxable. Subsidies are capital in nature. It is important to note that the Finance Act, 2015 with effect from A 2016-17, included the term subsidy' in the definition of 'income' under Section 2(24) of the Act.
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