ACA Marketplace Plans

About This Program

The ACA Marketplace (Healthcare.gov) is where individuals and families who do not have employer coverage, Medicaid, or Medicare can buy health insurance with federal subsidies. The subsidies — called premium tax credits — are based on income and the cost of coverage in your area. At lower incomes, they can reduce a $500/month premium to $10–$20/month or less. At higher incomes, the subsidy is smaller but still meaningful. Subsidies are available to households with income from 100% to 400% of the federal poverty level, with enhanced subsidies (available since 2021) potentially available above 400% FPL if the benchmark plan would otherwise cost more than 8.5% of household income. The subsidy is calculated against the "benchmark" silver plan in your area — you can apply it to any metal tier plan. Plans come in four metal tiers: Bronze (lowest premium, highest out-of-pocket), Silver, Gold, and Platinum. Households at 100–250% FPL also qualify for Cost-Sharing Reductions (CSRs), which significantly lower deductibles and copays on Silver plans specifically. A silver plan with CSRs often provides better total value than a bronze plan for lower-income households even though the premium is higher. Open enrollment runs November 1 through January 15 in most states, with coverage starting January 1 or February 1 depending on when you enroll. Outside open enrollment, you can only enroll if you have a qualifying life event — losing job-based coverage, getting married, having a baby, or moving to a new coverage area all trigger a 60-day special enrollment period.

Eligibility Requirements

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