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Más información sobre los subsidios de seguro médico

Más información sobre los subsidios de seguro médico

When planning for monthly expenses, it is important for every household budget to include health insurance costs. Sin embargo, entendemos que no siempre es fácil agregar este tipo de gasto a tus finanzas mensuales. En este punto los subsidios pueden ayudar.

¿Qué es un subsidio de seguro médico?

If you do not have health coverage provided through an employer, or eligible for Medicare, or Medicaid, you may qualify for federal financial help, called a health insurance subsidy, established by the Affordable Care Act (ACA) to help cover some of the premium and out-of-pocket costs of health coverage.

Available health insurance subsidies

Existen dos tipos de subsidios de seguro médico:

  1. El crédito fiscal anticipado para las primas reduce tus primas mensuales. The ACA premium tax credit is based on your estimated income and household size (including yourself, your spouse, and anyone you will claim as a tax dependent – even if they do not need coverage). También tiene en cuenta el costo de la cobertura médica en tu estado. If you qualify, you can choose to apply your premium tax credit to your monthly insurance premium as an advance premium tax credit (APTC). This means you will not have to pay the full amount of your monthly premium. If, at the end of the year you’ve taken more premium tax credit in advance than you’re due based on your final income, you’ll have to pay back the excess when you file your federal tax return. If you’ve taken less than you qualify for, you’ll get the difference back when you file your tax return.
  1. Cost-Sharing Reductions (CSRs) are extra savings that reduce out-of-pocket costs by lowering your deductible, coinsurance or copays, and your out-of-pocket maximum. If your income qualifies you for CSRs, you must enroll in a plan in the Silver category to get the extra savings on out-of-pocket costs.

Keep in mind, you may be eligible for both the APTC and the CSRs, which can help you save on all your annual health plan costs.

Cómo puedes saber si eres elegible para un subsidio de seguro médico

Your eligibility for a health coverage subsidy depends primarily on how much you earn compared to yearly updated federal poverty level (FPL) guidelines. As part of the American Rescue Plan Act passed on March 11, 2021, new federal guidelines went into effect that impact access to financial help.

If your household income is between 100% and 250% of FPL, you could be eligible for both the APTC and CSRs.

If your household income is more than 250% of FPL, you could be eligible for the APTC, and pay no more than 8.5% of your expected annual income toward premiums.

La cantidad de integrantes del hogar y el costo de la cobertura médica en tu estado también afectan la elegibilidad. 

Infórmate más sobre los subsidios de seguro de la Ley de Cuidado de Salud a Bajo Precio

The ACA Health Insurance Marketplace offers approved health insurance plans in four metal plan categories: Bronze, Silver, Gold, and Platinum. The categories differ by what percentage you pay of your yearly costs of care.

If eligible, the APTC (subsidy) is available in any of the four metal categories. CSRs are only available if you select a Silver plan.

The estimates in the table below are based on an average population. Your costs will vary.

Plan Bronce Silver Gold Platino
Lo que paga tu plan 60% 70% 80% 90%
Su costo 40% 30% 20% 10%
Available Health Insurance Subsidy Crédito fiscal para las primas Premium Tax Credit and Cost-sharing Reductions Crédito fiscal para las primas Crédito fiscal para las primas

Infórmate más sobre la inscripción abierta para los seguros médicos" de la ACA para personas y familias, para que sepas cuándo presentar tu solicitud.

Subsidios de seguro médico para servicios dentales y oftalmológicos

While health coverage eligible for a subsidy includes dental and vision care benefits for children, it may not always include them for adults. Si necesitas cobertura para toda la familia, también hay planes dentales y de visión independientes que pueden ofrecer la cobertura adicional que necesitas a un costo que se adapta a tu presupuesto.

Encuentra la opción de cobertura del seguro médico adecuada

Receive the support you need to enroll in health coverage. Con Anthem, recibirás ayuda para elegir un seguro médico" e instrucciones para completar el proceso de inscripción en una cobertura médica subsidiada. Incluso podemos ayudarte a saber si eres elegible para los ahorros.

Compare health insurance plans and find out if you qualify for financial help.

Buscar planes (en inglés)