Más información sobre los subsidios de seguro médico

How Do Health Insurance Subsidies Work?


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.

What Is A Health Insurance Subsidy?


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. Advanced Premium Tax Credit (APTC) helps lower monthly premiums. 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.

  2. 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.



How To Know If You Are Eligible For Health Insurance Subsidy


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. 



Learn More About Insurance Subsidies Under The Affordable Care Act


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

What Your Plan Pays





Tu costo





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

Learn More about ACA open enrollment for health insurance for individuals and families, so you know when to apply.



Health Insurance Subsidies For Dental and Vision


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.



Find The Right Health Insurance Coverage Option


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.

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