Do You Know If You Qualify For a Health Care Subsidy?


| 3 min read

Under the Affordable Care Act, everyone is required to have health insurance, whether it’s through your employer, parents or the Marketplace. Last year, nearly 11.7 million Americans enrolled in a health plan during open enrollment. If you’re one of the many Americans who is enrolling in an individual plan, you might be eligible for financial assistance through subsidies. Blue Cross Blue Shield of Michigan’s team of health plan advisors are ready to help you understand whether or not you qualify for the federal subsidies that help reduce the costs of health plans. Before you discover whether or not you qualify for subsidies, it’s important to understand what they are and how they work. The basics of subsidies A subsidy is a form of financial assistance that helps you pay for your individual health care plan. Think of it as a discount, not a loan (you don’t need to pay back the funds you receive). Last year, around 80 percent of individuals who enrolled in a Blue Cross plan received some form of a subsidy through the federal government. Two types of subsidies you may qualify for:
  • The Advanced Premium Tax Credit (affects your premium) lowers your monthly health insurance payment
  • The Cost Sharing Reduction (affects your copay) reduces the amount you pay out-of-pocket for services
Know if you are eligible Subsidies are based on income levels, and Blue Cross makes it easy for everyone to know if they qualify. Our subsidy estimator tool makes it simple to check your eligibility for 2016. It’s important to note that if you qualify for Medicaid or Medicare, or if an employer offers coverage that meets the minimum essential coverage and affordability standards, you likely will not qualify for a subsidy. Subsidy eligibility is dependent on a number of variables (income, dependents, filing status, etc.), so it’s important to check your eligibility each year as your status is likely to change. Once you know if you qualify, contact a health plan advisor or agent or visit us online at to learn more about health plans that will fit your needs and budget. How to enroll This year’s open enrollment period is November 1, 2015 to January 31, 2016. If you want your coverage to begin January 1, 2016, you need to sign up for your new plan by December 15, 2015. (You can sign up for a new plan through January 31, 2016, but coverage might start later in the year.) Blue Cross offers a wide range of plans and prices to meet your needs, including less expensive options. A Blue Cross health plan advisor can work with you to find a plan that best fits your health care needs and financial situation. Looking to enroll or modify your current health care plan? Visit us online at or contact a health plan advisor at 888-899-4931. If you prefer that face-to-face support, you can stop by one of Blue Cross’ statewide walk-in centers, which have extended hours, including weekends, during open enrollment. Photo credit: Austin Kirk
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association