What are “income-based costs” and how are they calculated?

How much you pay each month for health insurance can be based on your annual household income. This sample chart shows different income levels relative to household size and a measurement called the Federal Poverty Level (FPL).

Annual Income at 100% of the Federal Poverty Level and Other Levels (Updated Jan. 31, 2017)

Monthly Premiums Under the Second Least Expensive Silver Level Plan (Calendar Year 2014)


For example, if you’re a family of four in the 200% FPL (meaning 200% of the number that the federal government designates as “living in poverty” for that size family) group, you earn approximately $47,700 per year and you’ll be paying about $250 a month for insurance for your entire family if you choose the Silver plan. People will be eligible for different federal subsidies and financial help from the federal government based on their household income. One of the federal subsidies available is called an Advanced Premium Tax Credit (APTC). Once you fill out your application, we’ll tell you if you qualify for the credit. If you do qualify, the credit will go directly to the insurance company so you will be paying less on your monthly bills right from the start. Cost Sharing Reductions (CSRs) are another federal subsidy that is applied to lower your out-of-pocket healthcare costs. Individuals and families who make less than 250% of the Federal Poverty Level ($29,175 for an individual and $59,625 for a family of four) are eligible to receive CSRs.