Subsidies and Tax Credits

  • Note: Open enrollment for 2016 is now closed.

    You may be able to enroll in a plan if you've had a major life event, such as getting married or having a baby. Find out about special enrollment periods.

    More than half of Americans who buy individual health coverage are eligible for financial help with the cost of their health plan. Whether you qualify depends on your annual household income and the number of people in your household.

    Financial help is available only if you cannot get health insurance that meets certain minimum coverage and affordability standards through your employer or your spouse’s employer. You're not eligible for financial help if you have Medicare or certain other government programs. Your financial eligibility will be re-verified each year when you renew your health plan.

    Find out if you might qualify for a subsidy and how much help you could get.

    What is your age?

    We can help

    A Premera health plan can be yours for little cost if you qualify. Premera can help you learn whether you qualify for financial help with your health plan costs and help you buy a plan.

    Call us 888-334-0109 to discuss your plan options.

    Are you eligible for financial help? 

    There are two types of financial help or subsidies: tax credits and cost-share reductions. In addition, some people with low incomes may qualify for Medicaid; state and federal governments pick up the entire tab for this.

    The government measures people’s incomes in relation to the federal poverty level (FPL). If your annual household income is less than four times the federal poverty level (400 percent), you may qualify for a tax credit. If your income is less than 2.5 times (250 percent) of the FPL, you may qualify for cost-share reductions.

    Note: If your financial or family situation changes during the year, such as if you lose your job or change jobs, your employer no longer offers health coverage, or if you have a baby or adopt a child, you may become eligible for financial assistance.

    This chart shows the guidelines whether you might qualify for each type of help for a 2016 plan.

    People in household Maximum income for tax credit (400% of FPL) Maximum income for cost-share reductions (250% of FPL)
    1  $58,880 $36,800
    2  $79,680 $49,800
    3  $100,480 $62,800
    4  $121,280 $75,800
    5  $142,080 $88,800

    Tax credits 

    The main form of help is the monthly health plan bill tax credit. This credit comes from the federal government and helps reduce the amount you have to pay each month toward the cost of your health coverage.

    How do you apply for tax credits? 

    If you're eligible for tax credits, you must purchase your health plan through a health exchange.

    In Alaska, that's the federal exchange, Premera can help you determine whether you qualify for financial assistance, help you sign up for a health plan, and apply for a tax credit. Contact us at  888-334-0109 to discuss your plan options.

    How much will you get? 

    It depends! The tax credit is designed to reduce the percentage of your household income you pay for your health coverage. So the amount you get will depend on both your income and the cost of the plan you choose to purchase.

    Cost-share reductions: Lower costs when you need care 

    The second type of financial help lowers the amount you pay when you receive care, such as visiting the doctor’s office or filling a prescription.

    How do you apply for cost-share reductions? 

    The cost-share reduction is only available if you purchase a silver-level plan through Call us at  888-334-0109. We can help you with the application process through

    Premera offers several silver plans that are eligible for these cost reductions.

    Learn more about the cost-share subsidy in this short video from

    Health insurance and your taxes

    This year the Internal Revenue Service will require that you provide information on your health plan coverage.

    If you get coverage through an employer or directly through Premera, you will only need to confirm that you had coverage for the year. If you didn’t have coverage for at least 9 months of 2014 you may have to pay a penalty.

    If you enrolled through you’ll receive a statement from them (Form 1095-A) that will help you complete your tax return.

    If you either got a tax credit or are facing a penalty, you may want to use a tax filing service or speak with a financial advisor to make sure your tax return is correct.

    Find more information about how health coverage affects your tax filing, along with all the forms you might need, at