Subsidies and Tax Credits

  • subsidy chart for PBC 2017

    Find out if you may be eligible

    Here's some good news: The majority of Washington state residents who buy individual health coverage are eligible for financial help with the cost of their health plan. Your annual household income and the number of people in your household determine whether you qualify. Your eligibility must be re-verified each year when you renew your health plan.

    Financial help is available only if you are not offered a health plan through your employer or your spouse’s employer that meets certain minimum standards for coverage and affordability.

    If you have a plan from Medicare or certain other government programs, you won't be eligible for a subsidy or tax credit. This chart gives you can idea of whether you might qualify for a subsidy. Note: The incomes listed reflect subsidy information for 2016. Income levels for 2017 will be posted as soon as they're available.

    Tax credits for health plan premiums

    The most common form of financial help is a tax credit for health plan premiums. The federal government provides this type of credit. These credits 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 the state health exchange. In Washington, that's Washington Healthplanfinder. Premera can help you determine whether you qualify for financial assistance, help you sign up for a health plan through Washington Healthplanfinder, and apply for a tax credit.

    How much will you receive?

    The amount you receive will depend on your income and the cost of the plan you choose to purchase.

    Cost-share reductions lower costs when you receive 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. These are called cost shares.

    How do you apply for cost-share reductions?

    The cost-share reduction is available only if you purchase a silver plan through Washington Healthplanfinder. Premera offers silver plans that are eligible for these cost reductions.

    We can help you with the application process through Washington Healthplanfinder. Call us weekdays from 8 a.m. to 8 p.m. at 855-515-8436 with any questions.

    Health plan coverage and your taxes

    The Internal Revenue Service (IRS) requires that you provide information about your health plan coverage on your annual tax return.

    If you receive coverage through an employer or directly through Premera, you'll need to confirm that you had coverage for the year. If you didn't have coverage for at least 10 months of 2016 you might have to pay a penalty.

    If you enrolled through Washington Healthplanfinder, you'll receive a statement from them—IRS Form 1095—that you'll need to complete your tax return.

    If you received a tax credit or are facing a penalty for not having coverage, you might want to consult with a tax or 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, on the Affordable Care Act page of IRS.gov.