The FAQs below are intended to help you understand this Calculator. More detailed questions and answers about signing up for coverage are available on our Marketplace FAQ page.
I am having difficulty viewing or understanding my results. What should I do?
It could be that you are using an older version of Microsoft Edge or Firefox. Try updating to a newer version of your web browser. Not sure which browser version you are running? Check here for Microsoft Edge or here for Firefox. If you continue to have technical problems with the Calculator after updating your browser, please contact KFF.
Please note that we are not able to provide individual advice or assistance understanding your results.
Does the calculator provide definitive results for what I will pay?
No. Although this comparison calculator is based on actual premiums for plans sold in your area, there are several reasons why your calculator results may not match your actual tax credit amount or premium payment. For example, the calculator relies completely on information as you enter it, whereas the Marketplace may calculate your Modified Adjusted Gross Income (MAGI) to be a different amount or may verify your income against previous year’s data. Additionally, some plans may include non-essential benefits, which would not be subsidized by premium tax credits. To find out if you are eligible for financial assistance under current law and to sign up, you must contact HealthCare.gov, your state’s Health Insurance Marketplace, or Medicaid program office. Note that data under the baseline ACA subsidy column is hypothetical.
How do health insurance subsidies work?
Subsidies are financial assistance from the Federal government to help you pay for health coverage or care. The amount of assistance you get is determined by your income and family size. For more information of how health insurance subsidies are calculated, visit this page.
What is included in household income? How do I know what to enter for my income?
For information on how to calculate your household income, see here.
What is Medicaid? How does it relate to financial help through the Health Insurance Marketplace?
Medicaid is a comprehensive, free health insurance program for people with limited income. This interactive takes into account whether your state has expanded Medicaid or not and will give you an estimate of whether your household income qualifies you and your family for Medicaid or the Children’s Health Insurance Program (CHIP), if applicable. Members of your family that are eligible for either Medicaid or CHIP are not eligible for subsidies in the Marketplace and would instead need to sign up for Medicaid or CHIP.
If I am eligible for Medicare, can I still sign up on the Marketplace?
No, you cannot sign up for new Marketplace coverage if you are eligible for Medicare. Most people age 65 and older are eligible for Medicare, which is the health insurance program run by the federal government. If you are eligible for Medicare, even if you do not choose to enroll in Medicare, you are not able to purchase Marketplace coverage.
When using the Health Insurance Marketplace Calculator, if some members of your household are eligible for Medicare and others are not, you should enter your full household size (including those who are eligible for Medicare) in Question #4. For the following question, please enter only those family members who are signing up for Marketplace coverage (do not enter adults who are eligible for Medicare in Question #5).
If you are over the age of 65 but not yet eligible for Medicare due to immigration status or your work history, you may be eligible for Marketplace coverage and subsidies. You can use the Health Insurance Marketplace Calculator by entering your age as 64.
What are my options if I have job-based health coverage?
In general, people who qualify for health insurance through their job are not able to get financial assistance through the Marketplaces.
However, if your employer’s coverage is either unaffordable or doesn’t meet the health care law’s “minimum value” requirement, then you may be eligible for financial help to purchase through the Marketplace. Family members (spouses and children) who are eligible for employer-sponsored coverage can still qualify for Marketplace premium tax credits if the employer-sponsored coverage is considered unaffordable. Starting in 2023, the so-called “family glitch” has been fixed to allow family members in these circumstances to enroll in subsidized coverage.
When using the Health Insurance Marketplace Calculator, you can answer “No” to Question #3 if your employer’s coverage is unaffordable or does not meet the minimum value requirement.
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