Qualifications for Affordable Care Health Insurance Subsidy

September 27th, 2013 by admin | Filed under Healthcare Reform, Illinois Health Insurance Exchange, Obamacare.

There has been much interested in understanding what the qualifications are for health insurance under the Affordable Care Act. In Illinois, as with all states, determining an individual’s or family’s ability to receive subsidized health insurance, will be based almost exclusively on income.

Families who earn less than 4 times the national poverty level, will be able to apply for health insurance through a Health Insurance Exchange (HIX), in order to receive more affordable coverage. For many, the premiums they pay after January 1st, 2014 will be significantly lower than what they paid prior to the official rollout of Obamacare and Affordable care benefits.

Income Requirement for Obamacare

Subsidy Calculator

For those wishing to apply for discounted health insurance coverage under the Affordable Care Act, their income will play a major role in deciding their eligibility. The amounts used will vary from individuals and families, as will the premiums each ends up paying for their plan. Since Illinois is a state which continues to offer Medicaid, anyone who makes more than 138% times the national poverty line will be able to purchase their plans from the IL health insurance exchange.

Individual Health Insurance Under Obamacare


In Illinois, an individual (unmarried with no children) has two options: either purchase insurance directly from a major health insurance provider, such as Blue Cross Blue Shield of Illinois and others, or purchase it at a discounted rate though an established health insurance exchange (HIX).

For those looking to purchase a plan directly from a major health insurance carrier, they will likely see an increase in premiums ranging from moderate to sharp. These rates are expected to be higher than premiums prior to the roll out of health care reform on January 1st 2014, in order to help fund the discounted rates that those below the poverty line (unemployed, poorer families, etc.) will be required to pay.

This will be applicable to those individuals who earn more than the established poverty levels. The other option, those who earn less than 4X the established poverty level, is that they will be allowed to purchase health insurance directly from the Illinois Health Insurance Exchange.

Which Individuals Can Apply for Affordable Care?

If you’re an individual in Illinois making under $45,960 year, you should be eligible for subsidized health insurance. Here’s the break down: The current poverty level for individuals on their own is $11,490. To determine eligibility for subsidized health insurance, that number is then multiplied by four, to reflect four times the established poverty level, or $45,960 annually. So, if an individual is making less than 45,960 annually, they will be able to apply for discounted coverage provided under the Affordable Care Act. From there, they will be able to log on to the Health Insurance Exchange website, and choose from the various plans offered to those unmarried and without children or dependents.

Family & Households Under Obamacare

For families wondering how their insurance premiums will change, we use the same formula as we did with individuals. The only difference is the actual numbers used to determine eligibility. Again, we will be taking the established US poverty figures, to determine if they will need to buy health insurance through a major carrier (Blue Cross Blue Shield, etc.), as well as whether or not they may apply for discounted family plans.

Which IL Families Can Apply for Affordable Care?

To see if you qualify for a health insurance subsidy, use the subsidy calculator.

If you’re an Illinois family making under $94,200, you should be able to receive benefits under Obamacare. To be certain on whether or not your family will be able to receive benefits under President Obama’s Affordable Care Act, you must first use the poverty requirement guidelines. This will tell you if your family’s household income qualifies for discounted healthcare coverage.

The baseline poverty level for families in the United States is $23,550. When we take that number and multiply it by four, just as we did with individuals, the final income adjustment equates to $94,200. Again, if a family in Illinois or Chicago is making less than $94,200 annually, they will be able to receive discounted healthcare benefits under Obama’s new plan.

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