ACA-Income Table: do I qualify for a subsidy?

 

 

2015/2016 OREGON POVERTY GUIDELINES
Number of persons in family/household who are included on your Federal tax return Poverty guideline (100% of FPL) 138% of FPL

(Below this limit, adults may qualify for OHP)

150% of FPL

Between 138% and 150% may qualify for CSR 3*

200% of FPL

Between 150% and 200% may qualify for CSR 2*

250% of FPL

Between 200% and 250% may qualify for CSR 1*

305% of FPL (below this limit, children may qualify for OHP) 400% of FPL (below this limit, adults may qualify for a subsidy)
1 $11,770 $16,243 $17,655 $23,540 $29,425 $35,899  $47,080
2 15,930 21,983 23,895 31,860 39,825 $48,587 63,720
3 20,090 27,724 30,135 40,180 50,255 $61,275  80,360
4 24,250 33,465 36,375 48,500 60,625 $73,963 97,000
5 28,410 39,206 42,615 56,820 71,025 $86,651 113,640
6 32,570 44,947 48,855 65,140 81,425 $99,339 130,280
7 36,730 50,687 55,095 73,460 91,825 $112,027 146,920
8 40,890 56,428 61,335 81,780 102,225 $124,715 163,560
*CSR means that in addition to receiving a tax credit/subsidy to help purchase your plan, your plan is enhance. Silver plans only. See below.

Cost-sharing Reductions Calculations Table

Reduction in Maximum Annual Limitation on Cost Sharing for 2016
Plan Variation(from 70% AV Silver Plan) Income Range for Individual* Individual Out-of-Pocket Maximum(standard 2016 limit: $6,850) Income Range for Family of Three* Family Out-of-Pocket Maximum(standard 2016 limit: $13,700)
94% AV Silver Plan Variation
(for households with a MAGI between 100-150% of FPL )
$11,770- $17,655 $2,250 $20,090- $30,135 $4,500
87% AV Silver Plan Variation (for households with a MAGI between 150-200% of FPL) $17,655- $23,540 $2,250 $30,135- $40,180 $4,500
73% AV Silver Plan Variation (for households with a MAGI between 200-250% of FPL) $23,540- $29,425 $5,200 $40,180- $50,225 $10,400
  • Adults will be able to earn up to 138% of Federal Poverty Level and still qualify for the OHP.
  • Children of parents earning up to 305% of FPL may qualify for OHP.
  • Adults earning between 139 and 250% of FPL will be eligible for CSR ‘Cost Share Reduction’. CSR is available on Silver plans, and it means that the deductibles and copays will be shrunk down to make medical care more affordable. This is an additional/extra benefit above and beyond the subsidy for which these same people will qualify.
  • Household members earning less than 400% of FPL may qualify for a subsidy, but ONLY if they purchase new insurance through Cover Oregon and don’t have coverage available to purchase through employment.
  • The Small Employer Tax Credit, which started in 2010 will be expanded in 2014 but only for new group health insurance plans purchased through Cover Oregon.