Who Qualifies for Obamacare, and How Is the Premium Determined?


Quick Answer

The Affordable Care Act creates health insurance marketplace exchanges allowing Americans to shop for health coverage, explains Bankrate. All Americans may shop for insurance in these exchanges, but not everyone qualifies for tax credit assistance with premiums.

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Who Qualifies for Obamacare, and How Is the Premium Determined?
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Full Answer

The Affordable Care Act sets standards defining which employer-provided health plans are considered unaffordable for families and individuals, notes Bankrate. Americans who do not have health insurance through an employer or cannot afford health insurance may qualify for a tax credit. As of 2015, these credits are available to Americans making less than 400 percent of the federal poverty level. Since health insurance plan premiums differ depending on location and family health needs, Bankrate recommends that consumers shop carefully for plans and consider what benefits they actually need from a health care plan.

According to Bankrate, a typical Affordable Care Act health care plan with tax credit subsidies cost $82 per month in 2014. Without tax credits, this premium was $346 per month. Bankrate suggests that some Americans may benefit from purchasing catastrophic coverage plans with high deductibles if they are young and healthy. Catastrophic plan premiums are generally lower, but they also provide fewer benefits than traditional plans and cost more in out-of-pocket expenses before the benefits begin to cover the costs of care.

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