Subsidized Coverage

Health coverage is available at little to no cost to individuals with incomes below certain levels. Medicaid and Children’s Health Insurance Program (CHIP) are examples. Marketplace plans with premium tax credits are subsidized coverage.

Cost-sharing subsidies: Cost-sharing subsidies limit the amount individuals and families with incomes at or below 250 percent of the FPL pay in out-of-pocket expenses. For example, out-of-pocket expenses for individuals and families with incomes between 100 and 150 percent of the FPL would be capped at 6 percent. The government pays the subsidies directly to the insurer, which then lowers deductibles, co-payments, and other out-of-pocket costs.