If you’re preparing to explore the ACA Marketplace for the first time, APTC may be new to you. Even still, for those who may already be familiar with browsing and enrolling through an ACA health insurance plan, there are new potential savings worth exploring with APTC. The latest initiatives out of Washington D.C. could translate to even more affordable monthly premiums. These premium tax credits are absolutely essential for individuals and families to leverage affordable health insurance coverage. And today, we’ll share three things you need to know to take advantage of these incredible cost savings.
1. What Is APTC and Why You Need to Know?
APTC stands for “advance premium tax credit” and is a type of health insurance subsidy offered to those leveraging the ACA Marketplace for health insurance plans. APTC is designed to help people with lower incomes afford their monthly health care premiums. The APTC will make it possible for Marketplace participating Americans to receive up to thousands of dollars in financial assistance toward the cost of his or her monthly premium payments.
ACA Provisions for Affordability
When the Affordable Care Act was first officially passed back in 2010, it already had financial assistance applications built-in, designed to reduce the costs of coverage for those enrollees who qualified. For millions of Americans, this translated to substantial savings, in some cases up to several thousands of dollars each year, making those health plans more affordable. In a sense, it’s the ACA benefit that made it the “affordable care” sought after by so many Americans back then.
More Americans Are Opting for ACA Coverage
Whether you’re turning to the Marketplace for health insurance because your employer switched from a group plan to an ICHRA or HRA, or you’re without coverage altogether, the potential subsidies may still be available. Health insurance providers are flocking to the Marketplace, too, driving competition and better rates for coverage. The effects of the pandemic continue to heighten the need for “affordable” health insurance, making the APTC savings that much more essential today.
The ACA Receives Additional Funding
President Biden signed additional relief funding for the Marketplace to directly assist Americans who find coverage there, who were adversely affected by the pandemic. The existing APTC can now offer additional savings based on these latest provisions. And in some cases, monthly premiums could be below $100 each month. Even if you already have Marketplace coverage, consider revisiting your newly available tax credits.
2. How Is APTC Eligibility Determined?
When it comes to premium tax credit eligibility, there are a few things to know regarding eligibility. Not everyone can explore the Marketplace or leverage APTC. Here’s how to tell if you’re able to enroll for yourself or your family.
You’re without Affordable Health Insurance
Right now, if you’re without coverage due to a recent job loss or employment furlough, you can browse healthcare.gov or W3LL to explore health plan options. If you already have insurance right now but anticipate changes that will have you shopping for 2022 coverage, you can also prepare for the upcoming Open Enrollment. Once you experience any kind of loss in coverage, or no longer have “affordable coverage” available to you, the ACA Marketplace is an option, with potential APTC to help with the costs.
Household Income Levels
You can be eligible for APTC if your household income level falls between 100 and 400 percent of the official definition of the Federal Poverty Line (FPL.) Take a look at your household incomes now. For one individual earning $12,490 to $49,960, you are eligible. For a family of two earning between $16,910 to $67,640, APTC discounts are available. And a family of four with a total household income level of $25,750 to $103,000 is also eligible.
Qualifying Life Events
If you experience any major life-changing events, or as the ACA calls them, Qualifying Life Events (QLEs,) you may be eligible for ACA coverage and APTC premium savings. Examples of these might include a move to a new state, having a baby, or getting married. Each of these scenarios will afford you the opportunity to review any existing health insurance plans, and make changes based on your new household or family dynamic.
3. How to Apply & Claim Your APTC
If you’re ready now to start exploring your options for APTC, you’ll need to know where to go and how to apply. Once you understand how you might benefit from leveraging the savings, it’s time to browse available health insurance plans and submit for your premium tax credits. Here’s how you can get started.
Browse the ACA Marketplace
Before you can claim any APTC savings, you’ll first need to browse the ACA Marketplace to consider health plans. There you can sort through health insurance options, sorted into metal tiers, representative of price points and coverage. Once you identify a plan that seems to be a good fit for you or your family, you can then explore APTC savings that may be available to you.
How You Can Claim and Apply Your APTC Savings
When you apply for the Marketplace coverage, an estimate will be calculated for you, based on your income and additional information provided. Based on that estimate, you can then decide if you want to leverage some or all of the APTC. The amount you select will automatically go to the insurance provider you selected, resulting in automatically lowered monthly premiums. Remember, using your APTC also means you will be required to file an IRS Form 8962 come tax time, outlining the amount of savings you claimed. And if your household size or income changes after you’ve claimed your APTC later in the year, you’ll want to connect with the ACA Marketplace and make adjustments accordingly to avoid paying back any premium benefits you no longer qualify for later.
Let W3LL Help You With Everything
If the APTC process still seems unclear, or you’re new to the ACA Marketplace altogether, you can take the first step with W3LL. As a partner with Healthcare.gov, you can use our easy-to-navigate platform to help with everything from browsing Marketplace plans, applying for APTC, and enrolling – absolutely free. Our team of health coverage professionals can help you with specific questions, too. And you’ll find it’s much easier to compare costs and coverage with our platform.
If you’re without health insurance now or anticipate a reduction in affordable coverage, don’t wait to explore your ACA Marketplace options. There could be substantial savings available to you in the form of APTC, making coverage for your household incredibly affordable. And don’t go it alone. Let W3LL be your guide, and start browsing with us today!
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