What the Government Considers “Affordable”
For employees receiving their benefits from an employer.
If the employee portion of the health insurance the employer provides costs more than 9.5% of the employee’s income, and it doesn’t cover at least 60% (Minimum Value) of the employees medical expenses, this is considered to be “unaffordable”. If your insurance is “unaffordable” you are then permitted to see if you qualify for a Subsidy (Advanced Premium Tax Credit). If the employee’s insurance from their employer is affordable, then the employee is NOT eligible for a tax subsidy.
If you DO NOT receive health insurance from your employer.
As individuals or families, if your portion of the health insurance premium costs more than 8% of your household income, it is considered “unaffordable”, which means you don’t have to buy a medical plan “excludable.”
For individuals and families that go to the exchange to buy health insurance, IF the insurance is greater than 8% of your Modified Adjusted Gross Income (MAGI) it is considered “unaffordable” and you are not required to buy insurance. MOST Americans will find they will qualify for either Medicaid or a Subsidized plan that makes insurance “affordable.”
Recent Posts
HMO, PPO, and EPO. What Is The Difference?
Health Maintenance Organization (HMO) vs. Preferred Provider Organization (PPO) vs. Exclusive Provider Organization (EPO)
Will Health Insurance Cover Rhinoplasty?
As is the case with all elective surgeries, rhinoplasty is not covered by health insurance when the procedure is not medically necessary. Cosmetic rhinoplasty changes the overall appearance of the individual’s nose by reshaping it or reducing its size.
Does Health Insurance Cover Drug Rehab?
Many who struggle with substance abuse, also struggle with mental health disorders like depression, anxiety, and bipolar disorder. Often, treatment will include medication, therapy, and rehab for both provided it’s medically necessary.