Health insurance is linked to several necessary factors like the household size. In this aspect, the data is used in determining whether an individual or family is qualified for cost assistance associated with buying health insurance through the Marketplace. To determine this, there must be a guideline to be used. The federal poverty guidelines for your household size is the one used in determining if a person qualifies for the cost assistance.
The guideline is also used in determining the eligibility of a person for Medicaid. It also provides exemptions based on the requirements for a person to buy insurance. Lastly, the guidelines are used in determining whether a high-earning person has to pay the Affordable Care Act taxes.
Currently, the new federal poverty guidelines for your household size are released. The previous one – the 2013 Guidelines – can still be used, but only to serve as reference. It is noted that both the Children’s Health Insurance Program and Medicaid eligibility will now be determined using the 2014 Guidelines. However, the advance premium tax credits eligibility will still be determined using the 2013 federal poverty guidelines. With the new federal poverty guidelines released, the state recommends for the Marketplaces to update the standards immediately. That way, it will be aligned to those marketplaces that are facilitated by the federal government.
The Rule of Thumb in Federal Poverty Guidelines for your Household Size
Those with income that is less than 4 times from the published Guideline for your household size will be receiving premium subsidies. This is enabled to help individuals in purchasing an affordable health insurance in their Marketplace. The tax credit is the one to be received upon filing one’s 2014 tax return. And, even though it is a tax credit, a person has to pay for the tax credit advance to their chosen insurance provider. Doing this is beneficial since it enables the person to lessen the amount of premium they are required to pay. Adjustments will be made later if it turns out that one’s year income is either less or more than the expected. After the adjustments, the tax credit will either be taken or added from any of the payment due or tax refund.
How the Federal Poverty Guidelines Work
The guidelines depend on the entire number of individuals within a household. The figures being used within the 48 states and the District of Columbia are the same for healthcare reasons. However, higher values are used in Alaska and Hawaii. The 100% column is showing each of the family size’s federal poverty guideline. The percentage columns are the one representing the income levels. These levels are commonly used in determining the healthcare costs for programs like the Affordable Care Act.
Those household sizes that are under the 400% of the federal poverty are the ones that can be qualified for reduced premium. This is because of the advanced tax credits. To those that belong under the 250% of the guideline, they are qualified for a policy that has reduced deductibles, maximum out-of-pocket cost and co-payments. To those living in States where Medicaid has been approved for expansion and belong under the 138% FPL, there is a chance to be qualified for Medicaid. To those in States not agreed for expansion, the FPL level is 100% to 133%.