Affordable Care Act

The Affordable Care Act (ACA) is a healthcare reform that makes insurance more affordable for low-to-moderate income Americans through subsidies, provides free preventative care, and protects people with pre-existing conditions.

How do I know if I’m eligible for subsidies?

You are eligible for the subsidies (i.e. premium tax credit) if you meet all of the following requirements:

• Have household income between 100% and 400% of the Federal Poverty Level. Click here to view current Federal Poverty Level numbers. If your income is above 400% of the Federal Poverty Level, you may still qualify for savings on a 2022 Marketplace health insurance plan.
  • For tax years 2021 and 2022, the American Rescue Plan (ARPA) temporarily expanded eligibility for subsidies by eliminating the rule that a taxpayer with household income above 400% of the federal poverty line cannot qualify
  • Have health insurance coverage through a Health Insurance Marketplace.
  • Are not able to get affordable coverage through an eligible employer-sponsored plan that provides minimum value.
  • Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
  • Pay the share of premiums not covered by advance credit payments.

  How much does healthcare cost under the Affordable Care Act?

  The subsidy offered by the Affordable Care Act depends on several factors including income, marital status, and number of children. To look at estimates before applying, click here.

  What type of preventative care is covered by the Affordable Care Act?

  Examples of preventative care include:

  • Checkups
  • Patient counseling
  • Immunizations
  • Health screenings

  Contact Healthcare.gov to learn more.

  How can I apply?

  Visit healthcare.gov to fill out an application online or call 1-800-318-2596 to speak with someone over the phone. The best time to apply is during the open enrollment period, which runs November 1 , 2022 – January 15, 2023. You may qualify for a special enrollment period if you recently lost health insurance, changed jobs, got married, had a baby, and/or other major life events.

  If you need help completing an application, an NC Health Care Navigator can assist you. Navigators are available in person, online, or via phone. Call 1-855-733-3711 or visit getcoveredamerica.org to schedule an appointment for help.

  Small businesses with less than 50 employees can get help applying for health coverage through the SHOP Call Center. The Call Center can help employers and employees when they call 1-800-706-7893 (TTY: 1-888-201-6445).

  How did The American Rescue Plan impact the Affordable Care Act?

  The American Rescue Plan led to several enhancements:

  • The amount of income you can spend on a health insurance plan is capped at 8.5%, meaning more people will qualify for Premium Tax Credits.
  • Most people currently enrolled in a Marketplace plan will qualify for more tax credits.
  • Health insurance premiums will go down.

  Need more information?

  Visit healthcare.gov or call 1-800-318-2596 (TTY: 1- 855-889-4325) to get more information about the Affordable Care Act.

  Last updated 9/21/2022