Premium Tax Credits and Subsidies

Residents in North Carolina who purchase health insurance plans through the Federal Marketplace may be able to receive a health insurance subsidy, paid in the form of advanced premium tax credits. These health insurance tax credits can help to significantly reduce the cost you pay for health plans offered through Blue Cross and Blue Shield of North Carolina®, or other insurance providers.

To qualify for premium tax credits (i.e. health insurance subsidies), residents of North Carolina must:

  1. Purchase health insurance through the Federal Marketplace.
  2. Earn an income that is at least 100% (and not more than 400%) of the federal poverty level.
  3. Not have access to Affordable Care Act compliant coverage through an employer or a spouse’s employer.

Requirement number three can be waived if the health coverage offered by an employer is considered unaffordable – more than 9.5% of the employee’s gross income to cover the employee only – or does meet Minimum Essential Value as defined under the Affordable Care Act.

The Federal Marketplace will recommend Medicaid for applicants who earn less than 100% of the federal poverty level. Because North Carolina did not expand Medicaid coverage, this will leave some people without access to a health insurance subsidy and without help from Medicaid. However, those who earn less than 100% of the federal poverty level will be exempt from the requirement to maintain health insurance coverage and will not have to pay a penalty for remaining uninsured.

For help determining how much of a health insurance subsidy you will receive, visit a personal reform advisor at WNC Health Insurance / The Asheville Blue Cross and Blue Shield of North Carolina® Store.  Our agents can help you to apply for health insurance subsidies and insure that you receive the maximum premium tax credits for which you and your family qualify.

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