Learn About Savings

Find Out if You Qualify For Savings

To help make health coverage more affordable, the government offers financial help—like Advanced Premium Tax Credits (APTCs) and Cost Sharing Reductions (CSRs).

If you qualify for financial help, it could help lower your monthly insurance cost. Find out before you shop.

Reminder: Government financial savings can only be used for plans purchased on the Health Insurance Marketplace. If you DO qualify for financial savings, be sure to look for Highmark plans when you shop on the Marketplace.

Learn about financial help and programs you may be eligible for. Check your eligibility and apply for savings on the Marketplace.

If you don’t qualify for financial savings, you can still purchase an Affordable Care Act (ACA) plan on the Marketplace.

Reminder: Highmark Inc., takes your privacy and security seriously. Learn more about how we protect your information.

What Happens Next?

After you’ve submitted your application to the Health Insurance Marketplace, learn more about the many ACA plans Highmark offers.

You’ll find Highmark plans available across Bronze, Silver, Gold and Platinum metal levels for individuals and families. There are many options to fit your budget and needs.

Need help figuring it out?

No problem – we’re here for you. Call us or chat with one of our agents.
Or, visit a local insurance agent in your area.

How long will the Marketplace application take?

The process may take about 30 minutes; more if you have a large family. You’ll need some information. Here’s a handy checklist:

You’ll need:
  • Employer and income information for everyone in your tax household. For example: paystubs, W-2 forms, or wage and tax statements
  • Social Security numbers (or document numbers for any legal immigrants)
  • Birthdates for everyone you are applying for
  • Policy numbers for any current health insurance
  • Information about any job-based health insurance available to your family
  • Tribe name if you or a family member are American Indian or Alaska Native

More About Eligibility

In general, you may be eligible for premium tax credits if you meet all of the following:
  • Must purchase an ACA health insurance plan
  • Be lawfully present in the United States and meet residency requirements
  • Be a current tax filer with the IRS
  • Not presently be in jail or prison
  • Not be eligible for coverage through an employer or government plan
  • Be within certain income limits
  • Cannot be claimed as a dependent by another person
  • Do not file a Married Filing Separately tax return (unless you meet the criteria in section 1:36B-2T(b) (2) of the Temporary Income Tax Regulations, which allows certain victims of domestic abuse and spousal abandonment to claim the APTC using the Married Filing Separately filing status)

You may be eligible for premium tax credits if your expected 2018 household earnings fall between 100% and 400% of the Federal Poverty Level (FPL). If your income falls below these levels, you may be eligible for other government health insurance programs.

For expected total household earnings in 2018, this amount is $12,060-$48,240 for an individual, or $24,600-$98,400 for a family of four. (Amounts in Alaska and Hawaii may differ.)

For more information, visit www.healthcare.gov.

To use the Advanced Premium Tax Credit, you must purchase a Bronze, Silver, Gold or Platinum level plan for yourself or your family through the Health Insurance Marketplace.
If I’m eligible for tax credit savings, when and how do I receive it?

For those who are eligible, the Advanced Premium Tax Credit (APTC) reduces either your monthly insurance premium or your yearly federal tax bill. You can choose which option makes the most sense for your budget:

  • If you’d like to take all of the tax credit to lower your monthly premium costs, it can be applied in advance – sent directly to your insurance company – to help lower your premium. Or,
  • You could choose to apply the credit towards any taxes you owe. Or,
  • You can have the credit refunded to you if you do not owe any taxes.
Are there other savings I might qualify for?

Yes. In addition to the Advanced Premium Tax Credit the government also offers cost-sharing reductions (CSRs). These are sometimes called “subsidies,” and are based on household size and income.

A cost-sharing reduction (CSR) lowers what you pay out-of-pocket when you use health care services (a copay, for example). CSRs are generally only available for individuals and families purchasing a Silver plan through the Health Insurance Marketplace.

You may be eligible for an Advanced Premium Tax Credit, a CSR, or both. You’ll find out more about these savings, or any programs you may qualify for, when you submit an application to the Health Insurance Marketplace.

If you’re a member of a federally recognized American Indian or Alaska Native tribe and you’re eligible for a cost-sharing reduction, you may use it to purchase any individual metal level plan available through the Health Insurance Marketplace. For more information visit www.healthcare.gov.

What if I’m an American Indian or Alaska Native?

You more easily qualify for lower out-of-pocket costs (also called cost-sharing reductions, or CSRs). You may even be eligible for $0 cost-sharing if your yearly income is expected to be below a certain level – around $73,800 for a family of four in 2018. Other financial help may be available for plans in the Health Insurance Marketplace.

When you submit an application to the Marketplace, you’ll learn more about financial help and programs that may be available to you.

Members of federally recognized American Indian and Alaska Native tribes are also eligible for special enrollment periods. They may purchase insurance for Marketplace products outside the yearly open enrollment dates.