Learning Center . Learning Insurance . Health Insurance Affordability

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Health Insurance Affordability

Learn if health insurance through your job is affordable, and if you can get financial help for a Marketplace plan.

Ask your job for the following information:

  1. Are you eligible for coverage now, or in the next 3 months?

  2. Does the plan offered meet the minimum value standard?

    • The plan covers at least 60% of the total allowed benefit costs.

  3. How much would the employee pay in premiums for the lowest-cost plan that meets the minimum value standard?

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Checking if the plan is affordable:

Find 9.96% of your household monthly income before taxes.

  • Add together all incomes from your household.

  • Multiply the total monthly household income by 0.0996

    • Example: The monthly plan premium at your job is $350/month. You make $5,500/month before taxes. $5,500 x 0.996 = $548

    • In this example, the plan is considered affordable since the plan premium is less than 9.96% of the monthly income.

If your plan is considered affordable, then you will not be able to get financial help from HealthCare.gov.

If your plan is NOT affordable, you can apply for financial help on HealthCare.gov. Go to www.healthcare.gov to apply, or call 1-800-318-2596. You can also call (877) 942-6837 for local help.

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You can download a printable PDF of this information

Click the image to download a copy in English and Spanish.

An educational worksheet about health insurance affordability, with sections on asking your job for information, calculating household income, checking plan affordability, and applying for a Marketplace plan. It includes instructions, checkboxes, dollar amounts, and color coding for ease of understanding.