Obamacare Health Insurance & Subsidies

August 20, 2015

Individuals and families in North Carolina can apply for subsidies that will help reduce the cost of health insurance. Although the individual mandate requires all individuals to purchase health insurance or pay a tax, there is help for those worried about the costs of coverage. The Kaiser Family Foundation estimates that approximately 48% of Americans will be eligible for subsidies.  

Who Qualifies for Obamacare Subsidies? 

In general, individuals in North Carolina earning up to  $47,080 and families earning up to $97,000 annually who do not have access to an affordable plan may qualify for subsidies (up to 400% of the poverty line). Individuals and families with employer-sponsored health coverage are not eligible for premium subsidies unless the employee pays more than 9.5% of their income in health care premiums. 

Health insurance subsidies are administered on a sliding scale. That means you will receive a larger benefit if you make $17,000 or less annually than you would should you make $28,000 annually. A family of four earning less than $24,250 annually will qualify of 100% subsidized health care. 

Minimum Income Levels for North Carolina Obamacare Subsidies

2016 Federal Poverty Guidelines
Family Size 100% 250% 400%
1 $11,770 $29,425 $47,080
2 $15,930 $39,825 $63,720
3 $20,090 $50,225 $80,360
4 $24,250 $60,625 $97,000
5 $28,410 $71,025 $113,640
6 $32,570 $81,425 $130,280
7 $36,730 $91,825 $146,920
8 $40,890 $102,225 $160,360


How Can I Apply?

You can apply for subsidies when you purchase an Obamacare health insurance plan. The subsidy application through healthcare.gov is extremely complicated. To ensure your application goes through, work with a licensed insurance agent. An agent will make sure your application is approved and that you take advantage of all the subsidies you qualify for. With an expert on your side, you can find the plan you want at a price you can afford without all the hassle.

How Will Subsidies be Provided? 

Premium subsidies offered for qualifying individuals and families will be paid in the form of refundable or advanceable tax credits. Advanceable tax credits allow the person to receive reimbursement at the time of need. Cost-sharing subsidies will be offered to protect lower income families from high out-of-pocket costs.  

Thus far, the North Carolina insurance regulators have approved 67 insurance plans to be offered this year as part of the Patient Protection and Affordable Care Act through the health insurance exchange. Blue Cross Blue Shield plans to offer 26 of the 67 approved health insurance plans in North Carolina. They are the only insurer that plans to offer subsidized health coverage in all 100 counties of North Carolina. At Carolina Insurance Professionals, we specialize in BCBSNC health insurance plans because they offer the most comprehensive coverage in North Carolina whether you are purchasing health insurance through the exchange or privately. 

We can help you compare your costs and coverage for private health insurance plans as well as plans that become available through the federal exchange in North Carolina.  For help navigating the changing landscape of health care, give us call. We are happy to help you discover more about your individual health insurance options in North Carolina.