You might qualify for Medicaid coverage (OHP) if your household income is below 138% of the federal poverty level.
During the process of determining your subsidy, you might end up qualifying for OHP and/or Children’s Health Insurance Plan. If that is the case the Health Insurance Marketplace will forward your already completed application to the Oregon Health Plan and they will make a determination.
Guidelines for reduced health coverage, or possibly at no cost, depending on your income level.
A tax credit can be used to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace.
Income between 100% and 400% Federal Poverty Level (FPL): To qualify in Oregon your household income must be between 100% and 400% FPL to qualify for a premium tax credit that can lower your insurance costs
• Income above 400% FPL: If your income is above 400% FPL, you may now qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.
• You might qualify for Medicaid coverage if your household income is below 138% of the federal poverty level.
• You can use all, some, or none of your premium tax credit in advance to lower your monthly premium.
If you use more advance payments of the tax credit than you qualify for based on your final yearly income, you must repay the difference when you file your federal income tax return.
If you use less premium tax credit than you qualify for, you’ll get the difference as a refundable credit when you file your taxes.
You can buy health insurance through other sources, but the only way to get a premium tax credit is through the Health Insurance Marketplace.
How to determine your Premium Tax Credit Amount:
• Household size, zip code, and current year’s estimated household income.
• How to determine your income: What you need to determine is your Modified Adjusted Gross Income (MAGI).
This figure is used to determine eligibility for premium tax credits and other savings for Marketplace health insurance plans and for Medicaid and the Children's Health Insurance Program (CHIP). MAGI is adjusted gross income (AGI) plus these, if any: untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest.
• For many people, MAGI is identical or very close to adjusted gross income.
• MAGI doesn’t include Supplemental Security Income (SSI).
• MAGI does not appear as a line on your tax return.
