Tax Credit and Premium Estimator
NEW! 2015 Tax Credit and Premium Estimator (For instructions on how to use this estimator, click “Microsoft Excel Version of Estimator” below.) The 2015 web-based estimator will be available soon on this page.
The 2014 web-based estimator shown below is compatible with most internet browsers except Internet Explorer Version 9 or older. If your browser is not compliant, there is a Microsoft Excel version of the 2014 estimator available below. You can also call the Customer Service Center at 1-855-355-5777 to get an estimate of your premium.
You may be able to get help paying for a health plan when you enroll in NY State of Health, the Official Health Plan Marketplace. Federal tax credits are available to most individuals with income of $45,960 or less or a family of four making $94,200 or less in 2014. In 2015, federal tax credits are available to most individuals with income of $46,680 or less or a family of four making $95,400 or less.
Unlike most tax credits, you do not have to wait until you file your taxes to get the credit. Marketplace premium tax credits allow you to reduce your costs right away. You have the option to take all or some of the tax credit as an advance payment made directly to your health plan to lower their monthly health plan premium. Health insurance coverage is more affordable because you will pay less each month. The Marketplace will tell you if you qualify for assistance and the exact amount when you apply for coverage.
You can use the estimator below to estimate your premium tax credit and see what you could pay for coverage if you purchase a Marketplace health plan. (Tax credits do not apply to either catastrophic or Medicaid/Child Health Plus coverage.)
This Tax Credit and Premium Estimator is intended to provide you with an estimate. It is not a final calculation. The advanced premium tax credit you qualify for and the premium you pay will be determined at the time of enrollment. There may be differences between this estimate and the amount you actually pay based on a variety of factors including but not limited to changes in household income and family size.
- Household Size. Count everyone you claim on your federal income tax return, even if they are not all applying for health insurance coverage.
- Annual Income. The figure used to determine eligibility for tax credits in the Marketplace and for Medicaid and Child Health Plus is modified adjusted gross income (MAGI). Generally, MAGI is your adjusted gross income plus any tax-exempt Social Security, interest, or foreign income you have.
- Level of Coverage. Health plans in the Marketplace are sorted into metal tiers (Platinum, Gold, Silver, Bronze). Catastrophic coverage is also available to young adults through the Marketplace. You can choose to see the plans in just one of these tiers or you can choose to see all the metal tier plans. Your premium tax credit can be used when you purchase a plan at any metal tier, but you cannot use the tax credit if you purchase a catastrophic plan.
- Estimating Your Premium.
- Monthly Premium Amount. The full premium cost each month before your tax credit is applied.
- Estimated Tax Credit. The amount of your estimated monthly advance premium tax credit.
- Premium You Pay Each Month. The amount you would pay for each plan after your advance premium tax credit is applied.
- Monthly Premium Amount – Estimated Tax Credit = Premium You Pay Each Month.
- The estimated cost to purchase Child Health Plus coverage for children, if you qualify, also is shown. (This amount is not included in the premium amounts displayed in the table.)
If you are not able to use the 2014 web-based version of the estimator, a Microsoft Excel version of the 2014 estimator is available here. The Microsoft Excel version of the estimator includes two tables:
Table I: Tax Credit Estimator for Individuals and Families
This table asks questions about your household size and income, who is applying for coverage, what level of coverage you are interested in, and what county you live in. Based on the information you provide, the estimator will calculate the estimated amount of premium tax credit you are eligible for toward coverage purchased through the Marketplace. This table also shows the estimated cost to purchase Child Health Plus coverage for children, if applicable. (This amount is not included in the premium amounts displayed in Table II.)
Table II - Premium Rate Estimator
This table shows the premiums for health plans available to the consumer based on information provided. It includes the full premium amount, the value of tax credits the consumer may be eligible for, and the amount of premium the consumer will owe after tax credits are applied.