New York State Health Insurance Subsidy Calculator

How the Subsidy Works

The New York State Health Insurance Marketplace offers premium tax credits to help eligible individuals and families afford health insurance. The subsidy amount is based on your income, household size, and the cost of the silver plan in your area.

The formula for calculating the premium tax credit is:

The Federal Poverty Level (FPL) is adjusted annually for inflation. The percentage based on income determines how much of the FPL you qualify for, and the cost sharing reduction factor accounts for the additional cost of the silver plan.

Eligibility Requirements

To qualify for a premium tax credit, you must meet certain eligibility requirements:

• Be a U.S. citizen or legal resident
• Reside in New York State
• Not be eligible for other coverage through an employer, Medicare, or Medicaid
• Have an income between 100% and 400% of the Federal Poverty Level

How to Apply

To apply for a premium tax credit, you can use the New York State Health Insurance Marketplace:

1. Visit the New York State Health Department website
2. Click on "Get Covered" to start the enrollment process
3. Provide your personal information, income details, and household size
4. Select a health insurance plan
5. Complete the application and pay any required premium

The application process typically takes about 15-30 minutes to complete.

Worked Examples

Example 1: Single Person with Income of $25,000

For a single person with an income of $25,000, the calculation would be:

This person would qualify for a premium tax credit of $10,500.

Example 2: Family of Four with Income of $50,000

For a family of four with an income of $50,000, the calculation would be:

This family would qualify for a premium tax credit of $20,000.