Federal and State Subsidies

If you enroll in a new plan through the Health Connector, such as Tufts Health Direct, you may be eligible for certain state and federal subsidies to help you pay for your health insurance premiums and other costs. The level of help you can get is based on your federal poverty level (determined by your income and family size).

When you apply for and enroll in a new Health Connector plan with coverage effective in 2015, you will find out exactly what subsidies you qualify for.

  • You may be eligible for an advanced federal premium tax credit, which helps lower the amount of your monthly premium.
  • Or, you may be eligible for a lower-cost Health Connector plan called a ConnectorCare plan, which offers lower monthly premiums, and lower out-of-pocket costs when you receive covered services.

 

Federal premium tax credits

You may be eligible for a federal premium tax credit if you:

  • Are a Massachusetts resident
  • Are a U.S. citizen/national Click for Definition, a qualified immigrant Click for Definition, or a lawfully present immigrant Click for Definition
  • Earn up to 400% of the federal poverty level ($46,680 yearly for an individual)
  • Do not have access to affordable Click for Definition employer-sponsored health insurance that meets minimum value standards Click for Definition
  • Are not incarcerated
  • Are not eligible for other government-sponsored insurance (e.g., MassHealth, Medicare, TRICARE)

Federal premium tax crecits are paid directly to your selected Health Connector plan on a monthly basis, to lower your share of your monthly premium. (No payments are made directly to you.) If you apply for a federal premium tax credit, you don’t have to wait until you file your taxes to receive this subsidy; these will begin once you enroll.

Your federal premium tax credit amount is calculated using a formula that looks at your tax household’s projected annual income (what you expect to earn in the upcoming year), along with the Health Connector plan premiums available to you and the eligible members of your family (if applicable). Because this formula uses your projected annual income, if your income changes during the benefit year, you may need to reconcile the amount of premium tax credits you receive when you file your next tax return. It is important that you update the Health Connector if there are any changes to your income during the benefit year.

If you do apply for a federal premium tax credit, when you file your 2015 tax return, you may be eligible for an additional tax credit if your premium tax credit was too low (included in your tax refund), or you may actually owe the government if you received a higher amount of premium tax credit than you were eligible for.

ConnectorCare plans

You may be eligible for a lower-cost ConnectorCare plan, such as Tufts Health Direct, if you:

  • Are a Massachusetts resident
  • Are a U.S. citizen/national Click for Definition, a qualified immigrant Click for Definition, or a lawfully present immigrant Click for Definition
  • Earn up to 300% of the federal poverty level ($35,016 yearly for an individual)
  • Do not have access to affordable Click for Definition employer-sponsored health insurance that meets minimum value standards Click for Definition
  • Are not incarcerated
  • Are not eligible for other government-sponsored insurance (e.g., MassHealth, Medicare, TRICARE)


When you apply for/enroll in a new Health Connector plan, such as Tufts Health Direct, you will learn more about your exact costs, what kind of subsidy or subsidies you qualify for (if any), and what options are available to help lower your health insurance costs.

Check this site often for more information and updates, as well as more links to tools and resources to help you understand your options and make educated choices.

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