Health Insurance Calculator

The ACA (Affordable Care Act) Marketplace is a service that helps people shop for and enroll in health insurance. This calculator is for individuals and families who do not have access to affordable employer-sponsored coverage and want to estimate their costs on the Marketplace. It uses your income, household size, age, and state to provide estimates.

The premium tax credit is based on your household income relative to the Federal Poverty Level (FPL). Generally, households earning between 100% and 400% of the FPL qualify for subsidies. The credit caps the percentage of income you pay toward a benchmark Silver plan, and the difference between that cap and the full premium is your subsidy amount.

If your employer offers health coverage that meets ACA affordability standards (generally costing less than ~9.02% of household income for self-only coverage in 2025), you typically do not qualify for Marketplace subsidies. If employer coverage is unaffordable or unavailable, you may be eligible for a premium tax credit through the Marketplace.

The Federal Poverty Level is an income measure published annually by the federal government. Your income relative to the FPL determines whether you qualify for Medicaid, CHIP, or ACA premium subsidies. In 2025, households earning 100%–400% of the FPL may qualify for premium tax credits, and those below 150% may qualify for enhanced savings.

These metal tiers reflect how costs are split between you and your insurer. Bronze plans cover roughly 60% of costs (lower premiums, higher deductibles). Silver covers ~70%, Gold ~80%, and Platinum ~90% (highest premiums but lowest out-of-pocket costs). Cost-sharing reductions (CSR) are only available on Silver plans for eligible lower-income enrollees.

Yes. Children under 19 may qualify for the Children's Health Insurance Program (CHIP), which provides low-cost or free coverage depending on household income. Children aged 20 and younger can also be enrolled in Marketplace family plans. This calculator accounts for the number of children when estimating household premiums.

This calculator provides estimates based on 2025 federal benchmark data, FPL guidelines, and average premium information. Actual premiums vary by insurer, specific plan, county, and tobacco use. For exact plan prices and confirmed savings, complete a full application at HealthCare.gov or your state's Marketplace.

If your household income falls below 138% of the FPL (in states that expanded Medicaid), you may qualify for Medicaid rather than Marketplace coverage. Medicaid provides comprehensive, low-cost or free coverage. Eligibility rules vary by state, so check your state's Medicaid program for specific thresholds.