ACA Premium Calculator

Healthcare Open Enrollment should be simple and easy. Understanding the relationship between Income, Health Insurance Premiums, and ACA subsidies is important in navigating the insurance marketplace and making wise and beneficial choices. This calculator is a helpful start.

Throughout the country, for every household with income less than 400% of the Federal Poverty Level (FPL), the maximum health insurance premium will be the same (Alaska and Hawaii with minor differences.) A 3 person household in San Francisco making $50,000/year will pay the same maximum amount for premiums as a downtown Detroit household or a family in rural Kansas. Age, zip code, and pre-existing conditions are not a factor.

Health Insurance Premium Calculator

ACA Subsidy Calculator





Premiums

Summary

Usage

Inputs:

Coverage Year: Which year is the coverage active? e.g. 2020 => Jan 1, 2020 – Dec 31, 2020
State: In which State do you live, Alaska, Hawaii, or the lower 48 / DC?
Household size: Household size = taxpayer + spouse (if applicable) + tax dependents (max: 10)
MAGI: What is your estimated MAGI (Modified Adjusted Gross Income) for the coverage year?

MAGI is often the same as your Adjusted Gross Income (AGI, Line 7 on the 1040) but could be different if you have tax-exempt interest, Social Security income, or excluded foreign earned income. See this excellent primer for more.

Outputs:

Household FPL: FPL level for the input household size and income

For a detailed understanding of FPL for your household size, see Federal Poverty Levels for ACA / Obamacare.

Max Contribution percentage: the maximum percentage of MAGI that a household will need to pay for the Second-Lowest Cost Silver Plan (SLCSP.) e.g. in 2020, for 300%-400% FPL the maximum contribution is 9.78%.

The actual subsidy value is equal to the full cost of the SLSCP minus the expected household contribution. If you select a more expensive Silver Plan or Gold Plan, actual premiums may be higher. If you select a lower cost Silver Plan or Bronze Plan, actual premiums may be lower, but the subsidy amount can be applied to any marketplace plan.

If this isn’t clear, please review Obamacare Optimization in Early Retirement.

Annual Premium: Max contribution percentage * MAGI
Monthly Premium: Annual Premium / 12

Comments:

Households with income below 138% FPL (or 100% FPL in non-Medicare expansion states) will not qualify for ACA subsidies and will instead enroll in Medicaid.

Households with income greater than 400% FPL are not eligible for subsidies and will pay full/unsubsidized premiums.

For a deeper level of understanding for the complex tradeoffs between income, taxes, and ACA subsidies, please review:

Call to Action

For quotes on 2020 ACA health insurance policies, head to HealthCare.gov

21 Comments

  1. Mark

    Hi,
    Very timely post. Keep up the great work! There is no coverage when travelling overseas, correct?

    Reply
    • Go Curry Cracker

      Some plans might allow for emergency coverage overseas, but most likely not. Even out of State coverage is sketchy… how a policy defines “emergency” can be the difference between being reimbursed and not. Travel insurance is cheap “insurance” (ahem) if it isn’t clear from reading your policy fine print.

      Reply
  2. DANIEL BEN DIETERICH

    Hi. Ordinary dividends and capital gains, (among others), must be included in the MAGI calculation for the ACA. What are some income-reducing options for those in the ER community, especially single retirees, with portfolios spinning off a decent amount of dividends, and perhaps having to sell a portion of their portfolio to fund annual living expenses, therefore realizing a capital gain? I’m single with zero dependents and am inching dangerously close to the “subsidy cliff”. Thanks.

    Reply
    • Go Curry Cracker

      There aren’t really many options… even giving away money (charitable contributions) doesn’t help. HSA contributions are maybe the only real way to reduce MAGI besides earning less.

      More out of the box thinking: You could potentially go abroad for a year, and use that time to step-up basis (even if it results in taxes paid.) You could also do this domestically and just pay full price for insurance for the year.

      Reply
  3. Mindy

    Thank you for this!! We kept our income down this year to do some Roth converting and it was a challenge to figure how much to convert and without triggering buku health premium payback/penalty. This calculator definitely helps us to plan for 2020!! Thank you!!

    Reply
    • Go Curry Cracker

      Please be careful… even $1 over, and BOOM!
      Triple check your math and don’t rely completely on this (or any) online calculator.

      Reply
      • Mindy

        Exactly right! I was glad to come across that info because at 12%, we thought about converting up to the next bracket! I left a good cushion in there for any error or forgetting something. Thank you for you helpful info!!

        Reply
  4. Kawaii

    I’m going to put in $19K IRA contribution for 2019. Is the MAGI before or after the IRA contribution?

    Reply
  5. Mark

    Note that some states have other FPL qualification limits – for example, MN requires MAGI >200% FPL to qualify for ACA, because it has another healthcare option between Medicaid and ACA.

    Reply
    • Go Curry Cracker

      NY also I believe (the BHP option.) Or many states with Medicaid or similar covering children at higher FPL levels.

      Reply
  6. Louise

    Household size is described as people that will be covered by the policy – is that definitely correct? I have a household of 2, my son and myself. I claim him as a tax dependent, but his health insurance is covered by his father, my ex-husband. Thanks for this work!

    Reply
    • Go Curry Cracker

      No, I phrased that poorly (I updated it, thanks!) Household size is taxpayer + spouse (if applicable) + tax dependents (with some exceptions.)

      Reply
  7. texasmohan

    Nice work! Wish I had this calculator when the ACA was first introduced.

    Reply
    • Go Curry Cracker

      Thanks!

      Reply
  8. Mark

    Seems to match both my back of envelope guestimate and the conversation I had earlier this year with an Obamacare Broker. Like a lot things to do with Government/IRS you never REALLY know what the outcome will really be until the following year. Having a nice easy to use calculator like this helps with planning/projections. Thanks!
    (13 work days and counting until retirement!)

    Reply
    • Go Curry Cracker

      13 days?! Congratulations!

      Thanks for checking the numbers

      Reply
  9. Dean

    Do Roth IRA withdrawals count toward MAGI?

    Reply
    • Go Curry Cracker

      Qualified Roth IRA withdrawals do not.

      Reply
  10. Ecc

    I have a question. My husband will be on Medicare. I will be on Aca. For Aca purposes, what magi should u use? Will it be Magi for both my husband and I? If so, that will include his SS, pension, and our dividends, etc.. so, even though I will Aca just for myself, I will have to consider his income, too?

    Reply
    • Go Curry Cracker

      MAGI is for the household (your combined income.)

      Although your combined MAGI will be higher than yours alone, subsidies are also based on household size – the federal poverty level will be higher for household size of 2 vs 1.

      Reply

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