Health Insurance Affordability Checker
About the Affordability Checker
Health insurance affordability is determined by your household income relative to the Federal Poverty Level (FPL). The ACA uses FPL percentages to determine eligibility for various programs: Medicaid covers those below 138% FPL in expansion states, premium tax credits are available from 100% to 400% FPL, and the affordability exemption applies when the lowest-cost plan available exceeds 8.39% of your household income. This tool helps you quickly identify which income tier you fall into and what options are most relevant to your situation, from Medicaid to marketplace subsidies to hardship exemptions. Knowing your FPL percentage is the first step in navigating the complex landscape of health insurance assistance programs.
Frequently Asked Questions
What does the affordability exemption mean?
If the lowest-cost bronze plan available to you costs more than 8.39% of your household income in 2026, you qualify for an affordability exemption from the requirement to have health coverage and may be eligible for a catastrophic plan.
What is the income limit for Medicaid in 2026?
In states that expanded Medicaid, households earning up to 138% FPL qualify. For a single person, that is approximately $21,597 in 2026. Non-expansion states have stricter eligibility rules.
What if my income is below 100% FPL and my state didn't expand Medicaid?
You may fall into the "coverage gap" — too high for Medicaid but not qualifying for marketplace subsidies. Some states have additional assistance programs. Contact your state Medicaid office for options.
How do I calculate my household income for ACA purposes?
ACA uses Modified Adjusted Gross Income (MAGI), which includes wages, salaries, tips, net self-employment income, unemployment compensation, Social Security benefits, and most other taxable income.
Can I get help if my income changes during the year?
Yes. Report income changes to the Marketplace promptly. If your income drops significantly, you may qualify for Medicaid or larger subsidies mid-year. If it rises, adjust your APTC to avoid owing money at tax time.
Disclaimer: Results are estimates only. Consult Healthcare.gov or a licensed insurance navigator for official determinations.