You're eligible for an ACA premium subsidy (Advance Premium Tax Credit, APTC) if you meet all of the following:
1. You don't have access to other affordable coverage.
- No Medicare, Medicaid, or CHIP eligibility (those are different programs)
- No "affordable" employer-sponsored coverage available (employer coverage is considered affordable in 2026 if the employee-only premium is less than 9.12% of household income)
- Note: starting in 2023, the "family glitch" was fixed — if employer family coverage is unaffordable for the family, family members can get subsidies even if employee-only coverage is affordable
2. Your household income is in the eligible range.
- Minimum: at least 100% of the Federal Poverty Level (FPL) — about $15,650 for a single person in 2026
- In states that didn't expand Medicaid: between 100% and 400% FPL (or higher if subsidies remain extended)
- In states that DID expand Medicaid: between 138% and 400% FPL — under 138% you'd qualify for Medicaid instead
- Through 2025, the IRA extended subsidies above 400% FPL (capping premium at 8.5% of income). This expires Dec 31, 2025 unless Congress extends. As of mid-2026, watch for legislation.
3. You're a U.S. citizen, national, or lawfully present immigrant.
- Lawfully present immigrants under 100% FPL who are NOT eligible for Medicaid due to immigration status can still get subsidies
- Undocumented immigrants are NOT eligible for Marketplace coverage or subsidies
4. You file a federal tax return.
- Married couples generally must file jointly to get subsidies (rare exceptions for domestic abuse and abandonment)
- You'll "reconcile" your subsidy on your tax return — if your actual income was lower than estimated, you get more credit; if higher, you may owe some back
5. You enroll through the Marketplace.
- HealthCare.gov for the federal Marketplace (most states)
- Your state-based exchange if applicable (CA, NY, MA, NJ, MD, etc.)
- Subsidies are NOT available off-Marketplace (e.g., direct from a carrier)
Quick eligibility examples (single person, 2026):
- $20,000 income (128% FPL): Eligible — expect ~$0/mo Silver (CSR) and very low premium
- $35,000 income (224% FPL): Eligible — expect ~$60-100/mo Silver (with CSR) or $0 Bronze possible
- $50,000 income (320% FPL): Eligible — expect ~$240/mo Silver, lower for Bronze
- $75,000 income (479% FPL): If subsidy cliff returns 1/1/2026: NOT eligible. If extended: pay 8.5% cap = $531/mo benchmark.
Special situations:
- Self-employed: Use estimated annual net business income; report changes mid-year
- Recently lost a job: You can update Marketplace income to the lower amount immediately for an updated subsidy
- Got married/divorced: Triggers a Special Enrollment Period AND changes household income calculation
- Income is unpredictable (gig workers, sales): Use a conservative estimate; the IRS will reconcile
Don't confuse subsidies with Medicaid:
- If you live in a Medicaid-expansion state (most states) and earn under 138% FPL, you'll be steered to Medicaid not Marketplace subsidies
- If you live in a non-expansion state (TX, FL, GA, AL, MS, SC, TN, WI, KS, WY) and earn 0–100% FPL, you fall in the "coverage gap" — too much for Medicaid, too little for ACA subsidies. Some states have alternative programs.
What to do next: [Free 60-second subsidy calculator](/aca/subsidy-calculator/) gives you a real estimate, or call (866) 534-1886 — we check your exact eligibility, including CSR Silver vs. Bronze trade-offs and the 2026 cliff impact for your income. Free.