The Affordable Care Act requires that individuals who receive health insurance from an employer pay a minimum of $95 a month for coverage, but many are choosing to pay an extra $2 a month to cover more of their medical costs.
That extra fee will cover some of the cost of private health insurance plans that offer discounts on deductibles and co-pays.
But many people are choosing not to pay that extra cost, so they’re paying an extra cost for a less-well-designed plan.
This article explains how to figure out if you qualify for an extra fee.
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How much do you need to pay to qualify for health insurance?
In the past, a large premium was often required to pay off the initial purchase of an individual health plan.
But the law requires that employers provide plans that cover their employees for a maximum of $2,000 per year for a year.
To qualify, an individual must be enrolled in an employer-sponsored plan with an annual deductible of at least $3,500, and the employer must have coverage for more than 50 percent of the employee’s household income.
That means, for example, if a full-time worker earns $55,000 a year and spends $1,000 on his or her insurance, the worker would pay $5,000 for each month his or she is enrolled in the employer’s plan.
To figure out how much an individual or household must pay to purchase an individual, the IRS will ask you about your income, your income-adjusted monthly premium, and your household income (for 2017, $18,400 for a single person, $31,000 if married filing jointly).
If you are not a full time worker and don’t have an employer plan, you can use a form that will tell you how much your employer is paying for your coverage.
This form, called the Employer-Sponsored Plan Disclosure Statement, will show your employer’s total contribution and the total cost to you for the coverage.
To calculate your total cost, multiply your income by your total household income and add up the two numbers.
Your total cost is then your monthly premium.
For example, to figure how much you would have to pay, you would need to calculate the total amount of money your employer has contributed to your insurance plan and the amount of the premium you would pay.
If your employer pays a maximum monthly premium of $4,000 and your monthly household income is $75,000, your monthly premiums would be $8,000.
For more information on employer-based coverage, including when and how to apply, see IRS.gov/aboutus/healthcare/health-insurance-subsidies/employer-sponsored-plan-disclosure-statement.