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What you need to know about subsidies with Cover Oregon

Starting in 2014, there are tax credits available to help people pay for their health insurance premiums if they meet the three requirements of qualifying for the tax credit and purchasing the health insurance through Cover Oregon.

In order to qualify for the tax credit, an individual and family must not have access to any other health insurance coverage. Generally, if insurance is available from an employer to an employee and their family, then the Premium Tax Credit will not be available to that family.

There is a rule with the Affordable Care Act that says if the payment for just insuring the employee is more than 9.5 percent of the gross wages, then that person would qualify for a tax credit.

But it seems that most of the time the “self-only” portion of the health insurance is below that limit. This can be frustrating as oftentimes the premiums to pay for the family is much greater than just receiving insurance for the person working at that business.

An individual can still apply for coverage through Cover Oregon if there is health insurance available through an employer, but that person will most likely be denied receiving the tax credit.

An individual and family will also need to qualify to receive the tax credit if their income is below a certain range based on their household size.

For example, a household of one could make up to $45,960 and still be able to possibly receive a tax credit. Add $16,080 for each additional member of a household to determine if that household size would possibly qualify for a tax credit. That means a household of two would be $62,040 and a household of three would be $78,120.

An individual can estimate how much of a tax credit they could potentially receive by entering their information at the “Browse Plans Now” section at Coveroregon.com.

Sometimes the results page will indicate that an individual does not qualify for tax credits even though they are within the range to receive a tax credit. This is because Oregon has one of the lowest health insurance premiums in the nation and sometimes the premiums are below the amount that the tax credit would give an individual.

Curious individuals can modify their household income to determine at what point, if any, would cause the tax credits to be generated.

Knowing that information should help someone know if it is even possible to receive a tax credit in 2014.

The third requirement to receive a tax credit is that the health insurance for 2014 must be purchased through Cover Oregon.

Health insurance can still be purchased outside of the exchange and the plans are very similar to the plans that are available through Cover Oregon.

If someone determines that they do not qualify to receive a tax credit, it would probably be more efficient to apply outside of Cover Oregon.

An individual may also decide to keep their current plan if the premium seems reasonable.

Individuals can contact a health insurance agent to help them decide if they have the best plan for their individual needs. Agents can also help an individual fill out the paperwork to apply to either Cover Oregon or a plan outside of Cover Oregon at no cost to the individual.

Paper applications must be submitted by Dec. 4 to have coverage on Jan. 1, 2014.