Looking for Ways To Save?
Virginia’s Insurance Marketplace is the only place where Virginians can apply for financial savings to help lower monthly health insurance costs. Ways to save include advance premium tax credits (APTCs) and cost-sharing reductions (CSRs). Nearly 9 out of 10 Marketplace consumers qualify for financial assistance. Some Virginians may also qualify for free or low-cost coverage through Virginia Medicaid or FAMIS.
Advanced Premium Tax Credits
APTCs are tax credits you can use to lower your monthly health insurance payment (called the “premium”). This type of assistance is only available through the Marketplace and is based on household income level and family size.
If your income changes, make sure you update your account information in the Marketplace. This helps to make sure you have access to all the financial savings you qualify for.
Cost-Sharing Reductions
If you qualify for an APTC, you may also be eligible for extra savings with CSRs. CSRs are discounts on the amount you pay for deductibles, copayments, and coinsurance. If you qualify for CSRs, you must enroll in a plan on the Marketplace in the Silver category. Visit our FAQs page for an explanation of the plan categories.
CSRs also lower your out-of-pocket maximum, which is the maximum amount you’ll pay for covered health services in a year. After you reach your out-of-pocket maximum, your insurance plan will pay 100% of covered health services.
You may qualify for additional CSRs if you’re a member of a federally recognized tribe or an Alaska Native Claims Settlement Act corporation shareholder.
Use the steps below to calculate your household income. Click on the savings calculator to enter your information and then click "see if I qualify" to see your financial savings.
Savings Calculator
How To Calculate Household Income
Before you apply for coverage through the Marketplace, estimate your household’s expected income for the intended year of coverage.
In the event your income changes during the year, make sure to update your insurance application within 30 days of the change.
1. Start with your household’s adjusted gross income (AGI) from your most recent federal income tax return.
- Your AGI is on line 11 of IRS Form 1040 from your tax return.
- Your AGI is on line 11 of IRS Form 1040 from your tax return.
2. Add the following kinds of income, if you have any, to your AGI:
- Tax-exempt foreign income.
- Tax-exempt Social Security benefits.
- Tax-exempt interest.
Don’t include Supplemental Security Income (SSI).3. Adjust your estimate for any changes you expect. For all members of your household, consider:
- Expected raises.
- New jobs or other employment changes, including changes to work schedule or self-employment income.
- Changes to income from other sources, like Social Security or investments.
- Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big effect on your savings.
Virginia Medicaid
The Marketplace will also check eligibility for low-cost or no-cost health coverage programs through Virginia Medicaid or Family Access to Medical Insurance Security (FAMIS is Virginia’s health insurance program for children). For additional information about Medicaid coverage in Virginia, you can visit Cover Virginia or call 1-833-522-5582.
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Contact the Marketplace’s customer service representatives if you need assistance enrolling in a health plan, need to update your personal information, or have any questions.
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