The Two Types of ACA Subsidies
2026 Income Limits for ACA Subsidies
| Household Size | 100% FPL | 150% FPL (Best CSR) | 250% FPL (CSR cutoff) | 400% FPL (PTC phase-out) |
|---|---|---|---|---|
| 1 person | $15,060 | $22,590 | $37,650 | $60,240 |
| 2 people | $20,440 | $30,660 | $51,100 | $81,760 |
| 3 people | $25,820 | $38,730 | $64,550 | $103,280 |
| 4 people | $31,200 | $46,800 | $78,000 | $124,800 |
How to Claim Your Subsidy
When you apply through HealthCare.gov or your state exchange, you enter your estimated household income. The system calculates your PTC and applies it directly to your monthly premium — you only pay the difference. At tax time you reconcile your actual income against the advance payments using IRS Form 8962.
If your actual income was higher than estimated, you may owe back some of the credit. If lower, you get the difference as a tax refund. Income changes during the year should be reported promptly to avoid a large year-end repayment.
Frequently Asked Questions
Only if your employer's plan is deemed "unaffordable" (your cost for employee-only coverage exceeds 9.02% of household income in 2026) or doesn't meet minimum value standards. If the employer plan is affordable, you don't qualify for PTCs even if the plan isn't great.
Under the current 2026 rules, the PTC phases out at 400% FPL — those above that threshold pay full unsubsidized premiums. This may change if Congress renews the enhanced subsidy provisions from the Inflation Reduction Act. Check HealthCare.gov for current rules.
Yes. Self-employed individuals use their net self-employment income (after deductions) to determine subsidy eligibility. You can also deduct 100% of health insurance premiums paid as a self-employed person on Schedule SE, reducing your taxable income further.