Understanding the 2018 Federal Poverty Guidelines For Cost Assistance Under the Affordable Care Act (ObamaCare) in 2018 and 2019

We explain the 2018 Federal Poverty Guidelines for assistance under the Affordable Care Act (ObamaCare). You’ll use these guidelines to determine cost assistance on plans sold during 2019’s open enrollment season.[1]

How Cost Assistance Works With the Federal Poverty Level

The Federal Poverty Level Guidelines are used to determine eligibility for cost assistance under the Affordable Care Act (ObamaCare).

  • Individuals and families with taxable income after deductions between 100% and 400% of the FPL may be eligible for cost assistance on health insurance premiums called Premium Tax Credits.
  • Individuals and families with taxable income after deductions between 100% and 250% of the FPL may be eligible for cost assistance on out-of-pocket costs called Cost Sharing Reduction subsidies.
  • Individuals with taxable income after deductions under 138% of the poverty level may be eligible for Medicaid (this differs by state).
  • Children from families with taxable income after deductions under roughly 300% of the poverty level may be eligible for CHIP (see CHIP eligibility).

To determine eligibility for subsidies you can simply sign up at the health insurance marketplace. With that in mind, you can also reference the 2018 poverty level chart below and compare your family income to the poverty level to get a sense of what assistance you might qualify for.

The 2018 Federal Poverty Guidelines and What They Are Used For

Below are the 2018 Federal Poverty Guidelines that went into effect on January 13, 2018. These are to be used for:

  • Medicaid/CHIP between Jan 2018 and Jan 2019.
  • 2019 marketplace cost assistance on all marketplace health plans held in 2019 and purchased during open enrollment for 2019 (which starts in 2018, and which is why it uses the 2018 levels).
  • For special enrollment in 2019.
  • For ACA taxes for the 2019 calendar year filed in 2020.

TIP: Alaska and Hawaii use different guidelines (see this link to guidelines as published on HHS.Gov). See a list of all guidelines on our Federal Poverty Level Page.

2018 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIA
PERSONS IN FAMILY/HOUSEHOLD POVERTY GUIDELINE
For families/households with more than 8 persons, add $4,320 for each additional person.
1 $12,140
2 $16,460
3 $20,780
4 $25,100
5 $29,420
6 $33,740
7 $38,060
8 $42,380

TIP: To find any other poverty level amount simply multiply the 100% poverty level dollar amount by the desired percentage of the poverty level. If you want to see what 400% of the poverty level is, you can multiply the 100% Federal Poverty Level dollar amount by 4.00 (so for a 1 person household it is $11,880 x 4.00 = $47,520). For 300% FPL multiply by 3.00. For 250% FPL multiply by 2.50. For 138% FPL multiply by 1.38 etc.

TIP: The 2018 poverty guidelines are in effect as of January 13, 2018. See also the Federal Register notice of the 2018 poverty guidelines, published January 18, 2018.

TIP: As noted, these guidelines will be used for taxes filed April 15, 2020, since those taxes will deal with 2019 tax credits, which will have been based on the 2018 poverty level. If you are filing taxes in 2019 for the 2018 calendar year, use the 2017 guidelines.

TIP: You’ll use the 2018 FPL guidelines for Medicaid and CHIP until late January 2019 when the new poverty level guidelines are released. To be clear, you don’t use these for cost assistance on 2018 plans. If you are using a special enrollment in 2018 because you had a life change and qualified, you should use the 2017 guidelines.

Citations

  1. U.S. FEDERAL POVERTY GUIDELINES USED TO DETERMINE FINANCIAL ELIGIBILITY FOR CERTAIN FEDERAL PROGRAMS