Avera Health Plans Marketplace
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Ready To Find Your Health Care Solution?

Open Enrollment is now over, but you may be eligible for coverage if your situation has recently changed.

Special Event

For you or anyone in your household, have any of the following events occurred in the last 60 days or will a loss of coverage occur in the next 60 days?

Select Your Special Event

Please Select A Special Event
Please Provide The Date Of Event

Qualifying Events

Applicant Info

Please provide some information about you and any family members.

(This is how we build you a custom list of available plans.)

Applicant Information

Please Provide A Valid Zip Code
Please Provide A Valid Date Of Birth
Please Select An Answer For Tobacco Usage
Please Select An Answer For Gender

Primary Applicant

Have you used tobacco 4 or more times a week in the last 6 months?

Family Members

Subsidy Eligibility

Let's find out if you qualify for a Payment Reduction.

In order to be eligible to receive premium tax credits, individuals must meet the following criteria. Click a topic to learn more.

File Federal Income Tax Returns

Because the premium assistance is provided in the form of tax credits, such assistance is administered by the Internal Revenue Service (IRS) through the federal tax system. The premium credit process requires qualifying individuals to file federal income tax returns, even if their incomes are at levels that normally do not necessitate the filing of such returns.

Married couples are required to file joint tax returns to claim the premium credit. The calculation and allocation of credit amounts may differ in the event of a change in tax-filing status during a given year (e.g., individuals who marry or divorce).

Enroll In A Plan Through An Individual Exchange

Premium credits are available only to individuals and families enrolled in plans offered through individual exchanges; premium credits are not available through SHOP exchanges. Individuals may enroll in exchange plans if they (1) reside in a state in which an exchange was established; (2) are not incarcerated, except individuals in custody pending the disposition of charges; and (3) are citizens or have other lawful status.

Undocumented individuals (individuals without proper documentation for legal residence) are prohibited from purchasing coverage through an exchange, even if they could pay the entire premium. Because the ACA prohibits undocumented individuals from obtaining exchange coverage, these individuals are not eligible for premium credits. Although certain individuals are not eligible to enroll in exchanges due to incarceration or legal status, their family members may still receive premium credits as long as these family members meet all eligibility criteria.

Annual Household Income Between 100% and 400% of the Federal Poverty Level

Individuals generally must have household income within a statutorily defined range (based on FPL) to be eligible for premium credits, with some exceptions. Household income is measured according to the definition for modified adjusted gross income (MAGI).7 An individual whose MAGI is at or above 100% FPL up to and including 400% FPL may be eligible to receive premium credits.

Not Eligible for Minimum Essential Coverage

To be eligible for a premium credit, an individual may not be eligible for minimum essential coverage (MEC), with exceptions (described below). The ACA broadly defines MEC to include Medicare Part A; Medicare Advantage; Medicaid (with exceptions); the State Children’s Health Insurance Program (CHIP); Tricare; Tricare for Life, a health care program administered by the Department of Veterans Affairs; the Peace Corps program; any government plan (local, state, federal), including the Federal Employees Health Benefits Program (FEHBP); any plan offered in the individual health insurance market; any employer-sponsored plan (including group plans regulated by a foreign government); any grandfathered health plan; any qualified health plan offered inside or outside of exchanges; and any other coverage (such as a state high-risk pool) recognized by the HHS Secretary.10 However, the ACA provides certain exceptions regarding eligibility for MEC and premium tax credits. An individual may be eligible for premium credits even if he or she is eligible for any of the following sources of MEC:

  • The individual (non-group) health insurance market
  • An employer-sponsored health plan that is either unaffordable or inadequate; or
  • Limited benefits under the Medicaid program.

Estimate Your Payment Reduction (optional)

Please Provide Your Household Size
Please Provide Your Household Income
Your monthly premium costs could be lowered by !
You may be eligible for lower cost, or free, health coverage with Medicaid or State Based Exchange. To learn more, visit Healthcare.gov
Based on the information provided, members of this household don't appear to be eligible for a premium tax credit.
Sorry, something went wrong. Please double check your answers for household size and household income. If you still have trouble entering your information, contact an agent for assistance.
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*Estimated Subsidy

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You Qualify For A Subsidy.

To learn more visit Healthcare.gov


No Subsidy Estimate Calculated.

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Available Off-Exchange

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