2025 ACA Marketplace · Premium Tax Credits · Bronze · Silver · Gold
| Household Size | 100% FPL | 138% (Medicaid) | 250% FPL (CSR) | 400% FPL |
|---|---|---|---|---|
| 1 person | $15,060 | $20,783 | $37,650 | $60,240 |
| 2 people | $20,440 | $28,207 | $51,100 | $81,760 |
| 3 people | $25,820 | $35,631 | $64,550 | $103,280 |
| 4 people | $31,200 | $43,056 | $78,000 | $124,800 |
| 5 people | $36,580 | $50,480 | $91,450 | $146,320 |
| 6 people | $41,960 | $57,905 | $104,900 | $167,840 |
FPL figures for 48 contiguous states + D.C. (2025). Alaska and Hawaii have higher FPL thresholds.
In 2025, you may qualify for a Premium Tax Credit (subsidy) if your income is between 100% and 400% of the Federal Poverty Level (FPL) — and in many states, even above 400% FPL due to enhanced subsidies. You must not have access to affordable employer-sponsored coverage and must enroll through the ACA Marketplace at healthcare.gov.
ACA metal tiers differ in how costs are split: Bronze plans have the lowest premiums but highest out-of-pocket costs (you pay ~40% of healthcare costs). Silver plans split costs 70/30 and are the only plans eligible for Cost-Sharing Reductions (CSR) if your income is under 250% FPL. Gold plans have higher premiums but lower out-of-pocket costs (80/20 split). If you qualify for CSR, Silver is almost always the best value.
ACA Open Enrollment for 2025 coverage ran November 1 – January 15, 2025. Outside open enrollment, you can only enroll if you have a qualifying life event (losing job-based coverage, getting married, having a baby, moving, etc.) which triggers a Special Enrollment Period (SEP). Some states have year-round enrollment for low-income individuals.
Medicaid provides free or low-cost health coverage for eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. In 2025, most states that expanded Medicaid cover adults with incomes up to 138% of FPL (~$20,783 for a single person). Medicaid expansion status varies by state — 40+ states have expanded. Check your state's Medicaid office for eligibility.
COBRA lets you keep your employer's health insurance for up to 18 months after leaving a job (36 months in some cases). The major downside: you pay the full premium — both your share and your employer's share — plus a 2% admin fee. This often costs $500–$800/month for an individual. Compare COBRA to ACA Marketplace plans, which may be significantly cheaper with subsidies.