Cost Assistance
What is Cost Assistance?
Cost assistance, also known as government subsidies, may be available when you enroll in one of our plans. There are two kinds of cost assistance. Based upon your household size and yearly household income, you may qualify for one or both:
What are Out-Of-Pocket Costs?
These are any expenses you pay out of your pocket for your health care services, including the deductibles, coinsurance and copayment (or copay) amounts. The monthly premium you pay to purchase your plan is not considered part of your out-of-pocket costs.
Deductibles: The specific dollar amount you pay for covered services before BCBSWY begins to pay.
Coinsurance: A percentage of the cost you pay for the covered service after you have met your deductible.
Copayment (or copay): The fixed amount you pay for covered services, usually at the time you receive care.
What are the Income Requirements for Assistance?
Your income and the size of your household are used to determine if you qualify for assistance. Use the tables below to see if you qualify.
To help determine if you might qualify for cost assistance, estimate your 2024 income using your household’s adjusted gross income or add up the following items for all the people in your household:
- Wages, salaries, tips
- Net income from any self-employment or business
- Unemployment compensation
- Social Security payments
- Other income: rental income, interest, dividends, capital gains, annuities, alimony, and some retirement and pensions.
Native Tribe Member?
Assistance with Monthly Premiums & Out-Of-Pocket Costs
Number of people in your household | Income Range |
The income ranges shown here are based on 2024 numbers and may be slightly different in 2025. | |
1 | $15,060 – $37,650 |
2 | $20,440 – $51,100 |
3 | $25,820 – $64,550 |
4 | $31,200 – $78,000 |
5 | $36,580 – $91,450 |
6 | $41,960 – $104,900 |
7 | $47,340 – $118,350 |
8 | $52,720 – $131,800 |
How Does Cost Assistance Impact my Coverage Options?
- Cost assistance will be determined by the Health Insurance Marketplace at the time of enrollment.
- Cost assistance to help pay your monthly premium may be applied to any of our Gold, Silver or Bronze plans.
- Cost assistance to reduce your out-of-pocket costs may be applied to any one of our Silver plans. Refer to these guidelines to see how your out-of-pocket costs might be reduced.