Cost Assistance

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:

Monthly Premiums

Cost assistance to help pay your monthly premium

Reduce Out-of-Pocket Costs

Cost assistance to reduce your out-of-pocket costs for deductibles, coinsurance and copayments

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.

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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 2020 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?

If you are a Native Tribe Member, please ask us about plan options and cost assistance available to you under the Affordable Care Act.

Assistance with Monthly Premiums

You may qualify for cost assistance to help pay your monthly premium if your yearly household income is between…

Number of people in your householdIncome Range
The income ranges shown here are based on 2019 numbers and may be slightly different in 2020.
1$12,490 – $49,960
2$16,910 – $67,640
3$21,330 – $85,320
4$25,750 – $103,000
5$30,170 – $120,680
6$34,590 – $138,360
7$39,010 – $156,040
8$43,430 – $173,720

Assistance with Monthly Premiums & Out-Of-Pocket Costs

You may qualify for cost assistance to help pay your monthly premium AND reduce your out-of-pocket costs if your yearly household income is between…
Number of people in your household Income Range
The income ranges shown here are based on 2019 numbers and may be slightly different in 2020.
1 $12,490 – $31,225
2 $16,910 – $42,275
3 $21,330 – $53,325
4 $25,750 – $64,375
5 $30,170 – $75,425
6 $34,590 – $86,475
7 $39,010 – $97,525
8 $43,430 – $108,575

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.
Silver Plan Guidelines
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