Health Insurance Subsidy Calculator
This estimator provides a practical approximation of the premium tax credit (subsidy) and your resulting monthly premium under marketplace rules. It uses household income, household size, and a benchmark monthly premium to compute an estimated monthly and annual subsidy and the net premium after subsidy.
Use the Quick estimate for a fast, conservative calculation. Use the Detailed estimate to include simple age and plan-metal adjustments. This tool is an estimator and does not replace official eligibility checks or precise calculations performed by state or federal enrollment systems.
Governance
Record 22d575214188 • Reviewed by Fidamen Standards Committee
Fast estimate that uses household income and size to compute percent of Federal Poverty Level (FPL), an approximate applicable percentage, and a subsidy based on a benchmark monthly premium you provide or accept as the default.
Inputs
Results
Estimated premium tax credit (monthly)
$473.89
Estimated premium tax credit (annual)
$5,686.67
Estimated monthly premium after subsidy
$126.11
Estimated applicable percentage (household share)
4.20%
Income as percent of FPL
2.4691
| Output | Value | Unit |
|---|---|---|
| Estimated premium tax credit (monthly) | $473.89 | USD |
| Estimated premium tax credit (annual) | $5,686.67 | USD |
| Estimated monthly premium after subsidy | $126.11 | USD |
| Estimated applicable percentage (household share) | 4.20% | — |
| Income as percent of FPL | 2.4691 | — |
Visualization
Methodology
Calculations use the Federal Poverty Level (FPL) as the income benchmark and an approximate applicable percentage schedule that maps income relative to FPL to an estimated household contribution rate. The FPL baseline used is 14,580 USD for a single-person household and adds 5,110 USD per additional household member (standard contiguous-US reference).
The tool computes an annual household contribution limit as applicable_percentage × annual_income, converts it to a monthly contribution limit, and then estimates the premium tax credit as the difference between the benchmark monthly premium and the household monthly contribution (floored at zero).
Detailed mode applies an age loading factor and a plan-metal multiplier to allow a more representative benchmark premium when you have specific plan expectations. All formulas are simplified approximations; actual marketplace calculations use official published tables and state adjustments.
Worked examples
Example: Household income $36,000, size 2, benchmark monthly premium $600. The tool computes FPL, income as percent of FPL, an applicable percentage, and returns an estimated monthly subsidy and the net monthly premium after subsidy.
Detailed example: Same inputs but age 60 and selecting Gold metal will increase the adjusted benchmark premium via the age and metal multipliers, which changes estimated subsidy and net premium accordingly.
F.A.Q.
Is this the official subsidy amount I will receive?
No. This is an estimator for planning purposes. Official subsidy amounts are determined by the marketplace when you enroll and may depend on more detailed household data, state-specific rules, plan availability, and legislative changes.
What is the benchmark premium?
The benchmark is typically the second-lowest-cost Silver plan in your area for the household. If you do not know the benchmark, enter an expected monthly premium or use the default; a marketplace or broker can provide the official benchmark for your ZIP code.
Why do results differ from other calculators?
Different calculators use different FPL base values, applicable percentage schedules, and may include state or ARPA adjustments. This tool uses a clear, conservative interpolation and documents its assumptions; always verify with official enrollment systems or tax professionals.
How accurate is the age and metal adjustment in detailed mode?
Age and metal multipliers are simplified approximations to help reflect typical price differences. They are not a substitute for quoting an actual plan in your ZIP code and may not capture insurer-specific rating factors.
Sources & citations
- Department of Health & Human Services - Federal Poverty Guidelines — https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
- Internal Revenue Service - Affordable Care Act estimator tools — https://www.irs.gov/affordable-care-act
- NIST Cybersecurity Framework (for secure processing and data handling best practices) — https://www.nist.gov/cyberframework
- ISO 9001 Quality Management (for QA and validation practices) — https://www.iso.org/iso-9001-quality-management.html
- IEEE Software Engineering Standards (for engineering rigor) — https://www.ieee.org
- Occupational Safety and Health Administration (OSHA) guidance (for operational safety and controls) — https://www.osha.gov
- NAIC — National Association of Insurance Commissioners — https://content.naic.org/
- Insurance Information Institute — https://www.iii.org/
Further resources
Versioning & Change Control
Audit record (versions, QA runs, reviewer sign-off, and evidence).
Record ID: 22d575214188What changed (latest)
v1.0.0 • 2025-11-16 • MINOR
Initial publication and governance baseline.
Why: Published with reviewed formulas, unit definitions, and UX controls.
Public QA status
PASS — golden 25 + edge 120
Last run: 2026-01-23 • Run: golden-edge-2026-01-23
Versioning & Change Control
Audit record (versions, QA runs, reviewer sign-off, and evidence).
What changed (latest)
v1.0.0 • 2025-11-16 • MINOR
Initial publication and governance baseline.
Why: Published with reviewed formulas, unit definitions, and UX controls.
Public QA status
PASS — golden 25 + edge 120
Last run: 2026-01-23 • Run: golden-edge-2026-01-23
Engine
v1.0.0
Data
Baseline (no external datasets)
Content
v1.0.0
UI
v1.0.0
Governance
Last updated: Nov 16, 2025
Reviewed by: Fidamen Standards Committee (Review board)
Credentials: Internal QA
Risk level: low
Reviewer profile (entity)
Fidamen Standards Committee
Review board
Internal QA
Entity ID: https://fidamen.com/reviewers/fidamen-standards-committee#person
Semantic versioning
- MAJOR: Calculation outputs can change for the same inputs (formula, rounding policy, assumptions).
- MINOR: New features or fields that do not change existing outputs for the same inputs.
- PATCH: Bug fixes, copy edits, or accessibility changes that do not change intended outputs except for previously incorrect cases.
Review protocol
- Verify formulas and unit definitions against primary standards or datasets.
- Run golden-case regression suite and edge-case suite.
- Record reviewer sign-off with credentials and scope.
- Document assumptions, limitations, and jurisdiction applicability.
Assumptions & limitations
- Uses exact unit definitions from the Fidamen conversion library.
- Internal calculations use double precision; display rounding follows the unit's configured decimal places.
- Not a substitute for calibrated instruments in regulated contexts.
- Jurisdiction-specific rules may require official guidance.
Change log
v1.0.0 • 2025-11-16 • MINOR
Initial publication and governance baseline.
Why: Published with reviewed formulas, unit definitions, and UX controls.
Areas: engine, content, ui • Reviewer: Fidamen Standards Committee • Entry ID: d89afe1acb82