When you fill out a Marketplace application, you’ll answer detailed questions about your income and household members.
You’ll simply answer the questions. The Marketplace does the calculations and tells you what programs and savings you qualify for.
Before you apply, you can make a ballpark estimate to see if you may qualify for savings. This page tells you how.
Important: The Marketplace makes the final determination of your eligibility for savings. The method below only helps you make a rough estimate that’s useful before you apply.
Start with your adjusted gross income (AGI). You’ll find this on your most recent federal income tax return. For most people, you can just use your AGI as your ballpark estimate for Marketplace eligibility.
Where to find AGI on IRS tax forms:
Add or subtract certain types of income
Some people may have to add or subtract items from their adjusted gross income to make a more accurate estimate.
Add the following kinds of income, if you have any:
Don’t include any Supplemental Security Income (SSI)
Now adjust your estimate for 2015
Remember, your eligibility for premium tax credits and out-of-pocket savings is based on your expected income for 2015, not your 2014 figures. So do your best to account for any changes you think will happen in 2015.
Consider things like expected raises, new jobs, or other employment changes; higher or lower tax deductions; and changes in income from self-employment.
Also account for any expected changes to your household, including gaining or losing tax dependents.
Now you have your ballpark estimate. You can use this figure if you’re applying for coverage with a Special Enrollment Period and you want to see plans and prices based on your income before you apply or to see if you may qualify for premium tax credits and other savings.
Of course you never know what’s going to happen in the coming year. That’s why it’s so important to update your Marketplace application all year whenever you have income or household changes that could affect your coverage.
It’s hard to predict your annual income if you’re unemployed. Still, it’s important to make your best estimate based on all current or expected sources of income for the year, for everyone in your household.
Officially, the measure of income used by the Marketplace is called “modified adjusted gross income,” or MAGI. It’s not a figure that appears as a line on your federal income tax form.
Here’s how the IRS describes MAGI:
Modified adjusted gross income is the adjusted gross income on your federal income tax return plus any excluded foreign income, nontaxable Social Security benefits (including tier 1 railroad retirement benefits), and tax-exempt interest received or accrued during the taxable year.
It does not include Supplemental Security Income (SSI).
There are some differences, depending on your state and other factors. The Marketplace application may ask you specific questions used to determine if you’re eligible for Medicaid. If it looks like anyone in your household qualifies for Medicaid or the Children’s Health Insurance program, we’ll send your application to your state agency. They may ask you for more information. If it turns out you’re eligible, they’ll help you enroll.