Find out what you actually qualify for
Health insurance options depend on your state, income, and household size. We will tell you if you likely qualify for Medicaid or ACA subsidies — then link you directly to the right marketplace. No email. No phone. No one calls you.
Why health insurance is the hardest to estimate
Unlike car or home insurance, health insurance rates depend on the age of every person being covered, your exact county, the plan tier you choose, and whether you qualify for subsidies. A family of five in Los Angeles County pays a completely different rate than the same family in Sacramento — same state, same income, different county. This is why we show ranges by household size rather than a single number, and why the only way to get your exact rate is to go directly to your state marketplace.
Understanding plan tiers
ACA subsidies — the thing most people miss
The Affordable Care Act provides two types of financial help that dramatically reduce what you actually pay. Premium Tax Credits reduce your monthly bill directly — for many households at moderate incomes they can cut the premium by 50–80%. Cost Sharing Reductions lower your deductibles and copays, but only on Silver plans.
The income cutoff for subsidies is 400% of the federal poverty level for your household size. For a family of four in 2026 that is roughly $124,800. If you are above that threshold you pay full price. If you are below it, do not skip the subsidy calculator on your state marketplace — the savings can be substantial.
Medicaid — if you qualify, use it
Medicaid provides free or very low cost coverage for people below roughly 138% of the federal poverty level in states that have expanded it. For a single person in 2026 that is around $20,120 annually. For a family of four it is around $41,400. If you are near or below those thresholds, check Medicaid eligibility before shopping marketplace plans — you may qualify for something significantly better than anything you can buy.
Open enrollment and special enrollment
ACA marketplace plans can only be purchased during open enrollment, which runs November 1 through January 15 for coverage starting the following year. Outside that window you need a qualifying life event — losing job-based coverage, getting married, having a child, moving to a new state — to enroll in a new plan.
Medicaid has no enrollment window. You can apply any time of year and coverage typically starts the following month if you qualify.
Following the One Big Beautiful Act signed in 2025, eligibility rules for federally subsidized health insurance have changed significantly. ACA marketplace subsidies and Medicaid programs now require verified lawful immigration status for enrollment. This affects who can receive premium tax credits and Cost Sharing Reductions through federal and state marketplaces.
State-run marketplaces like Covered California, NY State of Health, and others that previously extended coverage to undocumented residents using state funds are now operating under new federal guidance. Eligibility rules vary by state and are changing rapidly — what was available six months ago may no longer apply.
If your immigration status is anything other than US citizen or lawful permanent resident, verify your eligibility directly with your state marketplace before applying. Do not assume prior eligibility still applies.
For the most current eligibility rules in your state, go directly to your state marketplace or contact a certified enrollment navigator — they are free and available in every state.