ACA / Marketplace Information
Federal Poverty Levels for 2026 Health Coverage
Here are the Federal Poverty Level (FPL) income ranges used to calculate the amount of financial assistance consumers could obtain for 2026 Marketplace coverage.
| Household Size | 100% FPL | 150% FPL | 200% FPL | 250% FPL | 400% FPL |
|---|---|---|---|---|---|
| 1 | $15,650 | $23,475 | $31,300 | $39,125 | $62,600 |
| 2 | $21,150 | $31,725 | $42,300 | $52,875 | $84,600 |
| 3 | $26,650 | $39,975 | $53,300 | $66,625 | $106,600 |
| 4 | $32,150 | $48,225 | $64,300 | $80,375 | $128,600 |
| Each additional person | $5,500 | $8,250 | $11,000 | $13,750 | $22,000 |
- Florida did not expand Medicaid. Therefore, tax credits may be available as listed above for people with incomes above 100% of FPL
- Household incomes below 100% FPL do not qualify for federal financial assistance to obtain health insurance coverage1
- Household incomes above 100% FPL may qualify for Advance Premium Tax Credits to offset premium costs
- Household incomes between 100 – 250% FPL may also qualify for Silver with Cost-Sharing Reductions (lower out-of-pocket costs)
- Access to Silver Cost Share Reduction plans is not affected by federal decisions to fund the Cost Share Reduction program
- Applicant cannot be enrolled in or eligible for government sponsored Minimum Essential Coverage (e.g. certain Medicaid or Medicare)
- Applicants eligible for employer group health coverage as either an employee or dependent may qualify for financial assistance to obtain Marketplace coverage if the group plan is not affordable or does not meet Minimum Value requirements. As of 2023, affordability for employer group health coverage is determined for both employee self-only coverage and family coverage using the same annual percentage of household income. For 2026, the employer affordability percentage is 9.96%.
For example: Bob is married with two children, and they have a household income of $49,833 (155% FPL). The family has the opportunity to enroll in group coverage through Bob’s job. Bob’s self-only coverage from his employer costs $1,495 annually, or 3% of the household income, so he is ineligible for Marketplace financial assistance. Family coverage costs $14,950 annually, or 30% of the household income. Since the cost of employer coverage for the family exceeds the affordability threshold of 9.96%, Bob’s family may be eligible for financial assistance to obtain Marketplace coverage
Frequently Asked Questions
Can I change my Marketplace plan mid-year?
Only if you qualify for a Special Enrollment Period.
What happens if my income changes?
You should report changes promptly to avoid subsidy issues at tax time.
Do Marketplace plans include dental and vision?
Adult dental and vision are typically optional; pediatric coverage is included.
Is Marketplace insurance real insurance?
Yes. Plans are offered by major, reputable insurance carriers.
Can I keep my doctor?
It depends on the plan network. We verify this before enrollment.
ACA Enrollment Periods: When Can You Enroll?
Open Enrollment
Open Enrollment occurs once per year November 1st Through December 15th and is the primary time to enroll or change Marketplace plans.
Special Enrollment Periods (SEP)
You may qualify to enroll outside Open Enrollment if you experience a qualifying life event, such as:
Loss of health coverage
Marriage or divorce
Birth or adoption of a child
Permanent move to a new state or county
Significant household income change
Not sure if you qualify? We’ll help you determine your eligibility.
Are consumers required to pay back all of their advance payments of the premium tax credit (APTC) if they estimated their household income to be 100% or more of the FPL but their actual household income ends up being less than 100% of the FPL?
Consumers generally are not required to pay back APTC in this scenario.
If a consumer was enrolled in Marketplace coverage with APTC for one month or more based on estimating their household income to be at least 100% of the federal poverty level (FPL), and the consumer did not intentionally or recklessly misrepresent their household income when enrolling in the coverage, IRS rules state that this consumer may still qualify for and claim the premium tax credit on their tax return even when the household income as reported on their tax return is below 100% of the FPL.
This rule is not affected by Section 71305 of Public Law 119-21 that, for Plan Year 2026 onward, eliminates the excess APTC repayment limitations and requires consumers to repay all of their excess APTC, which is the amount of the APTC for the year of coverage that exceeds the premium tax credit allowed for the year. For years before 2026, excess APTC repayment amounts were capped for consumers with household income below 400% of the FPL.
The IRS has authority to deny the premium tax credit to an individual whose household income as reported on their tax return is below 100% of the FPL and who, with intentional or reckless disregard for the facts, provided incorrect information to the Marketplace in order to get APTC (e.g. intentionally or recklessly provided inflated household income to the Marketplace that was greater than or equal to 100% of the FPL to get APTC). See the IRS Form 8962 instructions for more information.
As described in the Form 8962 instructions under the “Estimated Household income at least 100% of the federal poverty line” section, the consumer provides information with intentional disregard for the facts if:
- They know that the information provided is inaccurate.
- They make little or no effort to determine whether the information provided is accurate and the lack of effort to provide accurate information is substantially different from what a reasonable person would do under the circumstances.
