This document provides answers to frequently asked questions about health insurance subsidies under the Affordable Care Act. It explains that subsidies may be available for individuals with incomes less than 400% of the federal poverty level, and that subsidies can be estimated using an online calculator. It also outlines that subsidies are only available through state or federal health insurance exchanges, and that local agents can assist with enrollment.

1. Health Insurance
Subsidies Q&A
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2. Do I qualify for a
subsidy under ACA?
• Answer. If you are a U.S.
citizen, ineligible for
Medicare or Medicaid,
and have an annual gross
household income of less
than 400% of the Federal
Poverty Level, you may
qualify for premium
subsidy assistance.
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3. Where do I calculate
my subsidy?
• Answer. Use our subsidy
calculator for a quick
estimate. A final subsidy
determination will be
made by the government
during your enrollment.
WNCHealthInsurance.com /Subsidy-Calculator
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

4. Do I need to submit a
copy of my tax return?
• Answer. No. Enter an
estimate of your expected
gross income for the year
to be insured. If you
underestimate, you will be
required to refund any
amount you didn’t qualify
for when you file your tax
return the following year.
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5. What happens if my
income changes?
• Answer. If your income
changes mid-year, you can
have your subsidy amount
adjusted for the remainder of
the year. This will help
prevent any overpayments in
the event of a salary increase,
or get you a higher subsidy if
income decreases.
• We can help you with this!
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

6. My employer's coverage is just
too expensive. Can I get a
subsidy instead?
• Answer. Typically not.
The only exceptions are in
cases where an employer's
plan is considered to be
unaffordable (more than
9.5% of your household
income) or covers less than
60% of benefit costs.
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

7. Am I limited to only certain
plans if I get a subsidy?
• Answer. Subsidies are
only available for health
insurance plans offered
on state-run health
insurance exchanges or
the Federal Marketplace.
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

8. Can I keep my doctor
or will I have to switch?
• Answer. It depends.
Check your insurer’s list of
in-network providers to
make sure your physician is
listed. If your doctor is not
listed as in-network, you
may want to switch to avoid
paying higher fees. Some
plans may not cover any
cost for seeing an out-of-
network physician.
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

9. Is the subsidy paid to me
or the insurance company?
• Answer. When you enroll
you can chose whether
you’d like to have your
subsidy paid directly to the
insurance company to get
lower premiums now, or if
you’d like to claim it when
you file your tax return the
following year (and pay
higher premiums initially).
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

10. Can my local agent
help me get enrolled?
• Answer. Yes. As long as
they have received the
proper certification, your
local insurance agent can
help you enroll in a
healthcare plan and apply
for subsidies.
• WNC Health Insurance
has certified agents ready
to help you enroll!
© 2014 WNC Health Insurance www.WNCHealthInsurance.com

11. For More Information
on Qualifying for
Subsidies:
WNCHealthInsurance.com/Insurance-Premium-Subsidies
Store Location:
1854 Hendersonville Rd. Ste. C
Asheville, North Carolina 28803
Store Hours: 9 am to 6 pm Monday - Friday
Local: 828-348-2583 Toll Free: 855-395-5552
North Carolina Health Insurance Since 1994
© 2014 WNC Health Insurance www.WNCHealthInsurance.com