Enhanced Subsidies with Inflation Reduction Act (IRA)
Advanced Premium Tax Credit (APTC): A tax credit individuals can use to lower their monthly insurance payment (called the “premium”) when they enroll in a plan through the Health Insurance Marketplace. The tax credit is based on the individuals’ income estimate and household information on their Marketplace application. Individuals can buy health insurance through other sources, but the only way to get a tax credit is through the Health Insurance Marketplace. The American Rescue Plan Act (ARPA) of 2021 has provided increased savings and lower costs to consumers enrolling in Marketplace coverage. With ARPA, more people became eligible to qualify for subsidies including enrollees whose income is greater than 400 percent of the Federal Poverty Guidelines (FPL). Now signed into law, the Inflation Reduction Act extends the expanded premium tax credits through 2025.
Federal Poverty Guidelines (FPL): A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine member eligibility for certain programs and benefits, including savings on the Exchange, and Medicaid and CHIP coverage.
2024 Poverty Guidelines
The 2024 poverty guidelines* for the 48 Contiguous States and the District of Columbia are in effect as of January 2024.
| Persons in family/household | Poverty Guideline |
| Persons in family/household 1 | Poverty Guideline$15,060 |
| Persons in family/household 2 | Poverty Guideline$20,440 |
| Persons in family/household 3 | Poverty Guideline$25,820 |
| Persons in family/household 4 | Poverty Guideline$31,200 |
| Persons in family/household 5 | Poverty Guideline$36,580 |
| Persons in family/household 6 | Poverty Guideline$41,960 |
| Persons in family/household 7 | Poverty Guideline$47,340 |
| Persons in family/household 8 | Poverty Guideline$52,720 |
*For families/households with more than 8 persons, add $5,380 for each additional person.
*Source: https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines.
Understanding Your Sentara Individual & Family Health Plans Options
Our plans offer a variety of price options. The Marketplace classifies plans by metallic tiers: Gold, Silver, and Bronze. Many health insurance carriers also classify their plans sold outside of the Marketplace by metallic tier, to make it easier for you to compare plans based on their prices and coverage. While this chart is not comprehensive it may help determine which metallic plan would work best for you.
| Gold | Silver | Bronze | |
| Monthly premium | Gold$$$ | Silver$$ | Bronze$ |
| Percent of Healthcare cost covered | Gold80% | Silver70% | Bronze60% |
| Good for members who... | Goldwant to pay more premium costs upfront to reduce out-of-pocket expenses at time of care. | Silverneed to balance monthly premium costs with out-of-pocket costs. | Bronzedon't plan to use a lot of healthcare services. |
Things to Consider
If you don't anticipate you will need a lot of healthcare services, you may want to consider a bronze or silver plan for a lower monthly premium; however, if you or a family member have an unexpected serious injury or illness, a Gold plan offers richer benefits and would cover more out-of-pocket costs.
Need Help? Talk to a Sentara Personal Plan Advisor today at 1-855-460-5819.
Have a Life Changing Event?
Did you lose Medicaid coverage? Changed jobs? Get married? These and other life events qualify you to enroll in health coverage during the Special Enrollment Period.