Free tool for agents
ACA subsidy calculator
Check a client’s premium tax credit in seconds with live CMS Marketplace data. Enter a zip code, household income and everyone’s age to see the monthly subsidy, the benchmark Silver premium, cost-sharing reductions and any Medicaid or CHIP flags.
Your estimate shows up here
Enter a zip code, the household income and everyone’s age. You will see the monthly premium tax credit, the benchmark Silver premium it is based on, what the household is expected to pay, and whether anyone qualifies for cost-sharing reductions or Medicaid/CHIP.
Questions agents ask
- Where do these numbers come from?
- Every figure comes from the CMS Marketplace API, the same data HealthCare.gov uses: the county for the zip code, the second-lowest-cost Silver (benchmark) premium for the household, and CMS’s estimate of the premium tax credit, cost-sharing reductions and Medicaid/CHIP eligibility.
- How is the premium tax credit calculated?
- The credit is the benchmark Silver premium minus the amount the household is expected to contribute, which is a percentage of income set by the IRS each year. If the benchmark plan costs less than the expected contribution, the credit is $0.
- Is there still an income cap on ACA subsidies?
- Yes. The enhanced subsidies that removed the cap expired at the end of 2025, so for 2026 households above 400% of the federal poverty level no longer qualify for a premium tax credit. The calculator shows $0 in that case.
- Does it work for every state?
- It uses data for states on HealthCare.gov. States that run their own exchange, such as California, New York and New Jersey, set their own plans and sometimes add state subsidies, so results there can differ.
- What are cost-sharing reductions?
- Households between 100% and 250% of the federal poverty level can get a Silver plan with a lower deductible and out-of-pocket maximum. The calculator shows the CSR level CMS estimates for the household.
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