Will tax credits help pay for your health plan? Here's what you need to know
Check to see if you qualify for tax credits before you choose your 2026 plan
Once you get beyond the sticker shock of your estimated 2026 health insurance premium, you may be confused about how much you’ll actually pay.
The good news: Advanced Premium Tax Credits (APTC)—created under the Affordable Care Act—remain in place. Most people in Maine should receive some financial support.
Even better, because premiums are higher this year, many APTC amounts will go up, too—some by hundreds of dollars—to help offset those costs. The amount you receive is based on your household income and paid directly to your insurance company on your behalf.
It's important that you check to see what you'll qualify for in 2026 while you're shopping for a plan.
Who's eligible for the APTC subsidy?
If you received APTC assistance last year, you’ll likely still qualify in 2026, unless your household income is 400% above the Federal Poverty Level (FPL). If you didn’t receive credits, but had a drop in income in 2025, be sure to check whether you’re eligible. For reference, 400% FPL is about:
- $128,500 for a family of four
- $84,500 for a couple
- $62,500 for a single person
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How can I estimate my 2026 APTC amount?
If you want someone to walk you through this process, check with your broker or talk to our advisor. You can schedule an appointment here. She’ll spend all the time you need to sort it out.
Prefer to do you own homework? Use the KFF Premium Calculator, which will give you a solid estimate. If you are considering renewing or buying a Marketplace plan, you can see your exact costs in the information from CoverME.gov.
Will I still get Enhanced Tax Credits?
If you’ve been following the news, you know about Enhanced Tax Credits, first enacted by the American Rescue Plan during COVID-19, and extended by the Inflation Reduction Act. Currently, they’ll expire on Dec. 31.
These credits removed the APTC’s so-called “subsidy cliff” of 400% FPL in income, instead basing support on whether your premiums cost more than 8.5% of your household income. If they did, you received tax credits, regardless of income.
The KFF calculator will show you what you could pay with enhanced credits vs. APTC credits.
If Congress doesn’t extend these enhanced credits, Mainers could see premium increases of about $180 a month, according to CoverME.gov. Rural households, those with covered children and those over the 400% income cap would be hardest hit.
What should I do now?
Plan as if enhanced credits won’t be available in time for 2026 Open Enrollment, which ends Dec. 15 for plans starting on Jan. 1. If Congress acts, we’ll update you immediately about how it may affect your coverage.
Need help reviewing your options? We’re here to help.
Have questions about your current plan and coverage? Please call Member Services at (855) 624-6463.
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