ACA subsidy estimator
Estimate your advance premium tax credit and what a benchmark plan might cost you each month.
Speak with a licensed insurance agent · TTY 711 Mon–Fri 10:00 AM – 5:00 PM
If you buy your own health insurance — self-employed, retired early, between jobs, or aged off a parent's plan — the Marketplace is where most people find coverage, and the advance premium tax credit is what makes it affordable. Getting the income estimate right is most of the job.
Marketplace plans are grouped into metal tiers — Bronze, Silver, Gold — that describe how you and the plan split costs, not how good the care is. Bronze has the lowest premium and the highest deductible. Gold is the reverse. Silver is where a rule most people have never heard of lives, and it can be worth thousands of dollars a year.
That rule is cost-sharing reductions. If your household income falls in the right range, choosing a Silver plan — and only a Silver plan — quietly upgrades your deductible, copays and out-of-pocket maximum to something much better, at no extra premium. Someone who qualifies and buys Bronze because the premium looked lower has usually made an expensive mistake.
The advance premium tax credit is calculated from your estimated household income for the coverage year, your household size, and the price of the benchmark plan in your county. Because it is advanced to you during the year and reconciled on your tax return, a bad estimate has consequences in both directions: estimate too high and you overpay all year, estimate too low and you can owe money back at tax time. For self-employed and commission-based households this is the single highest-value part of the conversation.
Sarah is licensed in Utah, Arizona and Idaho, so a household split across state lines or a move mid-year does not mean starting over with a new agent. And because she is independent, she compares SelectHealth, Molina, University of Utah Health Plans and Regence in Utah side by side rather than steering you to one.
Important: CUPS Insurance is not affiliated with, endorsed by, or operating on behalf of HealthCare.gov, the Health Insurance Marketplace, or any federal or state government agency. Plan availability, premiums and advance premium tax credits are set by the carriers and the Marketplace.
Free calculators for this coverage. Instant results in your browser — estimates, not quotes.
Estimate your advance premium tax credit and what a benchmark plan might cost you each month.
Work out where your household income falls as a percentage of the federal poverty level.
Compare what COBRA would cost you against a subsidised Marketplace plan for the rest of the year.
Find out in about a minute whether a recent life event lets you enroll outside Open Enrollment.
Your job offers health insurance, but covering the family costs a fortune. Check whether your spouse and children can get a subsidised Marketplace plan anyway.
You give the Marketplace your best good-faith estimate of household income for the coverage year, and you update it when things change — you do not have to wait until tax time. Sarah walks self-employed and commission-based households through a realistic estimate and tells you what to do mid-year if a good quarter or a lost contract moves the number.
Report it to the Marketplace as soon as you know. Your premium tax credit is based on your estimate for the year, and it is reconciled against your actual income when you file your taxes.
Estimate too low and you repay part of the credit at tax time; too high and you pay more each month than you needed to. Updating mid-year is far better than discovering the gap in April.
Only if that doctor is in the plan’s network, and networks on Marketplace plans are often narrower than people expect. Directories also go out of date.
The reliable check is to confirm with the practice directly that they take the specific plan for the coming year — not just "that carrier". We do this with you before you enroll.
During Open Enrollment for coverage starting the following year, or during a Special Enrollment Period if you have had a qualifying life event — losing other coverage, moving, marriage, a birth or adoption, among others.
Most Special Enrollment Periods run 60 days from the event. A loss of coverage usually also lets you apply in the 60 days before it happens, which is better because it prevents a gap.
This is not a complete list of Special Enrollment Periods. Visit HealthCare.gov for the full list.
Nothing. Carriers pay a commission when a plan is issued, and that commission is already built into the plan price whether you use an agent or not.
Buying the same plan on your own does not make it cheaper — it just means nobody checked your doctors and prescriptions first, and nobody picks up the phone in March when something goes wrong.
No, and no agency does. We are independent, which means we compare across the carriers listed on this site rather than representing a single one — but that is not the same as offering every plan on the market.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE to get information on all of your options.
Sarah Wood Rodriquez, licensed since 2009 — over 17 years — and licensed in Utah, Arizona, Idaho. NPN 14943086.
The person who answers the phone is the person who reviews your plan. There is no call center and no handing you between departments.
Call Sarah, a licensed insurance agent, at 435-292-8777 (TTY 711) or book a call. The first conversation usually runs twenty to thirty minutes and there is nothing to sign.
Bring your prescription list and your doctors’ names — with those, the comparison can be a real one rather than a generic one.
9 min read
Where the number comes from, why your income estimate matters more than anything else, and the Silver-plan rule that quietly saves some households thousands of dollars a year.
7 min read
Open Enrollment is not the only way in. If one of these happened in the last 60 days, you can probably enroll today — but the clock is already running.
9 min read
Health insurance is the reason a lot of people work longer than they need to. It is a solvable problem, and the solution is mostly about how you manage income in the bridge years.
A real conversation with a licensed agent who will check your doctors and prescriptions before you decide — and answer the phone all year after that.
Office hours: 10:00 AM – 5:00 PM · Ogden, Utah · NPN 14943086
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