APTC Subsidies
What Is APTC?
Section titled “What Is APTC?”The Advanced Premium Tax Credit (APTC) is a federal subsidy that reduces monthly health insurance premiums for eligible individuals and families. Eligibility is based on household income relative to the Federal Poverty Level (FPL).
How APTC Works
Section titled “How APTC Works”- The government determines the benchmark plan (second-lowest-cost Silver plan in your area)
- Your expected contribution is calculated as a percentage of household income
- APTC = benchmark plan premium minus your expected contribution
- The credit can be applied to any metal-level plan (not just Silver)
Income Thresholds
Section titled “Income Thresholds”| Income (% of FPL) | Expected Contribution |
|---|---|
| 100-150% | 0% of income |
| 150-200% | 0-2% of income |
| 200-250% | 2-4% of income |
| 250-300% | 4-6% of income |
| 300-400% | 6-8.5% of income |
| 400%+ | 8.5% of income (cap) |
Using the APTC Endpoint
Section titled “Using the APTC Endpoint”The APTC estimation endpoint calculates subsidies based on your location, age, income, and household size.
Pro This endpoint requires a Pro subscription.
curl -H "Authorization: Bearer op_YOUR_API_KEY_HERE" \ "https://api.opelyx.com/v1/health/plans/aptc-estimate?zip=33139&age=35&income=45000&household_size=1"The response includes the estimated monthly APTC amount and the net premium after applying the credit to each plan.
Related
Section titled “Related”- Cost Estimation Guide — Out-of-pocket cost modeling
- Billing Tiers — Pro subscription details