Zane Benefits Publishes New Information on Eligibility Requirements for Medicaid and Individual Health Insurance Tax Credits

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Under the ACA, the eligibility requirements for Medicaid and tax credits are to be based on an individual’s modified adjusted gross income.

Today, Zane Benefits, the number one online small business health benefits solution, published new information on eligibility requirements for Medicaid and individual health insurance tax credits.

According to Zane Benefits’ website, the Affordable Care Act (ACA) will come with changes in eligibility requirements for Medicaid and individual health insurance tax credits. In some states, eligibility will be based on an individual’s modified adjusted gross income (MAGI). Previously, eligibility was determined by state-specified thresholds based on personal income and assets.

Medicaid is a federal program that offers health services to low income individuals. The ACA gives each state the option for Medicaid Expansion. The states that elect to Expand Medicaid will broaden Medicaid coverage to include non-elderly citizens with incomes up to 138% of the Federal Poverty Level, as determined by their MAGI. The following groups will not be effected by the change in eligibility requirements:

Individuals who are eligible for Medicaid through another federal or state assistance program:
-The elderly
-Certain disabled individuals who qualify for Medicaid on the basis of being blind or disabled
-The medically needy
-Enrollees in a Medicare Savings Program

In addition, MAGI does not affect eligibility determinations through "Express Lane" enrollment (to determine whether a child has met Medicaid or CHIP eligibility requirements), for Medicare prescription drug low-income subsidies, or for determinations of eligibility for Medicaid long-term services and supports.

Tax credits will be available through each state’s health insurance exchange, which the ACA requires in order for individuals and families to compare and purchase health insurance plans. Depending on an individual’s MAGI, they may be eligible for assistance to make coverage more affordable – this assistance will be provided through health insurance tax credits.

These tax credits will be advanceable and refundable, meaning that the tax payer may claim the full credit amount before the end of the year, even if they have little or no federal income tax liability.

The amount a person will have to pay for their insurance premium will be capped as determined by what percent of the FPL their MAGI is. The most eligible tax payers will pay for their health insurance premiums will be 9.5% of their MAGI, the rest will be subsidized to them in the form of premium tax credits.

Click here to read the full article.

About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to small businesses and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit

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Christina Merhar
Zane Benefits
800-391-9209 6725
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