Many people who enroll through qualify for financial help to lower the cost of health insurance.
Depending on your income and household size, you may qualify for:
- Lower monthly premiums
- Lower out-of-pocket costs like deductibles and copays
- Oregon Health Plan (OHP) coverage
When you apply, Explore Health will check what savings and programs you may qualify for.
Types of financial help
Premium tax credit
The premium tax credit helps lower your monthly health insurance bill.
You can choose to:
- Use the savings right away each month to lower your premium
- Or claim the credit when you file your federal taxes
Most people choose to use the savings in advance to make monthly costs lower.
Cost-sharing reductions
Cost-sharing reductions help lower:
- Deductibles
- Copays
- Coinsurance
These extra savings are available on eligible Silver plans.
Who may qualify for financial help?
Your eligibility is based on things like:
- Household income
- Household size
- Whether you have other health coverage available
Most people qualify by completing an application through Explore Health.
Income and household size
Explore Health uses your estimated household income for the coverage year to determine whether you qualify for savings.
Income can include:
- Wages or salary
- Self-employment income
- Unemployment benefits
- Social Security retirement income
- Retirement account withdrawals
- Investment income
Some types of income usually do not count, including:
- Supplemental Security Income (SSI)
- Child support
- Workers' compensation
- TANF benefits
- Veterans benefits
Tax filing requirements
To receive a premium tax credit, you must file federal taxes each year.
If you are married, you usually must file taxes jointly to qualify for savings.
Some exceptions may apply for people experiencing:
- Domestic abuse
- Spousal abandonment
- Certain separate living situations
- Legal Seperation
What counts as other health coverage?
Some types of health coverage may affect whether you qualify for financial help through Explore Health.
This includes:
- Job-based health insurance
- Medicare
- Oregon Health Plan (OHP)
- COBRA coverage
- Some retiree health plans
- VA or TRICARE coverage
If your job offers health insurance
You may still qualify for financial help through Explore Health if the health plan offered by your employer costs too much.
For 2027, employer coverage is generally considered affordable if employee-only coverage costs less than 10.22% of household income.
Even if employee coverage is affordable, family members may still qualify for savings if family coverage costs too much.
If you have Medicare
People enrolled in Medicare usually do not qualify for financial help through Explore Health.
If you are turning 65 soon, Explore Health may contact you with information about Medicare and your coverage options.
If you have COBRA
If you are offered COBRA, you can compare Marketplace coverage through Explore Health before choosing COBRA.
If you are already enrolled in COBRA:
- You usually must wait until COBRA ends or Open Enrollment begins before changing to Marketplace coverage
Some people qualify for a Special Enrollment Period when COBRA coverage ends.
Special savings for American Indian and Alaska Native households
American Indian and Alaska Native (AI/AN) households may qualify for additional savings and protections.
Depending on income and tribal status, some Tribal members may:
- Have no deductibles, copays, or coinsurance
- Get special enrollment flexibility
- Receive lower costs when getting care through Indian Health Service or Tribal health providers
Learn more about extra savings and protections for Tribal members.
How Explore Health checks information
Explore Health checks information like income and household size using secure electronic data sources.
Sometimes we may ask for documents to confirm information on your application.
Examples of documents may include:
- Pay stubs
- Tax returns
- W-2s or 1099 forms
- Unemployment letters
- Social Security benefit letters
If we need more information, we'll let you know what documents to send and when they are due.
What if your income changes?
It's important to report income or household changes as soon as possible.
Changes may affect:
- Your monthly savings
- Eligibility for programs
- Your tax filing next year
Common changes include:
- Starting or losing a job
- Changes in income
- Marriage or divorce
- Having a baby
- Moving
Some applicants may qualify for Oregon Health Plan programs instead of coverage through Explore Health.
If Explore Health determines you may qualify for OHP:
- Your information will be sent to OHP for a final decision about if you qualify
- You may still choose to buy a Marketplace plan at full cost without financial help
Need help?
Free enrollment help is available if you:
- Want to know if you qualify for savings
- Need help estimating income
- Have questions about your application
- Need language or accessibility support
Explore Health can help you find coverage that fits your life and your budget.