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Tools/Retirement withdrawals & early access/ACA Subsidy Calculator for Early Retirement✓ CHECKED AGAINST WORKED EXAMPLES · SEP 29, 2026

What will health insurance cost until 65, and how do I stay under the ACA cliff?

The law as of September 29, 2026: the enhanced credit expired on December 31, 2025, so the 400% cliff is back. See your credit and how much income fits under it.

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Coverage year
Plans in 2026: the 2025 poverty guidelines and Rev. Proc. 2025-25.
Where you live
YOUR PREMIUM CREDITUNDER THE CLIFF
$7,688/yr
At $45,000 of household income (288% of the poverty line for 1 person), the benchmark plan’s $12,000 a year would cost you $4,312, and the credit covers the other $7,688. The credit ends above $62,600: you can add $17,600 of income before that, and the first dollar past it costs $5,765.
Cliff (MAGI)
$62,600
Room before the cliff
$17,600
You pay a year
$4,312
Cost of $1 over the cliff
$5,765
UNDERSTAND YOUR RESULT
LIBRARY CHAPTERHealth Insurance Before MedicareCovering the years between leaving work and 65: COBRA, the ACA marketplace and Medicaid, how the premium tax credit and its 400% cliff work for 2026, and how your choice of withdrawals sets the income the credit is based on.LIBRARY CHAPTERHealth Insurance for Early Retirees: Your Income Sets the PriceThe coverage options between leaving work and 65, how the ACA premium tax credit works now that the enhanced credit has expired, where the 400% income cliff sits, and how to plan reported income around it.
Terms:ACA premium tax creditCost-sharing reductions (CSR)COBRA continuation coverage

What you pay at every income

What you pay after the creditFull benchmark premium
$13k$6k$0020406080Household income (MAGI), $ thousandsFull premium $12kYouCliffYou pay

At $45,000 you pay $4,312 a year for the benchmark plan. The line climbs as income rises because the credit shrinks, then jumps to the full $12,000 above $62,600, where the credit ends.

The subsidy schedule for your household

Income (MAGI)Of poverty lineYou pay a yearCredit a year
$15,650100%$329$11,671
$21,597138%$745$11,255
$23,475150%$984$11,016
$31,300200%$2,066$9,934
$39,125250%$3,302$8,698
$46,950300%$4,676$7,324
$54,775350%$5,456$6,544
$62,600400%$6,235$5,765
$62,601Over 400%$12,000$0

For 1 person with 2026 coverage, the credit is worth $11,671 at the poverty line and $5,765 at $62,600; one dollar more ends it. The figures assume a $1,000 a month benchmark premium.

Premiums until Medicare, held at today’s price

At your incomePast the cliff
5 years
$22k
$60k
10 years
$43k
$120k
To 65 (15 years)
$65k
$180k

At $4,312 a year, 15 years of marketplace coverage until Medicare at 65 cost about $64,673 at today’s premium and your income. Past the cliff the same plan costs $12,000 a year, $180,000 over the same 15 years, a difference of $115,327. This holds the premium at today’s price for every year and counts premiums only (deductibles and copays are extra). Premiums rise with age, and an insurer may charge a 64-year-old up to three times what it charges a 21-year-old (45 CFR 147.102), so real totals are higher.

What moves the needle

Each row re-runs the calculation with one change. Click to apply.

How it's computed

FORMULA
Cliff = 4 × poverty guideline for your household size
You pay = applicable % × MAGI, the % rising in a straight line inside each income tier
Credit = benchmark premium − what you pay (never below $0)
Credit = $0 above the cliff and below 100% of the poverty line
  • Coverage in 2026 uses the 2025 poverty guidelines ($15,650 for 1 person in the 48 states and DC) and the applicable percentages in Rev. Proc. 2025-25. The credit for a year uses the guideline in effect when that year’s open enrollment begins.
  • This is the law as of September 29, 2026. The enhanced credit that removed the 400% limit for 2021 through 2025 expired on December 31, 2025, and no extension has been enacted. If Congress restores it, these tables no longer apply.
  • The credit shown is the annual amount you would claim on Form 8962 at that income. The IRS looks the percentage up at whole percents of the poverty line, so a filed return can differ by a few dollars. The credit cannot exceed the premium of the plan you choose, so a plan cheaper than the benchmark can leave little or nothing to pay.
  • MAGI is the number you enter. The benchmark premium is the second-lowest-cost Silver plan for everyone on your plan; the $1,000 a month here is an example, not a quote or an average. Everything is held flat in today’s dollars, but premiums and poverty lines change every year and premiums rise with age.
  • Not modeled: Medicaid (in states that expanded it, adults below 138% of the poverty line usually qualify instead of the credit), immigration status (from 2027 only citizens, lawful permanent residents, Cuban and Haitian entrants and Compact of Free Association residents qualify), an offer of employer coverage, and cost-sharing reductions on Silver plans, which lower deductibles for incomes up to 250% of the poverty line.
WORKED EXAMPLE · SAMPLE NUMBERS
1 person with 2026 coverage: the poverty line is $15,650 (the 2025 HHS guideline for the 48 states and DC), so the cliff is 4 × $15,650 = $62,600. Your $45,000 is 287.5% of the line. The table rises from 8.44% at 250% to 9.96% at 300%, so at 287.5% the applicable percentage is 9.58%. You would pay 9.58% × $45,000 = $4,312 toward the $12,000 benchmark premium, and the credit covers $12,000 − $4,312 = $7,688.
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Questions about this result

Household income of more than 400% of the federal poverty line ends the premium tax credit completely, so one dollar over the line costs the whole credit, not a slice of it. For 2026 coverage that line is $62,600 for one person, $84,600 for two and $128,600 for four in the 48 states and DC, using the 2025 HHS poverty guidelines. For 2027 coverage it is $63,840 for one person, using the 2026 guidelines. Below the line the credit still shrinks as income rises.
Not as of September 29, 2026. The enhanced credit, which lifted the 400% limit for 2021 through 2025, expired on December 31, 2025. The House passed H.R. 1834, a three-year extension, on January 8, 2026, by 230 to 196, but the Senate has not passed it and no other extension has been enacted. If Congress restores the enhancement, the cliff would move or disappear and the figures on this page would change.
The marketplace uses modified adjusted gross income (MAGI): adjusted gross income plus tax-exempt interest, untaxed Social Security benefits and excluded foreign income, for everyone in your tax household who has to file. A Roth conversion, capital gains you realize and taxable IRA withdrawals raise it. Qualified Roth withdrawals, the basis you take back out of a taxable account and cash do not count, and deductible traditional IRA and HSA contributions lower it (26 U.S.C. §36B(d)(2); IRS FS-2025-10, Q8).
You reconcile on Form 8962 when you file. If the advance payments made during the year were larger than the credit you are entitled to at your actual income, you repay the difference. Before 2026 a cap limited that repayment for incomes under 400% of the poverty line; for tax years after 2025 there is no cap and the full excess is added to your tax (Pub. L. 119-21 §71305; IRS FS-2025-10, Q31). Over the cliff, every dollar of credit you received is repaid.
Marketplace coverage bridges the years until Medicare, which starts at 65 for most US citizens and long-term residents (immigrants on visas may not qualify). Once you are eligible for premium-free Medicare Part A, you generally can no longer get the premium credit for a marketplace plan. This page counts the years from the age you start coverage to 65 at today’s premium and income.
Through 2026, lawfully present immigrants, including people on H-1B and F-1 visas, can qualify if they meet the other rules. From 2027 the credit is limited to US citizens and nationals, lawful permanent residents (green-card holders), Cuban and Haitian entrants, and people lawfully residing under a Compact of Free Association (Pub. L. 119-21 §71301). People on temporary visas such as H-1B, F-1 and L-1, and other lawfully present immigrants who are not green-card holders, no longer qualify. Separately, from 2026 the credit is not available to lawfully present immigrants with income under 100% of the poverty line who are ineligible for Medicaid because of their status (§71302).
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