Family size means a headcount of you and all of your current dependents (for tax purposes).
Example 1: You live alone and have no dependents or you live with others and have no dependents. You are at the single or individual level. You must make at least 1 to 4 times guidelines (100% and no more than 400%) of the guidelines to get premium and copayment assistance. Your family size is one.
Example 2: You live with your wife and two children. They are your dependents for income tax purposes. Your household size will be four. However, if your spouse or one of your children has health insurance elsewhere, at work, or with Medicaid, your household size will still be four. If health insurance is available elsewhere for a household member who is your dependent, they are part of the family size. If you child has CHIP, they will be transfered to Marketplace Health Insurance and be on your private policy.
Example 3: Your mother or father lives with you and your family. Parents (grandparents), aunts, uncles, brothers or sisters are counted in the family size if they were also dependents (for tax purposes). If your grandmother lives with you, your spouse and two children, the household size is five. Your dependent parent, even if they have Medicare, Medicare Advantage or other health coverage will not be covered on Marketplace health insurance because they have health insurance elsewhere or can get it, but are included in family size. They are all counted in family size because they are your dependents(for tax puropses).
Example 4: One of your grandparents lives with you but they are not a dependent for tax purposes. They are not counted in household size because they are not your dependent. Their income is not included in the family income. For you, your spouse and two children, your family size is four. That is because the parent (grandparent) is not a dependent. To be counted in family size, they have to be your dependents.
Example 5: You live with your child who has CHIP health insurance. You earn enough to get Marketplace health insurance but do not have health insurance available. Your family size is two because your child is your dependent. You can enroll in the Marketplace and get cost support with a Silver plan and the child will by included in your private health policy. The Marketplace is only for people that cannot get health insurance elsewhere and have income within guidelines .
Another way to get help is if your health care insurance where you work costs more than 9.5% of your income, and, your income is between 1 to 4 times (100% and 400%) of guidelines. Your employer will give you information on the available health insurance.
If you have a change in family size, dependents, jobs, income, and move to another area, be sure to let the Marketplace know within the month the change happens.
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