SSDI counts as income on Healthcare.gov, which may lower your tax credits and raise your monthly premiums

When you report your income to Healthcare.gov, you must include your Social Security Disability Insurance (SSDI) benefit as part of your total household income. Healthcare.gov uses this income figure to calculate whether you may have access to for tax credits (subsidies) that reduce your monthly premium and out-of-pocket costs. The higher your reported income, the smaller your tax credit becomes. If your SSDI payment pushes your income above certain thresholds, you may lose tax credit may be able to access entirely.

This matters because SSDI is often the primary or only income source for disabled people, and reporting it accurately determines what you actually pay for health insurance. Many people on SSDI may have access to for tax credits because their SSDI income falls below the federal poverty line or just above it, but the amount of the credit depends on the exact income figure you report.

Key Takeaways

  • SSDI payments count as income when you create or update a Healthcare.gov account, and the amount directly affects your tax credit calculation.
  • Your monthly SSDI benefit is multiplied by 12 to get your annual income, which Healthcare.gov compares to the federal poverty line for your household size.
  • If your SSDI income is below 100% of the federal poverty line, you may not may have access to for tax credits but may may have access to for Medicaid instead, depending on your state.
  • You must report changes to your SSDI benefit within 30 days of receiving notice of the change, or your tax credit will be calculated incorrectly.
  • Some people on SSDI may have access to for both Medicaid and a Healthcare.gov plan, and which one you use depends on your state's Medicaid rules and your income.

How Healthcare.gov calculates your tax credit using SSDI income

Healthcare.gov asks for your expected household income for the year you are signing up. If you receive SSDI, you report your monthly benefit amount, and the system multiplies it by 12 to get your annual income. For example, if you receive $1,200 per month in SSDI, you report $14,400 as your annual income.

The system then compares your annual income to the federal poverty line for your household size. The poverty line changes every year. In 2024, the federal poverty line for a single person was $15,060 per year. If your SSDI income falls below this line, you are at 100% of the federal poverty line. If it is above the line, you are at a higher percentage.

Tax credits are calculated based on a percentage of the poverty line. Most people with income between 100% and 400% of the poverty line may have access to for tax credits. The closer your income is to 100%, the larger your credit. The closer it is to 400%, the smaller your credit. Above 400%, you receive no tax credit.

When SSDI income makes you ineligible for tax credits

If your SSDI income alone exceeds 400% of the federal poverty line for your household size, you will not receive a tax credit on Healthcare.gov. This is rare for people on SSDI alone, because SSDI benefits are typically modest. However, if you have other income sources—such as a part-time job, pension, or investment income—your total income may cross this threshold.

When you lose tax credit may be able to access, you pay the full unsubsidized premium for any plan you choose on Healthcare.gov. This can be significantly more expensive than the subsidized price. For example, a plan that costs $400 per month after a tax credit might cost $600 or more without one.

If your income is very low—below 100% of the federal poverty line—you may not may have access to for a tax credit through Healthcare.gov, but you may may have access to for Medicaid instead. Medicaid rules vary by state. Some states cover people with income below the poverty line; others have higher income limits. A few states have not expanded Medicaid at all. You can check your state's Medicaid rules on Healthcare.gov during signup.

Reporting SSDI changes and life events to Healthcare.gov

If your SSDI benefit amount changes, you must report the change to Healthcare.gov within 30 days. This is considered a life event that allows you to update your account outside the annual open enrollment period. You report the change by logging into your Healthcare.gov account, going to your process, and updating your income information.

Common SSDI changes include a cost-of-living adjustment (COLA), a change in your benefit due to a work incentive program, or a change because you turned 66 and your benefit converted from SSDI to Social Security retirement. Each of these changes affects your reported income and may change your tax credit amount.

If you do not report a change within 30 days, your tax credit will be based on outdated income information. At the end of the year, when you file your taxes, you may owe back some of the tax credits you received if your actual income was higher than what you reported. Conversely, if your actual income was lower, you may be owed a refund.

SSDI and Medicaid: when you may have both

In many states, people on SSDI with very low income automatically may have access to for Medicaid without having to explore separately. This is called Medicaid for SSI recipients or Section 1619 coverage, depending on your state and situation. If you may have access to for Medicaid, you may not need a Healthcare.gov plan at all, because Medicaid covers medical care.

However, some states do not automatically enroll SSDI recipients in Medicaid. In those states, you must explore for Medicaid separately. You can explore through your state's Medicaid agency or sometimes through Healthcare.gov itself during signup.

If you have both Medicaid and a Healthcare.gov plan, Medicaid is usually your primary coverage. This means Medicaid pays first, and your Healthcare.gov plan covers costs that Medicaid does not. This situation is uncommon but can happen if you live in a state with high Medicaid income limits and you also enroll in a Healthcare.gov plan.

How to report SSDI income accurately on Healthcare.gov

When you create a Healthcare.gov account or update your process, you will see a section asking about your income. You will be asked to enter your expected household income for the year. For SSDI, enter your monthly benefit amount and let the system calculate the annual amount, or multiply your monthly benefit by 12 and enter the total yourself.

You will also be asked whether you expect your income to change during the year. If you expect a COLA increase or another change to your SSDI, you can note that here. However, you do not need to predict future changes; you only need to report changes after they happen, within 30 days.

If you have other household members with income, include their income as well. Healthcare.gov defines household as you, your spouse (if married), and any dependents you claim on your tax return. If you live with someone who is not your spouse or dependent, their income does not count toward your household income.

What happens if you underreport or overreport SSDI income

If you report SSDI income that is lower than your actual benefit, you will receive a larger tax credit than you are may have access to to. At tax time, when you file your return and reconcile your tax credits, you will owe back the excess credit. The IRS will send you a notice, and you will have to repay the money or claim it as a reduction on your tax refund.

If you report SSDI income that is higher than your actual benefit, you will receive a smaller tax credit or no credit at all. You will pay more for your insurance than necessary. When you file your taxes and reconcile, you may be owed a refund of the excess premiums you paid. However, you will not receive this refund automatically; you must claim it on your tax return.

The safest approach is to use your most recent SSDI benefit statement (which you can view in your my Social Security account online) to confirm your monthly benefit amount before you report it to Healthcare.gov.

Frequently Asked Questions

Does my SSDI count toward the income limit for Medicaid?

Yes, SSDI counts as income for Medicaid purposes. However, Medicaid income limits vary by state and by program. Some states have higher income limits for people on SSDI than for other applicants. You can check your state's Medicaid income limit on Healthcare.gov or by contacting your state Medicaid agency directly.

If I get a COLA increase to my SSDI, do I have to tell Healthcare.gov?

Yes, you should report a COLA increase within 30 days. Log into your Healthcare.gov account, update your income information with the new benefit amount, and submit the change. This ensures your tax credit is calculated correctly for the rest of the year.

Can I get a tax credit if my only income is SSDI?

Yes, if your SSDI income is between 100% and 400% of the federal poverty line for your household size. Most people on SSDI alone fall within this range and may have access to for a tax credit. If your income is below 100% of the poverty line, you may not may have access to for a tax credit but may may have access to for Medicaid instead.

What if my SSDI benefit changes mid-year?

Report the change to Healthcare.gov within 30 days. The system will recalculate your tax credit based on your new income. If the change increases your income, your credit may decrease, and you may owe more per month. If it decreases your income, your credit may increase, and you may pay less per month.

Do I have to choose between Medicaid and a Healthcare.gov plan?

Not necessarily. In some states, you can have both. If you may have access to for Medicaid, it becomes your primary coverage. You can still enroll in a Healthcare.gov plan as secondary coverage, though this is uncommon. Ask your state Medicaid agency whether you can have both before you decide.