 [ Symptoms ] my lymph nodes under my arm are swollen pain level 8 went to er no solution need advice [ Disease ] it looks like you have already done a lot of research on your options if you do qualify for tax credit subsidies from the federal government you can choose to pay the monthly premium in advance and then claim the credit later on your taxes or to have the credit sent directly to the insurer if you choose the second approach you would pay the reduced premium amount for consumers who qualify for additional assistance with reduced copayments and deductibles those extra subsidies are sent directly to the insurer or health plan you choose so you do not have to pay those amounts out of pocket