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• décembre 7, 2021

Use the information from Form 1095-A to complete Form 8962 to reconcile your advance payments of the premium tax credit with the premium tax credit you are allowed on your tax return. Filing your return without reconciling your advance credit payments will delay your refund. You must file an income tax return for this purpose even if you are not otherwise required to do so. The premium tax credit helps lower your monthly premium expenses. This subsidy is available to people with family incomes of 100% of the poverty level or greater who buy coverage through the Health Insurance Marketplace.

See Line 1, later, for more information on figuring your tax family size. Beginning in 2020, employers can offer individual coverage health reimbursement arrangements (individual coverage HRAs) to help employees and their families with their medical expenses. If you are offered an individual coverage HRA, see Individual coverage HRAs , later, for more information on whether you can claim a PTC for you or a member of your family for Marketplace coverage. The cost of health insurance (your monthly premium) varies quite a bit by state, and even within regions of a state. This is because of several factors, such as the cost of living and cost of health care services in your area. Although the Health Insurance Marketplace Calculator is based on actual premiums for plans sold in your area, there are several reasons why your calculator results may not match your actual tax credit amount.

Part IV—Allocation of Policy Amounts

Alice must compute her contribution amount using the federal poverty line percentage for the household income and family size reported on her Form 8962. If your employer coverage is affordable for you but not affordable for your other family members, you may be able to take the PTC for your other family members if they enroll in a Marketplace qualified health plan. Finally, if your employer offered coverage for you but not your family, you may be able to take the PTC for your family members. For more information on affordability and minimum value, see Pub. You can claim payments in advance towards your monthly health insurance premium when you apply for health insurance through the Marketplace.

If you are claimed as a dependent on another person’s tax return, the person who claims you will file Form 8962 to take the PTC and, if necessary, repay excess APTC for your coverage. If someone else enrolled an individual in your tax family in coverage, and APTC was paid for that individual’s coverage, you must file Form 8962 to reconcile the APTC. You need to obtain a copy of the Form 1095-A from the person who enrolled the individual.

What Are the Income Limits for the Premium Tax Credit?

The FAQs below are intended to help you understand this Calculator. More detailed questions and answers about signing up for coverage are available on our Marketplace FAQ page. We used to offer Premium with Hulu for non-students, but not anymore. If you already have it but cancel or upgrade to a different plan (ex. Duo or Family), you’ll lose access to Hulu.

Family

John leaves columns (e) and (f) blank because he is not an applicable taxpayer and cannot take the PTC. Carol takes into account $7,000 ($14,000 x 0.50) of the premiums of the plan in which she and Mark were enrolled in figuring her PTC. Carol must then reconcile $4,250 ($8,500 x 0.50) of the APTC for her coverage.

Insurance Resources

• Conversely, you could be entitled to additional credits if your income is lower than estimated.
• The PTC is a tax credit for certain people who enroll, or whose family member enrolls, in a qualified health plan.
• Yes, the calculator estimates how much you may pay and the amount of financial assistance you will receive under the Inflation Reduction Act (IRA), which continued expanded amounts and eligibility for Marketplace subsidies.
• Therefore, 33% of the enrollment premium, the applicable SLCSP premiums, and APTC are allocated to Stephanie and 67% of these amounts are allocated to Keith.

According to Table 3, Joe and Alice use the rules under Allocation Situation 4, earlier. One qualified health plan covers Bret, his spouse Paulette, and their daughter Sophia from January through August, and APTC is paid for the coverage of all three. Bret and Paulette each file a tax return using a filing status of single. Bret, Paulette, and Mike must allocate the amounts from Form 1095-A for the months of January through August on the premium tax credit their tax returns using the worksheets and instructions in Pub. 974 because amounts on Form 1095-A must be allocated among three tax families (Bret’s, Paulette’s, and Mike’s). Generally, you are an applicable taxpayer if your household income for 2024 (described earlier) is at least 100% of the federal poverty line for your family size (provided in Tables 1-1, 1-2, and 1-3) and no one can claim you as a dependent for 2024.

FAQs: Health Insurance Marketplace and the ACA

Nancy enters this amount on the applicable lines in column (b), lines 12 through 23. If you file as married filing separately and are not a victim of domestic abuse or spousal abandonment (see Exception 2 under Married taxpayers, earlier), then you are not an applicable taxpayer and you cannot take the PTC. You must generally repay all of the APTC paid for a qualified health plan that covered only individuals in your tax family. If the policy also covered at least one individual in your spouse’s tax family, you must generally repay half of the APTC paid for the policy.

What to Watch in the 2024 ACA Open Enrollment

• Use Worksheet 1-1 and Worksheet 1-2 to determine your modified AGI.
• You can also go to IRS.gov and enter “premium tax credit” in the search box.
• Again, keep in mind that – even if your state did not expand Medicaid – you or some members of your family may still be eligible for Medicaid.
• Your household income plays a critical role, as it must be at least 100% but no more than 400% of the federal poverty line for your family size, although these ranges may vary by state.

See Individuals Not Lawfully Present in the United States Enrolled in a Qualified Health Plan in Pub. 974 provides a calculation necessary to figure the repayment limitation if an individual not lawfully present is enrolled with one or more family members who are lawfully present for 1 or more months of the year. If you completed Part IV for any Form 1095-A, add the monthly premium amounts allocated to you, if any, using the allocation percentage you entered on Form 8962, lines 30 through 33, column (e), to the monthly premiums for other policies that you did not allocate.

This does not mean that you personally will pay 30% of your expenses. Rather, this is an average across everyone enrolled in the plan. Your own costs will vary substantially from this amount, depending on how much care you use. For Marketplace coverage in 2025, the poverty level used is $15,060 for a single adult and $31,200 for a family of 4.

Part III—Repayment of Excess Advance Payment of the Premium Tax Credit

Generally, you cannot use the married filing separate filing status and claim the Premium Tax Credit on your tax return. However, there is an exception for taxpayers who are victims of domestic violence and spousal abandonment; they can claim the relief from the married filing joint filing status requirement for no more than three consecutive years. For the purposes of qualifying for the Premium Tax Credit, it is your modified adjusted gross income (or MAGI) plus the adjusted gross income or AGI of every other individual in your family who is required to file a tax return. Modified AGI is your AGI plus any excluded foreign income, nontaxable Social Security benefits (including Tier 1 Railroad Retirement benefits), and tax-exempt interest received or accrued during the tax year. However, it does not include Supplemental Security income (SSI).

If your entry on Form 8962, line 5, is 400 or more, there is no repayment limitation. Leave line 28 blank and enter the amount from line 27 on line 29. Complete this part to figure the amount of excess APTC you must repay. If you elected the alternative calculation for year of marriage, and line 24 is greater than line 25, enter -0- on line 26 and skip lines 27 through 29.