What disqualifies you from the premium tax credit?
To be eligible for the premium tax credit, your household income must be at least 100 percent and, for years other than 2021 and 2022, no more than 400 percent of the federal poverty line for your family size, although there are two exceptions for individuals with household income below 100 percent of the applicable ...
Premium tax credits are available to people who buy Marketplace coverage and whose income is at least as high as the federal poverty level. For an individual, that means an income of at least $14,580 in 2024. For a family of four, that means an income of at least $30,000 in 2024.
For purposes of the premium tax credit, your household income is your modified adjusted gross income for the year plus that of every other member of your family (see Q6) who is required to file a federal income tax return.
How can I avoid it? The easiest way to avoid having to repay a credit is to update the marketplace when you have any life changes. Life changes influence your estimated household income, your family size, and your credit amount. So, the sooner you can update the marketplace, the better.
The income range is $30,000 to $120,000 in 2024 for a family of four. (Income limits may be higher in Alaska and Hawaii because the federal poverty level is higher in those states.) The American Rescue Plan Act of 2021 also extended subsidy eligibility to some people earning more than 400% of the federal poverty level.
If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return. If you've taken less than you qualify for, you'll get the difference back.
The amount of your Premium Tax Credit is based on both the number of people in your household and your household income. Events that change your household size or income can change the amount of your Premium Tax Credit. Some examples of these types of changes include: Giving birth.
The premium tax credit is available to individuals and families with incomes at or above the federal poverty level who purchase coverage in the ACA marketplace in their state. Through the end of the 2025 coverage year, there is no maximum income limit for the premium tax credit.
Premium tax credits reduce your premium for most Marketplace policies. The amount of the tax credit you may receive depends on your income and the cost of Marketplace health plans in your area.
Normally, people who under-estimate annual income – and receive too much advanced premium tax credit (or APTC) during the year – are required to repay some or all of the excess when they file their federal tax return for that year.
Why do I owe taxes because of health insurance?
If you used more premium tax credit than you qualify for, you'll pay the difference with your federal taxes. If you used less, you'll get the difference as a credit. Refer to glossary for more details. your premium tax credit.
If the consumer underestimated their income at the time of application and excess APTC was paid on their behalf during the year, they would have to repay some or all of the excess tax credit when they file. There are maximum repayment limits which vary depending on income, shown in Table 3.
A premium tax credit can help you save on health insurance costs by reducing your monthly bill. It's only available for those who purchase insurance through a state or federal health insurance marketplace, and your income must fall below a certain threshold to qualify.
| Income type | Include as income? |
|---|---|
| Federal Taxable Wages (from your job) | Yes |
| Tips | Yes |
| Self-employment income | Yes |
| Unemployment compensation | Yes |
Who is eligible for health insurance subsidies? In 2024, you'll typically be eligible for ACA subsidies if you earn between $14,580 and $58,320 as an individual.
| Health insurance plan member | Average monthly cost for an HMO plan | Average monthly cost for a PPO plan |
|---|---|---|
| Adult individual age 21 | $342 | $404 |
| Adult individual age 27 | $361 | $423 |
| Adult individual age 30 | $390 | $458 |
| Adult individual age 40 | $438 | $516 |
They will inquire about your tax return from the IRS and other databases. If you underestimated your income for that year and received a subsidy, you will need to pay the entire subsidy back the next time you file your taxes.
A household of two with income between $34,840 and $52,260 would have to repay no more than $1,650 if they received too much federal premium tax credit. *For other household sizes, see the Program Eligibility by Federal Poverty Level for 2022 chart.
The Form 1095-A will tell you the dates of coverage, total amount of the monthly premiums for your insurance plan, the second lowest cost silver plan premium that you may use to determine the amount of your premium tax credit, and amounts of advance payments of the premium tax credit.
Your APTC is calculated based on your estimated annual household income, household size and where you live. If your income or family size changes, this may impact the APTC you receive. Report changes to Covered California within 30 days of the change.
Is it better to underestimate or overestimate income for Obamacare?
If you find that you've overestimated your income when enrolling in a Covered California plan, it can have significant implications for your healthcare subsidies. Overestimation typically means you received less in subsidies than you were actually eligible for.
- Bad debts.
- Canceled debt on home.
- Capital losses.
- Donations to charity.
- Gains from sale of your home.
- Gambling losses.
- Home mortgage interest.
- Income, sales, real estate and personal property taxes.
2024 Medicaid Income Limits in New York
The income limit for a single person to qualify for Medicaid in NY in 2024 is $20,121 a year or $1,677 a month. For a family of two (couple), the annual income limit is $27,214 or $2,268 a month. This is a significant increase from 2023.
Income, household size and affordable coverage
Under the Affordable Care Act, eligibility for subsidized health insurance is calculated using a household's Modified Adjusted Gross Income (MAGI).
If the consumer underestimated their income at the time of application and excess APTC was paid on their behalf during the year, they would have to repay some or all of the excess tax credit when they file. There are maximum repayment limits which vary depending on income, shown in Table 3.
