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How premium tax credits work

When you apply for coverage in the Health Insurance Marketplace, you’ll find out if you qualify for a “premium tax credit” that lowers your premium – the amount you pay each month to your insurance plan.

The amount of your premium tax credit depends on the estimated household income for 2016 that you put on your Marketplace application.

Find out if your estimated 2016 income is in the range to qualify for a premium tax credit.

You can apply some or all of this tax credit to your monthly insurance premium payment. The Marketplace will send your tax credit directly to your insurance company, so you’ll pay less each month. This is called taking an “advance payment of the premium tax credit.”

When your income changes, so does your premium tax credit

If your income changes, or if you add or lose members of your household, your premium tax credit will probably change too.

It’s very important to report income and household changes to the Marketplace as soon as possible.

  • If your income goes up or you lose a member of your household: You’ll probably qualify for a lower premium tax credit. You may want to reduce the amount of tax credit you take in advance each month. This way you don’t wind up taking more credits than you qualify for.
  • If your income goes down or you gain a household member: You’ll probably qualify for a bigger premium tax credit. You may want to increase the amount of tax credit you take in advance so you have a lower premium bill each month.

IMPORTANT: If at the end of the year you’ve taken more advance payments of the premium tax credit than you’re eligible for, you may have to pay money back when you file your federal income tax return. This is called “reconciling” the advance payments of the premium tax credit and the actual premium tax credit you qualify for based on your final 2016 income.

More answers: Premium tax credits

My eligibility results say I’m also eligible for "cost-sharing reductions." What does that mean?

In addition to a premium credit, your income qualifies you to save on the out-of-pocket costs you pay whenever you get health care, like deductibles and copayments. But you get these additional savings only if you buy a plan in the Silver category. Learn about cost-sharing reductions.

What if my income is too high for a premium tax credit?

You can still use the Marketplace to buy a health plan without a premium tax credit. You can also buy a plan outside the Marketplace, where you may find more options.

Learn about the 4 ways you can buy coverage if you don’t qualify for premium tax credits.
Can I appeal a decision about whether I qualify for a premium tax credit?

If you think we made a mistake when you get your eligibility results in the Marketplace, you have the right to appeal.

Learn how to appeal a Marketplace decision.