Frequently Ask Questions
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You are eligible for the premium tax credit if you meet all of the following requirements:  
  • - Purchase coverage through the Marketplace.
  • - Have household income that falls within a certain range.
  • - Are not able to get affordable coverage through an eligible employer plan that provides minimum value.
  • - Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
  • - Do not file a Married Filing Separately tax return.
  • - Cannot be claimed as a dependent by another person.

For purposes of the premium tax credit, your household income is your modified adjusted gross income plus that of every other individual in your family for whom you can properly claim a personal exemption deduction and who is required to file a federal income tax return.

The actual premium tax credit for the year will differ from the advance credit amount estimated by the Marketplace if your family size and household income as estimated at the time of enrollment are different from the family size and household income you report on your return. If your actual allowable credit on your return is less than your advance credit payments, the difference, subject to certain caps, will be subtracted from your refund or added to your balance due.

The premium tax credit is an advanceable, refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through the Health Insurance Marketplace, also known as the Exchange, beginning in 2014.

The Health Insurance Marketplace is the place where you will find information about private health insurance options, purchase health insurance, and obtain help with premiums and out-of-pocket costs if you are eligible.