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When do you get a health care tax credit?

To sum it up...
  • Premium Tax Credit is a refundable credit you receive after purchasing health insurance through the marketplace.
  • Find out if you or your family qualify for the Premium Tax Credit
  • Know what life changes will affect your Premium Tax Credit
  • Decide whether you want to use your Premium Tax Credit towards your monthly premiums, or just collect it at
  • the end of the tax year
  • Know what documents and forms you need to file to get the Premium Tax Credit

The healthcare tax credit is called The Premium Tax Credit. The Premium Tax Credit is when you or your family get a refundable credit when you purchase your insurance through the Marketplace.

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Who Qualifies for the Premium Tax Credit

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To qualify for the Premium Tax Credit, you must meet all of the following requirements:

  • Your household income needs to fall under a certain range.
  • If you’re married, you cannot file separately. But there are exceptions to this, such as being a victim of domestic violence and spousal abandonment.
  • You can’t be claimed as a dependent.
  • You must have purchased your insurance through the Marketplace.
  • You’re not able to get employer-sponsored coverage.
  • You can’t qualify for Medicare, Medicaid, TRICARE, or any other government health coverage.
  • To see if you or your family qualify for the Premium Tax Credit, click on this tax tool or check this eligibility chart.

Life Changes

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If you or your family qualify for this Premium Tax Credit, any kind of life changes can affect the amount you get or maybe even your eligibility. Some of these life changes include:

  • Marriage
  • Divorce
  • Birth of a child
  • Adopting a child
  • Becoming pregnant
  • Your child turns 26
  • Change in employment status
  • Getting or losing employer-sponsored coverage
  • Getting or losing government healthcare
  • Moving to another address within your state
  • Changes in income
  • Changes in Social Security benefits
  • Death

When any life change occurs, please make sure you report them, so that you can get the help you need.

To report these life changes, please go to Healthcare.gov.

To find out how much a life change affects your premium tax credit, please check out the IRS Estimator tools.

Claiming and Reconciling Your Credit

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If you purchase insurance through the Marketplace, the Marketplace will estimate how much tax credit you will get back at the end of the tax year. The estimation is based on information, such as the size of your family, your projected household income, and if those you’re enrolling are eligible for non-Marketplace coverage.

When you get the estimate from the Marketplace, you can choose whether you put that some of that credit, all of the credit, or none of the credit towards your insurance company. Depending on how much credit you put towards your insurance, this will lower what you pay for monthly premiums. This is called Advance Credit Payments.

If you don’t get or choose not to do Advance Credit Payments, you will need to pay for the full monthly premium to continue coverage.

If you choose and get Advance Credit Payments, please make sure you file Form 8962, Premium Tax Credit (PTC) at the end of the tax year. File this form even if you don’t need to file a return.

If you choose not to do Advance Credit Payments, you can claim the full Premium Tax Credit you’re allowed to claim on your taxes.

For more information on how claim and reconcile your credit, check Premium Tax Credit: Claiming the Credit and Reconciling Advance Credit Payments.

Documents and Forms You Need to File

To get the Premium Tax Credit, make sure you file the proper documents and forms. Here is a list of the documents and forms you need:

  • Form 1095-A
    Form 8962
    Form 1040

For more information about the Premium Tax Credit, please check Publication 974.

For more information about the Marketplace and forms for yourself and your dependents, please check the Health Insurance Marketplace Statements page and the IRS Question and Answers section.

By being aware of the information above, it can help you and your family get the relief you need from high healthcare insurance costs. Healthcare shouldn’t have to be a burden. So make sure you check to see if you qualify for the Premium Tax Credit so that you can get the help you need.

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