Healthcare

Keep Your Affordable Care Act Marketplace Insurance Information Current

9/27/2015

The introduction of the Affordable Care Act has meant that insurance is available to many people who previously found it out of reach economically, but in order to qualify and get the most out of the program, it is important that those who are purchasing their health insurance through the marketplace keep their personal information current. Whether you purchase coverage through the federal marketplace or through that offered by your state, if you qualify for an advance premium tax credit (APTC) then all changes in your status, whether the size or make up of your family or your income levels, need to be reported in as timely a manner as possible in order to make sure that the credit you receive is correct.

Advance premium tax credits are specific subsidies on premium payments that are made available for those who are of low to moderate income. In order to qualify for these credits, taxpayers are required to provide current information on family size and income and the credit is calculated on a monthly basis based on the information provided.

Changes to any of the following can affect the credit to which you are entitled:

Income, whether an increase or a decrease
Birth or adoption of a child
Marriage or divorce
New job that provides access to health insurance coverage
Gaining or losing eligibility for access to health insurance
Changing residence

Taxpayers who are applying for the advance premium tax credit are permitted to use the IRS estimator in order to calculate exactly what impact any of these changes may have, but what is most important is reporting them to the marketplace as quickly as possible in order to make sure that the correct premium is in place in a timely manner – this minimizes the impact of receiving too little or too great a credit. Those who end up with a credit that is larger than that to which they are entitled end up owing money back to the government, and those who aren't getting a large enough credit end up paying more than they need to out-of-pocket for their insurance premiums.

Those whose premium credits were too high and who need to repay the government may have the advantage of a limitation of repayments – that limit is set at between $300 and $2,500. But if the credits are too high and your income is also too high to qualify for the tax credit, they may end up having to repay all of the subsidies that the government provided for them, without the limit coming into play. This can be a large amount of money, but this possibility can be minimized by making the appropriate changes and reporting the correct amounts promptly.

If you are a married couple that has chosen to file separate tax returns, not only do you shut yourself out of being able to claim a premium tax credit, but you also will be required to repay in full any credit that you have already received. This rule is waived in the case of spouses who have been abandoned or abused, as well as for those filing as the head of household.

The regulations imposed by the Affordable Care Act can be a great benefit to many, but they can also be difficult to navigate. If you are uncertain as to whether any recent changes in your life need to be reported to the government, or whether you qualify for an Advanced Premium Tax Credit, the tax professionals at TaxBuzz.com will be happy to provide you with the assistance and guidance that you need.

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Lee Reams, BSME, EA

Editor-in-Chief

Besides his role at CountingWorks as an educator and speaker to thousands of accountants nationwide, Lee manages a technical research service for a large group of tax accountants which sharpens his technical skills. Lee served on the Board of Blackline Systems, is a former Board of Director for the California Tax Education Council, is a Past President of the San Fernando Valley Chapter of Enrolled Agents, Member and Past Director for the California Society of Enrolled Agents.

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