My father currently has Obamacare and his income falls under the poverty level requirements. He recently filed his income taxes and was informed that he owes back the money provided for subsidies. I researched the information on subsidies and tax credits but still no clarity. Can information be provided so that we have a clearer understanding as to why he has to pay back the subsidies. Thank you in advance.


If you projected a higher annual household income then you claimed, you may owe tax credits you received in advance up to the repayment limit for your income when you file 8962 at tax time.

That means you can't pay higher than the amount listed for your family size and % of the Federal Poverty Level (amounts are subject to change each year, so always double check this year's repayment limits).

The repayment limits can be found in the instructions for the 8962 form used to reconcile tax credits. One other cause for having to repay tax credits is due to claiming eligibility, but not being eligible due to having access to affordable employer coverage. Make sure to take exemptions on the 8965 form and to double check payments made using the individual shared responsibility worksheet on the 8965 instructions to avoid overpaying the fee if you missed at least one month of coverage in the year.

Line 28. Repayment Limitation. The amount is limited to certain amounts ensuring you can’t owe more than you can afford if you received too many Advanced Premium Tax Credits. Please note that you’ll owe back all tax credits if you make over 400% and will owe back nothing if you make less than 100%.

Income % of FPL Filing Status:
Filing Status:
All Other
Less than 200% FPL $300 $600
At least 200% FPL
but less than 300%
$750 $1,500
At least 300% FPL
but less than 400%
$1,275 $2,500
If your year end income exceeds 400% FPL, you will have to return the total amount of Advances Premium Tax Credits you received.If you make too little to qualify for subsidies (less 100% FPL), then you owe NOTHING.That being said, if you know you are going to price out of cost assistance, make sure to update your Marketplace account. You may become eligible for a free or low-cost Medicaid plan if your state expanded Medicaid.

Go here to see income as a percentage of the Federal Poverty Level.

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Paula L Curran on

I had self-employment qualified subsidy from Jan-July and met the income guidelines for that subsidy during those months. In August I increased my work hours with an employer who provided me health care coverage from August-Dec? Now I am told I am required to reimburse the entire subsidy because my August-December income exceeded the 400% eligibility. Is this correct? on

Yes, this is generally right. As a self-employed individual you can take some big deductions, so if you only went over a little you may be able to get around this.

Generally it is frustrating, but yes, if you go over 400% you have to repay what was advanced to you. Just wrote about this actually:

Leigh on

Happened to me too..Same scenario. Was told that It’s cannot go after you or withhold future refunds for this bill.

sharon lapierre on

What happen when they were covered but never was because of accent health made a mistake 4 months a waited to be covered but never was the insurance sent me a paper saying I was what do I do? How can I prove it

Catherine Zoerman on

After not getting a straight answer, we took money from an IRA to pay up credit cards, when my husband went off on disability… they want almost $8000 paid back….and if we drain our IRA, we will owe all back for this year….scared to get a job and owe more…..this is not fair on

If the income is taxable, then it counts toward MAGI and affects tax credits. This makes taking taxable payments before Medicare age tricky as it eats into assistance. It is fair when the person lives in a non-expansion state and that is the only income qualifying them for assistance, it feels far less fair when you are a hardworking family being kept in an income bracket despite having savings in a market-based retirement account due to trying to get subsidy levels right.

I’d never found it to be the most agreeable or elegant pairing of systems, but it is explainable with logic.

Jenny on

When we enrolled in the marketplace last year, we claimed eligibility because although my employer offers insurance, it is far from affordable. What we didn’t understand (and an insurance agent helped us to enroll, so she clearly didn’t understand either) was that it apparently WAS affordable according to the standards. The questionnaire on the marketplace just asked if the insurance was affordable, it didn’t give us any standards make that decision, so we said NO, it’s not affordable. Are we going to have to pay these subsidies back? If so, we are going to owe somewhere in the neighborhood of $12,000! Does the repayment limitation apply to us? We thought we were filling out the questionnaire honestly.

ashley barnhart on

This happened to me as well. I actually made less than what I projected and my employer does not provide coverage. I still paid back all the subsidy I received. So why did this happen? on

If you make less then you shouldn’t owe back the subsidy. You should owe it back when you make over. With that said, the instructions themselves (pertaining to Line 28. Repayment Limitation from 8962) say: less than 200% is capped at $300 for a individual and $600 for a family.

When I wrote up the guide last year (by going through this line by line) I very strongly recall one of those “subtract line X from line Y and if the amount is less than Z then enter zero” steps. Thus, I am almost certain the repayment about for below 100% FPL is zero… that said, you can see the link above which is what i’m quoting for the “less than 200% numbers.

In other words, you should in no way owe back the whole credit if you go under the amount, and i’m pretty sure the amount you owe back in practice is nothing.

See here:

Nick on

I have the very same issue. Employer offered me insurance for 2016 but I declined it a year ago as it seemed very affordable. Come a few weeks ago I get a letter in the mail saying my employer has appealed my eligibility and the marketplace is going to make a final judgement. Bad thing is, I don’t have a copy of the original cost of the employee plan anymore. If it turns out it was actually affordable (less than the 9.66%) for single and I get my eligibility taken away for the tax credit, do I have to pay all of it back? I will be looking at a $3000 bill come tax time if so. I understand the limits for overpayments and underpayments but those are for people who were deemed eligible. What about for individuals who made a miscalculation about the affordability and denied their company’s insurance?

Rick on

Your initial response to the original question stated, “If you projected a higher annual household income then you claimed, you may owe tax credits you received in advance up to the repayment limit for your income when you file 8962 at tax time.”

Yet, now you state the following, “If you make less then you shouldn’t owe back the subsidy. You should owe it back when you make over.”

So, which is it, I’m confused… on

So, it is both, but if you go under specific thresholds the amount you owe back is capped. If you go under the 100% threshold into medicaid territory, then i’m pretty sure it is all forgiven (it is a $300 max repayment under 200% FPL, but almost positive it is waived if you go under 100% FPL).

The problem is that the forgiveness of the fee is buried in one of the forms (8962 i’m pretty sure) and I haven’t worked through the form in over a year (and would need to reconfirm this to feel 100% confident in offering the advise without the caveat).

So, to the above, “you may owe back money… but within the bounds of the repayment limits”.


Ann C Reed on

My son and his wife are at 200% of the FPL, yet when they completed the proper forms, the results show they owe the full amount of subsidies they received. Why is that when this page says the full amount will need to be repaid if one is at 400% of the FPL? on

They should not owe back the full amount at 200% unless that amount was under the amount owed for 200%.

For example, if they projected 100% and then got less than $1,500 in credits and thus owed back less than $1,500.

Does that make sense. To be clear, this should read “you don’t owe back the full amount if it exceeds the threshold limit).

Always looking for the easiest way to say these somewhat complex things!

Hope that clears it up.

Steven on

I am self-employed. I expect my income to fall below the yearly max for subsidy next year, but I am not sure. Am I better off signing up for subsidies now, with knowing that I will very likely have to pay it back. Or am I better off just not signing up for subsidies, only to find out later that I would have qualified?

Second question: Am I right in assuming that monthly income is irrelevant when projecting future income? some months I make very little so if I based it off of that then I would quality but some months I might make more than the cutoff.

Erin on

If you believe that your income (projected income) will exceed 400% Federal Poverty Level (FPL), you should still consider getting a plan from your states Marketplace, but I would recommend against taking Premium Tax Credits (PTC) in advance (APTC). Any advanced credits you received and were in eligible must be paid back (with some limits). If your income ends up being lower than 400% FPL, you will get eligible Premium Tax Credits on your year end tax return. If you chose a Silver Plan from the Marketplace than there one additional benefit. If your income drops significantly below what you excepted (like you become seriously ill) than you can report those changes during the year and become eligible for Cost-sharing Reduction Subsidies (CSR) mid year. As long as you stay with the same insurer, any money paid towards your deductible already during the year will be counted towards the lower deductible (reduced by CSR).

Brien McMullen on

I just was advised by an Affordable care act representative to apply by not checking the box ‘asking for help with paying for insurance’ because my income has been too high to receive a subsidy. Later this year, I expect a big drop off in income that may leave me eligible for a subsidy.
Will I be able to amend my insurance later in the year to receive a subsidy? At the end of the year, will it be possible to receive those subsidies on my tax return? on

So nearly everything that happens with the ACA is a tax or tax credits. The upfront credits make it seem like perhaps something else, but for everyone, the last tally always happens on your taxes. You can claim any part of the credit you haven’t claimed at tax time as long as you had qualifying marketplace coverage for the year.

Kevin on

So basically i have to pay for tax ad the end of the year for my house over 6k plus family about health 2.5k, addition tax return 1.5k = 9k total a year. that 9k of free money going to the government that’s crazy.

Tracy on

For 2016, I had coverage through the marketplace for 9 months before I became eligible to get coverage through my employer. For the entire 9 months, my income estimate was right on for the subsidies I received. Nothing ever changed, but I still checked it every three months. Then AFTER I cancelled my coverage through the marketplace, my income increased because I got a small raise.
Now I’m filling out my tax return and it’s saying that I was overpaid tax credits because my annual income is higher than what I estimated with the marketplace. Though it’s calculating only the 9 months I had their coverage, it’s using all 12 months income. Why? Was I supposed to go back and update my income even though I no longer had their coverage? I don’t understand it. How can they penalize me for a higher income when I didn’t even have their insurance anymore?

Erin on

Yes, you are responsible for paying back any cost assistance you received in advance that you ended up not being eligible for. There are limitations to how much you can owe back, but it’s your responsibility to estimate your income to the best of your ability, to update the marketplace if that estimate changes, and to be prepared to pay back tax credits if your income is higher then you estimated. This is because it is a tax credit based on your annual federal income taxes for the year that you are simply given the option to receive them in advance.

LINDA Bates on

Can I claim what I paid back last year on this years taxes?

Dwayne Wayne on

This is BS.
I claimed the EXACT AMOUNT of earnings and still have to pay back 45% of my subsidy, and that’s on the lowest costing bronze plan. The first year of Obamacare I picked a gold plan and ended up paying back 55% of what they gave me… and I always entered the EXACT AMOUNT in earnings for the year.

dee on

How would i know if im going to make more money during the year i filed for obama care it goes by the prior years income. so i shouldnt have to pay back subsidies.

Rick on

Can we have an honest discussion regarding the potential dire ramifications for the self-employed and/or commissioned employees? 2017 premiums being offered in my state are absolutely horrendous (not to mention I only have one choice of providers…thanks Obama). With that said, as a commissioned self-employed individual, I have a broad idea where my income may fall at the end of the year, but realistically, I cannot project with any accuracy. My family of three is on the border of 400% of the fpl, but we won’t know until year’s end. However, I simply cannot afford the low-cost option being offered at $1798 a month without some sort of subsidy. Therefore, I am forced to accept the subsidy ($800/mo) offered in order to barely make ends meet. But what happens when/if I exceed the the 400% income threshold by even $1.00?? I will be expected to repay the entire $9,600 subsidy! This is outrageous and unacceptable! Who can afford this!! I know I can’t. I can neither afford the premium without the subsidy nor can I afford the potential tax ramifications should I barely exceed the appropriate thresholds…In other words, I’m screwed… on

Honest conversations are the best kind. Those are the conversations where we find that we all have unique problems, but seek to find commonalities and fixes which benefit the American people in general.

If you are going to go over the cliff, utilize all deductions you can from IRAs, to HSAs, to GoodWill.

Kgill on

I am self employed too and screwed..We are dropping it and doing without. Our deductible is 14k before it pays a thing! (7k each.) The 400 we pay bucks is going in a savings accout. I had to pay 1500 this year for underestimation of income. I cannot estimate my income!!!

Beverly Cross on

My family is facing this exact thing. We were all good, within limits, for 10.5 months. Then we had an unusual jump in income, which ended up pushing us over the 400% by $900 dollars. We’re now facing a $15,000 tax bill. This is outrageous! I have the same frustration as you.

Trish on

Yes you are correct! I just wrote similar story myself. Having to pay back what you could not afford in the first place is not understandable. It almost discourages someone from finding a higher paid job…or working at all.


I am exactly in the same shoes as this family. How are we expected to pay back the full
subsidies at barely over the 400% fpl! I could never afford the premium witht the coverage they offer. I want to know who to contact and see if we can get help paying it back like everyone else gets help! Self employed that is screwed!

carol cairns on

I received Obama care insurance for 2016, no payment due from me, I am 64 and I still worked but made under the guidelines of 15,500 do i owe back the internal revenue service?

Jenny on

From the time I reported my income to my insurance agent to enroll me in Obamacare my income has not changed the only thing that had changed was I became single because my husband had passed away so could that be the reason why I have to pay back some of the money that they helped me pay the premiums with? If so that does not seem right my income had not changed why do I have to be punished because now I am widowed?

Aileen on

I had coverage through Covered CA for 7 months when I was making less money and did not have employer-based coverage. The last 5 months I got a new job where I began to make more and received employer-based coverage. I took the time to call Covered CA to stop insurance through them. Why is my PTC still based on my entire year when I was covered all year, but only 7 months through the marketplace. Now, I am being ding with a $750 repayment amount. The time I was covered through them, I absolutely needed it.

Isabel Markle on

so how would that help the less fortunate. if you have to pay back . they take the refund that people depend on.

dan hoeper on

i was under the 62040 but i inherited and ira when my passed away that put me over by 5000

dan hoeper on

i was under the 62040 but i inherited and ira when my mom passed away that put me over by 5000

Katie on

I owe back $600, but don’t understand why. I made MUCH less this year than expected so I didn’t underestimate my income when applying. However, I did get married this September, is this why I owe money? If so, my husband and I are filing married but separate, shouldn’t that mean that being married has no affect on my eligibility?

Deb Owens on

My husband is 79 years old, with a Railroad pension,nothing from Social Security. He has Medicare coverage and supplemental insurance with Blue Cross Blue Shield.He PAYS for this. I am 61, work part time and have insurance thru the Market Place (currently with Health Alliance). My husband PAYS for HIS AND MY insurances. Tax year 2014 we paid $1500 back to Obamacare. 2015 we paid back ( I think it was) $600 or $700 to Obamacare. Our tax person was not able to really explain WHY this was the case???? We appreciated the ‘help’ for my insurance, BUT feel that we are penalized with the end result….making life even more difficult on our limited low income. What’s going on and why? I am worried about 2016 taxes, even though our financial status has not changed. on

If you owed back credits then you must have made more than you projected:

That or a mistake of some sort was made.

I agree, psychologically the problem with advanced tax credits is that one ends up having to pay them back. I never loved that solution, still don’t in retrospect. Unfortunately the GOP solutions so far have included making people pay back the full amount and restricting credits (neither of which would actually help people directly). Still waiting and pushing for better solutions for if and when the next change happens. Fingers crossed!

S on

How funny that you blame the GOP for having to repay healthcare credits. Don’t ever forget that it was Obama and his liberal cronies who came up with this to begin with. The GOP simply has to live with the screw-ups of the past administration. on

I blame the GOP for not doing anything to fix issues that needed fixing and instead going on an ideological crusade to turn healthcare into tax cuts for the rich. I don’t blame them for what the Democrats themselves got wrong.

Bhargav Patel on

Me and wife is filing jointly for 2016 tax returns. Now I was not working in the month of january. We obtained obama care health coverage on the basis of my wife salary which was around $30000. I went back to work after some time. Our total salary for the year of 2016 is $48000 for both of us. Do I get any benefits from capped assistance? If no, How much I expect to pay back? We have premium of $454 and tax credit of $465 for the year of 2016. Please inform. Thank you.

JudyDuu on

I run a S corp, 100% share holder. I paid $3k hearth insurance in 2016, but I have to repay
$2500 subsidy of health insurance. I wonder How much my Self-employed health insurance can be deductible (line 29 in F1040)?

Desiree on

My income for the year was about $20,000 but when I signed up for ObamaCare I estimated my income at $16,500. My CPA is telling me that i will owe $800 for over payment of subsidies. I am single and made about $20,000 for the year and paid about $1200 in taxes. Is there a cap on how much I have to pay back? Read that it is $300. If this is true how do I find out the information regarding the cap and how much I truly owe? Will the IRS send me a letter stating that I only owe the $300 or the $800?

Bob on

I guess the real question should be, Why do I have to pay back obamacare subsidies, and not the insurance companies? The tax payer never saw the money. So I guess the insurance companies keep the overpayment and we pay for it. The insurance companies are in a win win situation, they keep the overpayment and our insurance doesn’t kick in until after we pay an outrageous deductible. on

Very good point. The government fronts you money and gives it to the insurer. You owe the entity that fronted you the money. That is the answer.

Patricia Sewell on

My projected income was and is the same as when I applied for Obamacare..and I paid $200/month
I dropped Obama care when I turned 65 In November…I now had Medicare.
In late December I had to withdraw money from a retirement account for home repairs.
Income has not changed !
I have to pay back the entire year of premium “subsidy”to the tune of $7,500 dollars, because the home repair money was counted as income.
1. I cancelled Obama care 2 months prior because I turned 65.
2. My retirement money was used for a home repair…did not effect my monthly income.
This is a huge flaw in this healthcare plan.

Barbara on

I am going thru a divorce and had to take distributions from my IRA to pay my attorney. I have paid her thousands of dollars. That is considered income, so I have to repay Obamacare this year for the second time.
$7000.00. I have to take it from my IRA as I don’t have that kind of money in my checking account. I am a retired healthcare worker, 64 yo, working at Walmart to make ends meet. So much for a happy retirement. on

I am with you, paying taxes on withdrawing funds is not fun. This is made less fun by the way refundable tax credits work.

Trudi on

My husband and I started the year with the affordable health care because our income had changed and insurance premiums were not anything we could afford. In June 2016 my income changed and I called the bcbs office to let them know. They advised I needed to contact the Affordable healthcare office to report the change and they would be able to assist me. I called on June 13, 2016 and spoke to a representative advising him (Richard) that my income had changed. Richard stated that he had logged the change and that if I needed to do anything I would receive documents in the mail. I received nothing. We filed our taxes and to our surprise our accountant told us we would have to repay $10,000. back in tax credits because we made more than the limit allowed. I told her I had called and advised them of the income change and received nothing. We have contacted our attorney to find out what our legal right would be if we did what we were advised by reporting the increase in our income. In talking with others it seems it is almost a given that there is not follow through by the representatives at the affordable care offices to help individuals maintain compliance to avoid a penalty. If anyone else has come upon the same problem.

Leah on

Your mistake was calling. This should have been done through the ACA website. You see the changes right there and receive confirmation. It does take a month or two for your insurance carrier to “catch up” to the changes.

Cindi on

I don’t get a subsidy so why do they have the right to tell me what coverage I can have or not? Short term is not ACA comp. But it offers coverage and almost as good as AHC plans but less expensive. As long as I have insurance isn’t that all that should matter? But NO! If govt. isn’t going to help me pay for insurance then they need to let me get what I want and NO penalty. I’m sick of paying $$$ every month and when I need medical attn. It pays most nothing anyway…non aca comp.or otherwise. Deductible are so high to afford premiums..coverage don’t kick in til you are bankrupt. I’m sick of it!

kenneth on

Looks like this is just another way for the irs to get more tax money out of the working people without calling it an increase % to our federal income tax. I bet it makes Obama mad that Trump will get to spend all the money that obamacare brings in for the next four or eight years.

Erin on

What “money” does “Obamacare bring in” exactly?

Pam Mabry on

According to my 1095-A, my monthly premium is $299. I pay $164 each month. The monthly advance premium tax credit is $207. This doesn’t add up – so I am confused about why I have to repay anything. Shouldn’t the credit just be the difference (299-164=135)??

Lawrence on

This is crud Obamacare is only good for people who don’t earn a living I am fighting this in federal cour on

That really isn’t true, but certainly not everyone benefits equally.

Prakash on

My family members were in enroll in marketplace insurance for 2016. We didn’t know that we are non resident aliens for tax purpose and can’t do joint tax filing. We just knew it while filing taxes. After consultation with tax professionals we came to know that we need refund all the amount paid my marketplace for us. We are under 100% poverty line. What will be the consequences of this and how much amount we need to repay for this? Please advice us.

Erin on

There are limits to how much Advanced Premium Tax Credits the IRS can ask you to repay in the event that you end up not being eligible for them on your year end taxes (depending on your income). Nonresident Aliens are eligible for premium tax credits if they are lawfully present and meet the other requirements (like not being eligible for Medicare or Medicaid or employer coverage). If each individual income is below 100% of the federal poverty level ($12,060 for 2017) on your year end taxes, but were determined by the Marketplace to be eligible at the time you enrolled, you should be protected from having to repay any advanced premium tax credits. What’s a little less clear from reading the IRS instructions for Form 8962, is whether just one of you or both of you will file Form 8962 in order to reconcile those tax credits. You may want to reach out to you health insurance Marketplace for assistance or contact an IRS Tax Assistant Center to get clarification on that.

danielle on

I have no idea how to payback the subsidies.

I thought I could not get insurance from my husband’s employee so I chose Obamacare last year. Now I found that I could and the coverage is considered affordable .

When I fill f1040 this year I can not find any form to payback the subsidies. Maybe I just send a check to IRS?

Please help. Thank you. on

You pay them back with the help of the 8962 and 8965 forms (which you’ll attach with your 1040).

You’ll need all those forms, and potentially 1095-A is a reference.

danielle on

Thank you so much. But when I use 8962 it calculates out more money refund to me for I have house income only 173%.

Jean on

I only would up making $11500 this year and received $511 a month in subsidy for Blue Cross through Obamacare. I now realize I should have been on Medicaid. Will I have to repay the approx $6000 subsidy because I was on the wrong plan? I live in NJ. on

If you make less than 100% FPL you don’t have to pay back the subsidies. So generally the answer is no. With that said, if you somehow took credits, then had Medicaid start retroactively, but made between 100% and 138% FPL, there could be an odd case where you owed back some amount of credits up to the minimum limit. You’ll be able to calculate this when you file form 8962.

In other words, most likely not, but you would need to confirm that based on your specific situation.

Wanda Avret on

Why do I have to pay the IRS,$2550 for help on my Obamacare ins. I had for 8 months last year,February 1-September,30.October 1st I was put on SS disability? on

You could have had a total annual income due to SS income that caused your income to go above the threshold and thus it triggered the repayment limit.

That would be my guess.

You may want to take a close look, to trigger a fee that big you would have had to exceed 400% of the poverty level.

This is one of many reasons I don’t think the current system is an ideal long-term solution, the 400% level shouldn’t be a cliff, it should curve off slowly.

Kate P. on

My family used for 2016 and received subsidies in advance based on an estimated annual income. We ended up making more than estimated and will have to pay back ALL of the credit. My question is, based on Form 8962, our original estimate that they used to base coverage on was still more than the maximum percentage (400%) they say you would need to not pay the credit back. Why would they even give us the credit in the first place if we have to pay it all back? If we couldn’t afford the full monthly payments at the beginning of the year, and nothing changed for our income, what makes them think we can afford to pay that amount now, in full?

Suzanne Sloan on

My husband was out of work until August of 2016. He got a job and we stopped the Health Marketplace coverage. So, because he got a job starting in August, we went over our projected earnings. We have to pay the exemption back in full. This is ridiculous. Should he not have taken the job? on

One of “ObamaCare’s sticking points” is this sort of problem. I really wish the AHCA (“TrumpCare”) addressed this sort of thing directly instead of getting around it by offering age-based credits.

Erik on


I am currently a graduate student. I will be graduating next May, 2018, and won’t be starting to work until probably July after my board exams. Currently, I’m working a few times a month, which equates to the amount that falls between 100%-400% federal poverty level (~$13,000) Therefore, I qualify for credit to be used for government healthcare (Obamacare). My fear is that when I start working around July of next year, at the end of the year my total yearly income will be over 400% federal poverty limit. If this is the case, then as I am understanding from reading the thread here, I will be responsible to repay all the credits given to me from the beginning of the year (January, 2018), although, I have been making only about $13,000 total for the first 7 or so months of 2018. Upon graduation I will have total of about $200,000 in student loans debt. My question is: will the government consider my student loan debt when deciding how much I have to pay back for the credit I have been given for healthcare? Or will I have to repay all the healthcare credit for the entire year? I am not sure if there is a rule or clause for this factor. Thank you for all your help! on

Unfortunately, and write your congress person about this, student loan debt can not be written off for tax purposes (which has many implications, but for our purposes won’t reduce your income to help you qualify for ACA assistance).

You are correct though, you can take the credits upfront if you want, but if your income gets high enough this year you’ll owe them back.

Its your call. Owing back that which you have borrowed is rough, but reasonable. Its a valid option.

Another option is taking only a limited amount of credits or no credits.

One benefit is that only premium tax credits have to be paid back. If you get out-of-pocket assistance, that doesn’t have to be paid back.

All this said, you are supposed to be projecting your income for the year. If you know your income will be high, then technically you should project that (and thus you won’t qualify for tax credits). Of course, no one can see the future, so it is also reasonable to project income without the expected income from the expected job.

Hope that insight helps!

Erik on

Thank you very much for your help. This was indeed useful. One more question: how does one qualify for out-of-pocket assistance? Thank you again for your help!

meglena on

My mom – who immigrated to June of 2016 and then applied for her husband – thought that her husband, who is still in Bulgaria, would have gotten his visa to come over here by now (by end of 2017). And it hasn’t happened yet. So it looks like she would be filing her taxes in April married filing separately. The problem is that when i helped her enroll for health insurance the beginning of the year, thinking her husband would arrive by the end of the year, we told the Market Place that she would be filing jointly. And she ended up getting monthly subsidies of $599 for her insurance premium. So now that it looks like she would end up filing married separately would that mean she has to pay all the subsidies back? Which would be about $7000. Another issue is her gross annual income it looks like will be between 20000 – 22000$ which is actually higher than what we thought it would be when we enrolled her also. Is there a cap of the penalty she would have to pay? Is she going to be in trouble with the IRS? Please help! Thank you!

SunniD on

I turn 65 on Dec. 16 and will go on Medicare Dec.01. I called to cancel my AFA insurance on Nov. 30 and was told it would take 2 weeks. I was told I would have to pay for those 2 weeks. I will not be able to use the AFA insurance over that 2 week period as I will be on Medicare Insurance, which I also have to pay for. My only income is Social Security $928 per month. Without the subsidy my insurance was over $850 per month, but with it I paid $24. I have no other income and no way to pay half of the $850. I did not know the cancellation would not take effect for 2 weeks. What can I do? Where do I turn for help? on

You can appeal. Start with an appeal to the insurer. If an internal appeal doesn’t work, you can do an external appeal.

roxie jempfert on

I knew nothing about this , I retired and only needed 3 months from market place. I turned 65 last year and my income is my Social Security and my pension. I also bought a new house this year and changed locations I took money from my investments to put down on my house along with the proceeds from sale…I did this to lower my house payments on a 132,000 house not a mansion…Am I going to have to pay those 3 months back? at that time I had no idea my condo would sell at a loss and that I was buying a new home?

Laurie on

I’m in the same boat but because I was unemployed for the 1st half of the year. I didn’t know I if my annual salary would be more than unemployment insurance at the time so I estimated low since I subsequently got a job. Seems wrong that I would have to pay back all that money because of a low estimate when I didn’t have info at the time where I could have estimated better.

Sandra Page on

This does not address my situation. I made $11,000, less in 2018 than the income that set my co-pay from 2017. My co-pay was based on me Making $11,000. more than I actually did. Now the IRS wants me to reimburse Covered. California $575. more than I have already paid, when I made so much less. WHY? on

If you made less, and not more than you said, you shouldn’t have to reimburse the marketplace. You should call Covered CA directly and have them explain to you exactly what the situation is. There must be something else at play here.

James Bell on

Wow. After reading all these comments I’m afraid to apply. It’s better to stay on my non-approved health insurance until I am 65 even though I retired and not working. on

I really disagree. Cost assistance under the ACA is a great deal if you can get it. You just have to really think out what your income looks like for the year and get ready to adjust your credits as needed if that changes.