Costs & Taxes

You must reapply for the affordability exemption at least annually to qualify for this exemption for that year. The definition of “affordable” has changed from 2015 to 2017 and may change again in the future. In 2017, if your lowest cost minimal essential coverage you are eligible for (whether employer-based or Marketplace) which costs more than 8.13% of the household income is eligible for this exemption. You can claim it on the 8965 – Exemptions form, but you’ll need to get this exemption through the marketplaces.

Social Security Disability (SSD) counts as income for getting cost assistance on the Marketplace. If your household income is between 100% – 400% of the Federal Poverty Level then you can get cost assistance.

If I file head of house hold but only claim myself will that affect my cost for Obama care?

Non-taxable Social Security benefits are counted as income for ObamaCare and affect tax credits. This includes disability payments (SSDI), but does not include Supplemental Security Income (SSI).

If you are self employed, or if your medical expenses are over 10%, you can deduct health insurance premium payments.

If you got cost assistance for even one month you need to file 8962 using a 1095-A. This is true even if you no longer need Tax Credits.

The ObamaCare subsidy is based on MAGI, but is not included as income for MAGI. You calculate your MAGI before claiming the net tax credit.

We are as sure as the final rule from the IRS in front of us that 9.5% applies to employee-only coverage and not dependent or family coverage.

If you don’t know what you’ll make, we suggest getting a Marketplace Silver plan, only taking partial tax credits up front, and adjusting cost assistance as needed.

Tax credit repayment limits are based on annual income, in the case of death this remains true. It depends upon whether a tax return must be filed for the deceased.

The ACA counts annual household income, this is true even if you lost employer-based coverage and income.

Generally someone owes the penalty if they didn’t have coverage or an exemption for a month, however they can also owe money back if they owe back premium tax credits due to making more income

You can find the lowest cost bronze plan tax tool, used to determine affordability exemptions, at HealthCare.Gov. We have provided the link

If you have a gap in coverage due to an insurer error you may be able to claim a “general hardship” from the Marketplace.

Generally you can only owe back tax credits if you gain income, not if you lose income. So if you go from Marketplace to Medicaid and claim under 100% of the Federal Poverty level you’ll owe back nothing.

Lump-sum income is counted for the month for Medicaid and Medicare, but for ACA subsidies we believe it counts as annual.

Dependent’s AGI is something to keep in mind when claiming credits on form 8962, a dependent can throw off household income and really mess with repayments and tax refunds.

If you have a Marketplace health plan you can retroactively get subsidies, if your income fluctuates consider taking only partial credits upfront or none at all, also if you get a Silver plan you can adjust cost sharing amounts throughout the year at no extra cost.

The only months you are penalized for are FULL months you don’t have health insurance or an exemption for. If you get covered during open enrollment or have less than 3 months without coverage then you wont’ owe the fee for those months.

Paying back advanced tax credits is based on household income (as a percentage of the federal poverty level). The repayment chart below is from the 8962 instructions from the IRS.

The information for policy allocation is found in the 8962 instructions Part IV Allocation of Policy Amounts. You’l need a 1095-A (which is sent to the policy holder by the marketplace).

If you misplaced a 1095-A you can find it online. You can also find the information on your 1095 yourself, or request another copy from the Marketplace.

All the best information we have about 1095-A’s discusses how to get the form filed, at that point it’s up to the IRS. We can only imagine they are working hard to get everything flowing smoothly. You can always call them to follow-up or get assistance from TAS (tax payer advocate services).

The tobacco surcharge only applies to those who smoke 4 or more times a week, it doesn’t include ceremonial or celebratory use.