Nancy files her return using the filing status married filing separately and checks the box on the front of Form 8962. This would be an insurance plan that the Health Insurance Marketplace certifies and that provides your essential benefits. Income between 100% and 400% FPL: If your income is in this range, in . You do not meet the requirements under Estimated household income at least 100% of the federal poverty line if: No APTC was paid for your or your family's coverage; or. Alice must compute her contribution amount using the federal poverty line percentage for the household income and family size reported on her Form 8962. Enter the Marketplace-assigned policy number from Form 1095-A, line 2. Complete line 35, columns (a) through (d), as indicated in Pub. By the end of Part I, you'll have your annual and monthly contribution amounts (lines 8a and 8b). Nancy looks up her correct premium for the applicable SLCSP. Throughout these instructions, a qualified health plan is also referred to as a policy. 974 for more information. Married taxpayers Tom and Nicole applied for insurance affordability programs at the Marketplace for themselves and their two children whom they claim as dependents, Kim and Chris. Instead, you must determine the correct applicable SLCSP premium for your coverage family and enter that amount on Form 8962, lines 12 through 23, column (b). Henry enrolled himself, his spouse Cara, and their two dependent children, Heidi and Matt, in a policy for 2022 purchased through a Marketplace. Why do you need this? Electing the alternative calculation is optional, but may reduce the amount of excess APTC you must repay. On her Form 8962, Part IV, line 30, Carol enters Johns SSN in column (b) and enters 0.50 in columns (e) and (g). Individuals who are not lawfully present. Keith and Stephanie divorce in July. If you were married at the end of 2022, generally you must file a joint return. What are the current poverty thresholds? Gary and Jim must allocate the enrollment premiums of $15,000 reported on the Form 1095-A, Part III, column A, in proportion to each taxpayer's applicable SLCSP premium as follows. If you are using filing status married filing separately and Exception 2Victim of domestic abuse or spousal abandonment, earlier, does not apply to you, skip columns (a) through (e), and complete only Column (f), later. Reporting changes in circumstances promptly will allow the Marketplace to adjust your APTC to reflect the PTC you are estimated to be able to take on your tax return. You can also visit IRS.gov and enter premium tax credit in the search box. Mistakes in completing Form 8962 can cause you to pay too much tax, delay the processing of your return or refund, or cause you to receive correspondence from the IRS. If your correct applicable SLCSP premium is not the same for all 12 months, check the No box and continue to lines 12 through 23. Note. If line 25 is greater than line 24, subtract line 24 from line 25 and enter the result. Instead of allocating the applicable SLCSP premium, Nancy will enter the applicable SLCSP premium that applies to Nancy. If you completed Part IVAllocation of Policy Amounts for any Form 1095-A, add the monthly premium amounts allocated to you, if any, using the allocation percentage you entered on Form 8962, lines 30 through 33, column (e), to the monthly premiums for other policies that you did not allocate. Leave column (f) blank because you do not allocate the applicable SLCSP premium. As stated in the Census's Source and Accuracy of Estimates for Income, Poverty, and Health Insurance Coverage in the United States: 2011. C) 12.05%. See Individuals Not Lawfully Present in the United States Enrolled in a Qualified Health Plan in Pub. It is important to note that the poverty guidelines can vary by state, so it is best to check with your local Department of Health and Human Services . John is eligible for a premium tax credit of $4,083 for the year. Leave line 28 blank and enter the amount from line 27 on line 29. Alien lawfully present in the United States. Need to determine correct applicable SLCSP premium. If you enter an amount greater than -0-, the IRS will reduce your entry to -0-. Because John is not in Carols tax family, he is not in her coverage family, which consists of Carol and her dependent, Mark, for purposes of determining her applicable SLCSP premium. If APTC is paid for coverage of an individual who is not included in a tax family, the taxpayer who certifies to the Marketplace his or her intention to include the individual in his or her tax family for the year of coverage is responsible for reporting and reconciling the APTC for the individuals coverage. Therefore, they do not qualify a taxpayer to take the PTC. According to Table 3, Keith and Stephanie follow the rules under Allocation Situation 1. If you got married in 2022 and you and your spouse (or individuals in your tax family) were enrolled in separate qualified health plans during months prior to your first full month of marriage, add together the amounts from Form 1095-A, column B, for each plan (or plans) and enter the total. Enter -0- on the appropriate line on Form 8962, column (b). The thresholds vary by state. If you are married and filing a joint return, enter the first SSN that appears on your tax return. If line 28 is blank, enter the amount from line 27 on line 29. For purposes of the PTC, your tax family consists of the following individuals. If you checked the Yes box on line 10 and you are completing line 11, do not complete lines 12 through 23. For coverage in 2022, the Marketplace is required to provide or send Form 1095-A to the individual(s) identified in the Marketplace enrollment application by January 31, 2023. In this instance, 250% of the FPL would be an annual income of $66,250. You must file Form 8962 to compute and take the PTC on your tax return. This is compared to 8.2 percent of White people, and 8.1 percent of Asian people. If you have concerns about your safety, please consider contacting the confidential 24-hour National Domestic Violence Hotline at 1-800-799-SAFE (7233), or 1-800-787-3224 (TTY), or 1-855-812-1001 (video phone, only for deaf callers). If you need health coverage, visit HealthCare.gov to learn about health insurance options that are available for you and your family, how to purchase health insurance, and how you might qualify to get financial assistance with the cost of insurance. Lower-income households had incomes less than $48,500 and upper-income households had . Your tax family generally includes you, your spouse if you are filing a joint return, and your dependents. (Specifically, in the instructions for Part IV, see Policy amounts allocated 100% in either Allocation Situation 1. Joes PTC for 2022 is $4,359 (the lesser of $4,359, the excess of Joes applicable SLCSP premium of $9,600 minus the contribution amount of $5,296 ($66,196 x 0.0800), or $10,400, Joe's enrollment premiums). If you are a victim of domestic abuse or spousal abandonment, you can file a return as married filing separately and take the PTC for 2022 if all of the following apply to you. [6] You'll need the instructions for Form 8962 to calculate the numbers for the first 3 lines of Form 8962. 974 provides a calculation necessary to figure the repayment limitation if an individual not lawfully present is enrolled with one or more family members who are lawfully present for 1 or more months of the year. The Marketplace sends copies to individuals to allow them to accurately file a tax return taking the PTC and reconciling APTC. 974. For more information about eligibility for Medicaid, CHIP, and other forms of government-sponsored MEC, see Pub. The Census Bureau has changed the methodology for computing median income over time. The children become eligible for and enroll in government-sponsored health coverage and disenroll from the qualified health plan, effective August 1. The specific income levels vary with family size and relationships of household members. The policy covers Gary, Jim, and Garys two young daughters who are Garys dependents. In 2020, 17.9 million people fell below 50% of the poverty threshold (5.5% of the population), and 89.7 million people lived below the 200% poverty threshold (27.5% of the population). 974 for information on determining the correct applicable SLCSP premium or, if you enrolled through the federally facilitated Marketplace, go to HealthCare.gov/Tax-Tool/. Individuals who are incarcerated (other than pending disposition of charges, for example, awaiting trial) are not eligible for coverage in a qualified health plan through a Marketplace. Exception 2Victim of domestic abuse or spousal abandonment. Column (f) is left blank. You may need to allocate policy amounts under a qualified health plan using different rules for different months if you had a change in circumstance. If APTC is being paid for an individual in your tax family (described later) and you have had certain changes in circumstances (see the examples later), it is important that you report them to the Marketplace where you enrolled in coverage. 974 for information on determining the correct premium for the applicable SLCSP or, if you enrolled through the federally facilitated Marketplace, go to HealthCare.gov/Tax-Tool/. Kevin and Nancy are enrolled in a qualified health plan for 2022 with an annual premium of $10,000 and APTC of $6,500. Leave columns (e) and (f) blank. You cannot deduct the portion of your health insurance premium on your tax return that is paid for by the PTC or APTC (after you determine how much of any excess APTC you must repay). You are an applicable taxpayer for 2022. Taxpayers married at year end but filing separate returns. 4.0. Check if you qualify for a Special Enrollment Period. Alice is allocated 33% of the enrollment premiums, APTC, and applicable SLCSP premiums for the policy, and the remaining 67% of each is allocated to Joe. Because Michael and Colleen are not applicable taxpayers and cannot take the PTC, Colleen does not complete Part IV of her Form 8962. 974 for more information. See Pub. Complete this part to figure the amount of excess APTC you must repay. Enter the appropriate amount from Table 5 on line 28. Instead, you must determine the correct applicable SLCSP premium for your coverage family and enter that amount on Form 8962, lines 12 through 23, column (b). When this happens, the taxpayer receiving the Form 1095-A should provide a copy to the other taxpayers. Enter the amount from line 11(f) or add lines 12(f) through 23(f) and enter the total. If 100% of the policy amounts are allocated to you, check Yes on line 9 and complete Part IV by entering 100 in the appropriate box(es) for your allocation percentage. You cannot claim the PTC using this exception for more than 3 consecutive years. Either you or your spouse should have a start month that is the same as the first month you claim the PTC on lines 12 through 23. The recipient of the Form 1095-A should provide a copy to the nonrecipient. If no APTC was paid for the policy, the Marketplace may not know which enrollees are in which tax family, and therefore may furnish only one Form 1095-A showing the total premium. Both poverty thresholds and poverty guidelines are based on the official poverty measure established by the U.S. Census Bureau. If no APTC was paid for your or your family members coverage, the SLCSP premium reported in Part III, column B, lines 21 through 32, of Form 1095-A may be wrong, left blank, or reported as -0-. Ryan enters the monthly amounts allocated to him on Form 8962, lines 12 through 15, column (f) ($500 for January through April), and the total of $2,000 on lines 25 and 27. For more information on affordability and minimum value, see Pub. However, if you became eligible for APTC because of a successful eligibility appeal and you retroactively enrolled in the plan, the portion of the enrollment premium for which you are responsible must be paid on or before the 120th day following the date of the appeals decision. Programs using the guidelines (or percentage multiples of the guidelines for instance, 125 percent or 185 percent of the guidelines) in determining eligibility include Head Start, the Supplemental Nutition Assistance Program (SNAP), the National School Lunch Program, the Low-Income Home Energy Assistance Program, and the Children . 974 for more information on reconciling APTC when an unlawfully present person is enrolled individually or with lawfully present family members. Depending on the facts and circumstances, abuse of an individuals child or other family member living in the household may constitute abuse of the individual. (Some states may report -0- or leave column B blank on the Form 1095-A when no APTC is paid.) See Form 1095-C, line 14, and the, Don was eligible to enroll in his employers coverage for 2022 but instead applied for coverage in a qualified health plan through the Marketplace for coverage in 2022. Need to determine applicable SLCSP premium. For more information, see, Qualified Small Employer Health Reimbursement Arrangement, Other changes affecting the composition of your, For more information on how to report a change in circumstances to the Marketplace, see, For additional information about the tax provisions of the Affordable Care Act (ACA), see, The PTC is a tax credit for certain people who enroll, or whose family member enrolls, in a, APTC is a payment during the year to your insurance provider that pays for part or all of the premiums for a qualified health plan covering you or an individual in your tax family. Gary and Jim leave line 30, columns (f) and (g), blank. Headlines this week have suggested that low-income households brace for bouts with hunger . By 2019, following national trends, this percentage was 7.5%. If you shared a policy with another taxpayer and you are not making an allocation in all three columns, (e), (f), and (g), leave the column blank that does not apply. You should round the amounts on Form 1095-A to the nearest whole dollar and enter dollars only on Form 8962. For 2014, your household income is at least 100% but no more than 400% of the Federal poverty line for your family size (see Household income below 100% of the Federal poverty line, later, for certain exceptions). We focus on households with any child aged 18 or less living at or below 200% of the federal poverty line because this represents the upper threshold of eligibility for most safety net assistance. You are including an individual in your tax family for the year of coverage, but you did not indicate to the Marketplace at enrollment that you would do so. No APTC was paid for your coverage. 2.25 Applicable federal poverty line percentages. However, if an individual in your tax family enrolled in a qualified health plan in 2022 and the enrollment was effective on the date of the individual's birth, adoption, or placement for adoption or in foster care, or on the effective date of a court order placing the individual with your family, the individual is treated as enrolled as of the first day of that month. Transposition of numbers or errors in amounts (for example, line 12, column (a), monthly enrollment premium of $1,200 entered as $12,000). A qualified health plan may have covered at least one individual in your tax family and one individual not in your tax family if: You are married but filing a separate return from your spouse, You or an individual in your tax family was enrolled in a qualified health plan by someone who is not part of your tax family (for example, your ex-spouse enrolled a child whom you are claiming as a dependent), or. 974 because amounts on Form 1095-A must be allocated among three tax families (Brets, Paulettes, and Mikes). It is the amount of your household income you would be responsible for paying as your share of premiums each month if you enrolled in the, Your employer may have sent you a Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, with information about the coverage offered to you, if any. APTC was paid for you or another individual in your tax family. If you or a family member isn't lawfully present in the United States and was enrolled in a qualified health plan, see Individuals Not Lawfully Present in the United States Enrolled in a Qualified Health Plan in Pub. poverty measure, members of a household are considered poor if their household income is less than 50 percent of the median household income in that country. It is an economic measure used by government agencies to determine if an individual or family's income is eligible for certain federal subsidies and benefits. If an individual in your tax family is not enrolled in a qualified health plan, or is enrolled in a qualified health plan but is eligible for MEC (other than coverage in the individual market), he or she is not part of your coverage family. See Example 3 and Example 4, later. For instance, in 2021 the poverty guideline in the 48 contiguous states is an annual income of $26,500 for a family of four. Enter your allocation percentage as a decimal rounded to two places (for example, for 40%, enter 0.40). If you did not elect the alternative calculation for year of marriage or you are using filing status married filing separately and Exception 2Victim of domestic abuse or spousal abandonment, earlier, does not apply to you, skip columns (a) through (e), and complete only Column (f), later. Monthly APTC of $400 was paid for her, for a total of $3,200. To avoid making common mistakes on your Form 8962 and on your income tax return, carefully review all of the following before attaching Form 8962 to your tax return. If columns (a) and (b) of any of lines 12 through 23 are blank, leave column (c) of the corresponding line blank. Michael and Colleen each file their returns for 2022 as married filing separately and Exception 2Victim of domestic abuse or spousal abandonment does not apply to either of them. Ryan enters the amount from line 29 on the applicable line of his tax return. Once you complete line 11, skip to line 24. Your coverage family includes all individuals in your tax family who are enrolled in a qualified health plan and are not eligible for MEC (other than coverage in the individual market). For at least 1 month of the year, all of the following were true. Nancy is a victim of domestic abuse and is unable to file a joint return under the rules outlined in Exception 2Victim of domestic abuse or spousal abandonment under Married taxpayers, earlier. If an individual in your tax family was enrolled in a policy with an individual in another tax family and you are not taking the PTC, the taxpayer who is claiming the individual not in your tax family may agree to reconcile all APTC paid for the policy. You allocated the policy amounts under Allocation Situation 4. Was anyone in your tax family enrolled in a qualified health plan before your first full month of marriage? Enter this amount on Form 8962, lines 12 through 23, column (b). Sophia is claimed as a dependent by her grandfather, Mike. For additional requirements and more details, see Applicable taxpayer, later. 974 until you have completed Table 4 to determine whether you meet the requirements to elect the alternative calculation. If you are filing Form 1040-NR, you should include your dependents in your tax family only if you are a U.S. national; a resident of Canada, Mexico, or South Korea; or a resident of India who was a student or business apprentice. The facts are the same as in Example 1, except that Keith and Stephanie cannot agree on an allocation percentage. Yes. This SSN may or may not be reported on your Form 1095-A, depending on your relationship to the other taxpayer. A taxpayer who includes the gross income of a dependent child on the taxpayers tax return must include on Worksheet 1-2 the childs tax-exempt interest and the portion of the childs social security benefits that is not taxable. Also, if you leave your employment and are offered post-employment coverage such as COBRA or retiree coverage, you are not considered eligible for that post-employment coverage unless you actually enroll in the coverage. A household is considered low income if its income is below 50% of median household incomes. 0.0. Start by providing your household income and modified AGI. You file a separate return from your spouse on Form 1040 or 1040-SR because you meet the requirements for Married persons who live apart under Head of Household in the Instructions for Form 1040. APTC is a payment during the year to your insurance provider that pays for part or all of the premiums for a qualified health plan covering you or an individual in your tax family. The cost-sharing subsidy to help lower your deductible, copay, and coinsurance is available for people making below 250% of FPL. It is not based on the amount of premiums you paid out of pocket during the year. Joe and Alice have been divorced since January 2021 and have two children, Chris and Jane. Use Table 3 to determine which allocation rule to use for each month. They receive a Form 1095-A, which reports $800 for the enrollment premiums in column A on lines 21 through 32 and $850 for the applicable SLCSP premium in column B on lines 21 through 32 for January through December. Generally, there are two situations where your SLCSP premium may not be accurately reflected on your Form 1095-A. Generally, people can qualify for the credit if their income is more than 100% of the federal poverty guideline but less than 400% (1 to 4 times the federal poverty level). Taxpayers divorced or legally separated in 2022 or Allocation Situation 4. If you have more than one Form 1095-A, add the amounts together and enter the total on Form 8962, line 11, column (a). In computing PTC, Joe takes into account $10,400 of enrollment premiums ($13,000 x 0.80).