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Resource Guide
On Private Health Insurance Coverage & The Health Insurance Marketplace
FAQs tagged with “Eligibility for Premium Tax Credit”
- Can I get premium tax credits for health plans sold outside of the marketplace?
- Can immigrants get help paying premiums and/or cost-sharing for health insurance in the health insurance marketplaces?
- How do I appeal a marketplace decision?
- How do I apply for premium tax credits?
- How do I project my household size/income for next year if I’m pregnant now? I’m married and this pregnancy will be our first child. We want to find subsidized coverage in the marketplace.
- How much can I earn and qualify for premium tax credits in the marketplace?
- How often during the year can I adjust my premium tax credit amount? What documentation is required to make an adjustment? How long after I request the adjustment will it take effect?
- I buy my health plan directly from the insurance company. Why should I consider shopping for a new plan on the health insurance marketplace?
- I don’t usually file taxes because I’m not required to. Will that affect my eligibility for premium tax credits?
- I earn enough to qualify for premium tax credits, but I’m concerned my income may drop later this year to less than 100 percent of poverty. If that happens, will I have to pay back the premium tax credits I get?
- I get Social Security benefits and don’t make enough to pay federal income taxes on them. Do I count my tax-free Social Security benefits when I apply for premium tax credits?
- I have a college scholarship that covers my tuition and fees. Do I count that as income in determining my eligibility for subsidies?
- I have a marketplace plan and am receiving premium tax credits. I am now pregnant. Since I’m eligible for pregnancy-related Medicaid coverage, am I required to drop my marketplace plan and lose my financial assistance?
- I have an individual insurance policy. Can I drop it during open enrollment and go into the health insurance marketplace and qualify for premium tax credits?
- I have an offer of coverage from my employer, but the premiums are too expensive and I have to pay a lot out-of-pocket. Can I get financial help in the health insurance marketplace?
- I have an offer of employer-sponsored coverage, but the premiums are too expensive and I have to pay a lot out-of-pocket. Can I get premium tax credits in the health insurance market place?
- I have retiree coverage from my former employer, but the premiums are too expensive and I have to pay a lot out-of-pocket. Can I drop my retiree plan and get financial help in the health insurance marketplace?
- I never filed an income tax return before. Can I claim a premium tax credit?
- I qualified for cost-sharing reduction subsidies when I signed up for coverage in the marketplace. I’m getting more hours at work and might not qualify anymore. Will I have to change plans now and get a new deductible and out-of-pocket cap?
- I received premium tax credits to help pay for my coverage, but I didn't file a tax return. Will I still be able to get coverage next year and financial assistance?
- I see there are bronze plans that are really affordable. Is that the best plan for me?
- I understand eligibility for premium tax credits is based on our household income. Who counts as being in my household?
- I want to add my spouse and/or children to my employer-sponsored plan but I can’t afford the family premium. Can my spouse buy a more affordable plan on the health insurance marketplace?
- I’m 25 years old and eligible for coverage as a dependent under my parent’s employer plan. If I apply for my own marketplace plan with premium tax credits, will the marketplace consider the coverage available to me under my parent’s plan?
- I’m 62 and already collecting Social Security. Are my Social Security benefits counted in determining my eligibility for subsidies in the marketplace?
- I’m 63 and about to retire. I’ll be offered a retiree health plan. Can I look for better coverage and subsidies in the marketplace instead?
- I’m 63 and my husband is 65 and on Medicare. I'd like to apply for premium tax credits for marketplace coverage. Can we count my husband’s premiums for Medicare, his supplemental, and Part D against my required contribution for marketplace coverage?
- I’m a college student enrolled in my college’s student health plan. Can I drop it and go to the health insurance marketplace?
- I’m a retired veteran collecting VA pension benefits. Are those benefits counted in determining my eligibility for subsidies in the marketplace?
- I’m currently collecting workers compensation benefits. Are those counted in determining my eligibility for subsidies?
- I’m divorced and receive child support payments from my ex-husband. Do I count that in determining eligibility for subsidies?
- I’m eligible for COBRA but haven’t elected it yet. Does that affect my eligibility for marketplace subsidies?
- I’m eligible for health benefits at work, but I didn’t turn in my enrollment papers on time during the company’s open enrollment, so now I’m not covered. Can I get a policy in the marketplace instead? Can I apply for premium tax credits?
- I’m eligible for the student health plan but haven’t signed up yet. Do I have to enroll in that plan or can I apply for coverage and subsidies in the marketplace?
- I’m enrolled in student health coverage now, but I think I can get a better deal in the marketplace. Can I drop student health plan coverage and go to the marketplace instead?
- I’m in a common law marriage – what should I indicate as my marital status on my application for premium tax credits?
- I’m leaving my job and will be eligible for COBRA. Can I shop for coverage and subsidies on the marketplace instead?
- I’m married but estranged from my spouse. We file taxes separately. Am I eligible for premium tax credits?
- I’m married now but expect to get divorced this year. What should I indicate as my marital status when I apply for coverage?
- I’m married. I work full-time for a large employer that offers me health benefits, but won’t cover spouses. Is that allowed? Can my spouse apply for coverage and subsidies in the marketplace?
- I’m offered health benefits at work, but they’re not very good. I understand I may be eligible for marketplace subsidies if my job-based plan doesn't meet a "minimum value" standard. What does that mean?
- I’m raising my grandchild and claim her as a tax dependent. If I apply for marketplace subsidies, will we be considered one household?
- If I’m eligible for other coverage but haven’t enrolled in it yet, can I qualify for premium tax credits in the marketplace?
- Is the value of my house counted in determining my eligibility for premium tax credits in the marketplace?
- My 20-year-old daughter has a son. She’s a full-time student and I support both of them financially. Which one of us – me or my daughter – should claim my grandson as our dependent?
- My 23-year-old daughter lives with us but pays rent and helps buy groceries. Can we include her as a dependent?
- My employer offers a “mini-med” plan. It only covers preventive services and a few doctors’ visits each year. I want better coverage. Can I apply for coverage and premium tax credits in the marketplace?
- My employer won’t fill out the form that asks about the affordability of our coverage. I think my job-based plan is unaffordable and I’m not enrolled in it. Can I apply for marketplace coverage and premium tax credits without that form?
- My employer’s health plan doesn’t cover brand-name drugs, only generics. Does that mean it doesn’t have minimum value? Can I shop for better coverage and subsidies on the marketplace?
- My employer’s workplace wellness program increases premiums for employees who don’t participate and/or can’t meet certain targets for healthy behavior. Can I leave my employer-sponsored plan and get marketplace coverage?
- My hours at work were cut back and I no longer qualify for my employer’s health plan. I’ve been offered COBRA but it’s too expensive. Can I shop for coverage and subsidies on the marketplace instead?
- My income is below the federal poverty level and my state has not elected to expand Medicaid eligibility. Can I qualify for premium tax credits?
- My income is uneven during the year. Some months I earn very little, other months I earn more. I think my annual income will be low enough to qualify for subsidies next year, but I’m not sure. What if I’m wrong?
- My income is very low, but I just inherited $10,000 from my aunt. Will that affect my eligibility for subsidies?
- My kids are eligible for the Children’s Health Insurance Program (CHIP). Can I enroll them in our marketplace health plan and get premium tax credits for them instead?
- My large employer offers health benefits to me. My spouse works and has coverage through their job. To figure out whether my coverage is affordable, do I just count my income or do I count my spouse’s salary, as well?
- My mother lives on her own. She earns about $3,000 a year from Social Security and my husband and I pay her rent and help buy groceries. Can we claim her as a dependent?
- My parents have marketplace coverage, but don’t qualify for subsidies. I’m 24 and qualify on my own. My parents don’t claim me as a tax dependent. Can I be covered under their marketplace policy and apply my premium tax credit to their premium?
- My partner and I are unmarried and we have two children. How do we count our household size and income when we apply for subsidies in the marketplace? Can we buy one policy to cover the whole family?
- My partner and I live together but are unmarried. Is our combined household income what we should report?
- My spouse and I want to cover our 25-year-old child on our marketplace plan and apply for premium tax credits. We don’t claim her as a dependent, she doesn’t live with us, and she has a job. Do we have to count our child's income as part of our income?
- My spouse is an early retiree with affordable retiree health benefits from his former employer, but I’m not eligible to be on his plan. Can I apply for coverage and subsidies in the marketplace?
- My spouse is covered under my plan at work. If I retire and sign up for my retiree plan, will my husband be eligible to buy a plan on the marketplace?
- My wife and I have a teenager who has a part-time job. Do we count her income as part of our household income when we apply for marketplace subsidies?
- Should I use all of my advance premium tax credit toward my monthly premium, or should I consider saving some of it to receive on my tax return next year?
- We are a married, same-sex couple. When we apply for marketplace subsidies, will the marketplace consider us a married household?
- We claim my 22-year-old son, a full-time college student, as a dependent. He just got married. Can we continue to claim him as a dependent?
- What if I don’t know what my income will be next year?
- What income is counted in determining my eligibility for premium tax credits?
- What is a mini-med (or limited benefit) plan? What are the risks and benefits of buying one?
- When are you not eligible for premium tax credits?
- Who is eligible for marketplace premium tax credits?
- Why should I buy a plan on the health insurance marketplace?