Marketplace Verification and Appeals

I entered income information for next year on my Marketplace application. I expect my income next year will be much lower than it was this year because I had to change jobs. Healthcare.gov says I am eligible for a premium tax credit, but more information is needed. What does that mean?

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You have received a notice of a “data match inconsistency.” The marketplace tried to verify your income information in real time, using the most recently available data from the IRS, Social Security, and other agencies. Sometimes, the most recently available data won’t necessarily reflect your recent change in income. And if there is a large discrepancy between the income you report and what available data support, this is called a data match inconsistency.

When this happens, healthcare.gov will temporarily determine that you are eligible for tax credits, based on the income that you attested you expect to earn next year. But it will require you to send additional documentation.  Read the notice carefully and be sure to submit required documentation before the deadline. Enrollees are typically given 90 days to submit documentation. If you need an extension past the 90 day period, the Marketplace will give you another 60 day extension.  If you do not submit documentation, the Marketplace may reduce or terminate your tax credit amount.

If you have problems with a data match inconsistency on healthcare.gov, contact a Marketplace navigator for help. Contact information for navigators and other assisters in healthcare.gov states is available at Find Local Help.  You can also find more information on HealthCare.gov.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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