Renewing Marketplace Coverage

I filed my 2018 federal income tax return but didn’t realize I needed to include Form 8962. I received APTC in 2018 and will need premium subsidies in order to afford coverage next year. Can I still receive premium subsidies in 2019?

If you received APTC in 2018, you must file a 2018 income tax return and reconcile your tax credit amount this year in order to continue receiving APTC next year.  Remember, the advanced premium tax credit you received in 2018 was based on your estimated income for that year.  The law requires you to file a tax return at year end and reconcile your estimated income with your actual income.  If you had under-estimated your 2018 income, you might have repay some of the 2018 APTC that you received.  If you had over-estimated your 2018 income, you could claim additional tax credit when you filed your return.  Either way, the IRS requires this annual reconciliation.  People who fail to reconcile the APTC they received last year will not be allowed to continue receiving advanced premium tax credits next year.

To continue receiving APTC in 2020, if you haven’t yet filed a 2018 return with a completed Form 8962, you should do so as soon as possible.  To do this, you will also need Form 1095-A, which should have been sent to you by the Marketplace in January with information about your 2018 APTC.  If you don’t have form 1095-A, you should contact your Marketplace Call Center to obtain a copy; or if you live in a HealthCare.gov state, you can log into your account on HealthCare.gov and find it there.

If you need help filing your tax return, the Internal Revenue Service (IRS) lists programs offering free tax preparation assistance here.

As soon as you file your 2018 tax return and completed Form 8962, contact the Marketplace to update your account to reflect this change.  If you are in a HealthCare.gov state, you can log into your Marketplace account on HealthCare.gov and update your application.  Be sure to check the box telling the Marketplace you reconciled your premium tax credits.

If you can’t file your 2018 tax return before the end of Open Enrollment, you can still sign up for coverage next year, but will have to pay the full premium until you file and start receiving the advanced premium tax credit again.  If that happens, you will be able to claim a tax credit on your 2020 tax return for the months in 2020 when you paid the premium in full.

Keep in mind that later during the coverage year the Marketplace will check with the IRS to verify your return was filed and, if it cannot verify, will terminate your premium tax credit.

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.