Help Paying Marketplace Premiums: Challenges Estimating Income and Tax Consequences

My income is uneven and hard to predict because I am self-employed. Most years I make between $20,000 and $30,000, though two years ago I did especially well and earned $35,000. How will this affect my application for premium tax credits for the coming year?

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In reviewing your application, the Marketplace will compare the amount of income you estimate for next year to the most recent information about your income that is available (usually, that will be the tax return you filed this year reporting last year’s income.)  Generally, if that amount differs from the amount you put on your application by more than 25% or $6,000 (whichever is greater), you might receive a data match inconsistency notice from the Marketplace and you’ll need to provide more documentation.

In cases of an income data match inconsistency, the Marketplace will ask you to provide documentation within 90 days.  During that period, you can get premium tax credits based on the income you attested to in your application.  However, if you have not resolved the data match inconsistency within 90 days, the Marketplace will adjust or end your advance premium tax credit based on the most recent income information it can find.

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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