Help Paying Marketplace Premiums: The Basics

Should I claim a premium tax credit in advance or at the end of the year or some of both?

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That’s up to you. You can have 1/12 of your annual premium tax credit paid directly to your health plan each month to reduce your monthly premium right away. Or, if you can afford to, you can pay the entire health plan premium yourself up front and collect the premium tax credit in a lump sum next year when your file your tax return. Or you can have some of the tax credit paid directly to your insurer in advance but save some to claim as a refund when you file your tax return at year end.

Keep in mind that when you apply for the premium tax credit during Open Enrollment, you won’t necessarily know for sure what your income for the coverage year will be, so you will have to make your best estimate. Later, when you file your tax return, the IRS will compare your actual income to the amount of premium tax credit you claimed in advance. If you underestimated your income and claimed too much premium tax credit, you might have to pay back some or all of the difference. If you didn’t receive all of the premium tax credit you’re entitled to during the year, you can claim the difference when you file your tax return. If you’re uncertain about your income for the coming year, remember that you can modify the amount of premium tax credit during the year if your income changes. So, for example, if you are unemployed now, you can estimate your income will remain low all year and get a bigger tax credit; then if you get a new job during the year, you can report this increase in income to the Marketplace and reduce the amount of premium tax credit you get for the rest of the year.

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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