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Premium Tax Credit Change Estimator

Step 1 - Tax Year

Important

If someone else is able to claim you as a dependent, you are ineligible for the credit. The person claiming you may be eligible for the credit. Only use the estimator if no one else can claim you as a dependent on the federal tax return.

Please select the tax year:

Some of the figures used in determining the credit, such as the federal poverty line, are indexed to inflation. The estimator is updated annually as these figures are published. The adjustments are generally made at the end of the calendar year or beginning of the new one.

Step 2 - Your Information

  • Household income is your modified adjusted gross income plus that of every other family member for whom you claim an exemption and who is required to file a federal tax return. Modified adjusted gross income is the adjusted gross income on your return plus any foreign earned income exclusion, nontaxable Social Security benefits (including tier 1 railroad retirement benefits), and tax-exempt interest. It does not include Supplemental Security Income (SSI).

  • The benchmark plan is the second lowest cost silver plan available in your area that covers the members of your family (you, your spouse and your dependents) who are enrolled in Marketplace coverage and not eligible for other health insurance coverage such as employer-sponsored or government-sponsored coverage.

  • The total cost of the plan you choose on the Exchange before the premium tax credit is applied.

  • The advance payments of the credit paid directly to your health insurance provider.

This tool won’t report the changes you enter here to the Insurance Marketplace where you purchased your healthcare coverage. Please be sure to report all changes directly to that Marketplace, because they can affect both your coverage and your final credit when you file your federal tax return. You may have a tax refund or balance due, even if you report all your changes.

Step 3 - Changes to Your Coverage

This tool won’t report the changes you enter here to the Insurance Marketplace where you purchased your healthcare coverage. Please be sure to report all changes directly to that Marketplace, because they can affect both your coverage and your final credit when you file your federal tax return. You may have a tax refund or balance due, even if you report all your changes.

Your Estimated Premium Tax Credit

Based on the information you provided and any changes during the year, you may be eligible for a premium tax credit of:
The total advance payments of the credit being paid to your insurer:

Information used to estimate your credit

Total estimated annual income:
Percentage of the Federal Poverty Line:
Applicable percent:

The percent of your income that you are considered to be able to afford for your and your family's health insurance.

Total premiums for the year:
Estimated annual benchmark plan premium:

This is only an estimate. The Estimator determines the cost of the second lowest cost silver plan used for this estimation from the health insurance plans covering a state’s specific rating areas.

However, some health insurance plans are not available for every county in a rating area. Premium costs may also be affected by other factors. Therefore, the actual premium cost of the second lowest cost silver plan may vary from the premium amount used by the Estimator.

You should report changes to the Marketplace or Exchange where you enrolled in coverage. Please consult your Marketplace for the exact effect of any change in circumstance.

If you do not notify the Marketplace of changes during the year

When you claim the credit on your federal tax return, you'll need to repay about . The repayment is limited to because your income is of the federal poverty line. If you don't have enough tax withheld or don't have other credits to offset this amount, you may have a balance due when you file.

When you claim the credit on your federal tax return, the additional may be refunded (or reduce your balance due).

You will receive the correct amount of advance credit payments to match your premium tax credit.

To report a change to the Marketplace

If you enrolled in coverage through Healthcare.gov, follow these instructions to report a change.

If you enrolled in coverage through a state Marketplace, contact the state Marketplace to report the change.

This tool won’t report the changes you enter here to the Insurance Marketplace where you purchased your healthcare coverage. Please be sure to report all changes directly to that Marketplace, because they can affect both your coverage and your final credit when you file your federal tax return. You may have a tax refund or balance due, even if you report all your changes.

Tax
Year

2015

Key Terms

Applicable Percent

The percent of your income that you are considered to be able to afford for your and your family's health insurance.

Household income %
of Federal poverty line
Initial % Final %
< 133% 2.0 2.0
133% - 150% 3.0 4.0
150% - 200% 4.0 6.3
200% - 250% 6.3 8.05
250% - 300% 8.05 9.5
300% - 400% 9.5 9.5

Benchmark Plan

The benchmark plan is the second lowest cost silver plan available in your area that covers the members of your family (you, your spouse, and your dependents) who are enrolled in Marketplace coverage and not eligible for other health insurance coverage such as employer-sponsored or government-sponsored coverage.

The premium tax credit is based on the lesser of:

  • The premiums for the plan in which you and/or your family members enroll,

or

  • The premium for your benchmark plan minus your contribution amount.

Contribution Amount

The contribution amount is the amount you are considered to be able to afford to pay for health insurance. It would be the amount you pay if you enroll in your benchmark plan.

It is determined by multiplying your annual income by your applicable percent.

Family

Generally you (if no one can claim you as a dependent), your spouse (if married and both spouses are on the same return), and anyone else that you are able to claim as a dependent.

Federal Poverty Line

The poverty guidelines published by the Department of Health & Human Services.

HHS Federal Poverty Guidelines for 2015.

Eligibility for the premium tax credit for 2016 is based on the 2015 guidelines.

Health Insurance Marketplace

One of the state or the federal Exchanges where you can shop for and purchase health insurance.

Health Insurance Premium

This is the total cost of the plan you choose on the Marketplace before the premium tax credit is applied.

Household Income

Household income is your modified adjusted gross income (MAGI) and the MAGI of your spouse if you file a joint return, plus the MAGI of your dependents who are required to file a federal tax return.

Modified adjusted gross income is the adjusted gross income as reported on Form 1040 plus any:

  • Foreign earned income exclusion,
  • Nontaxable Social Security benefits (including tier 1 railroad retirement benefits), and
  • Tax-exempt interest.

It does not include Supplemental Security Income (SSI).

Silver Plan

Marketplace insurance plans are categorized by metal levels: bronze, silver, gold, and platinum. The metal level is based on how much the insurer pays for services covered under the plan.

A silver plan is a health insurance plan where the insurer pays on average 70% of the cost of covered services.

The premium tax credit is limited by comparing the cost of your coverage to that of the second lowest cost silver plan that covers you and your family.

If you are enrolled in more expensive coverage, you will pay the additional amount. However, if you are enrolled in coverage that costs less, your share of the premium will also be less.

For more information, go to healthcare.gov