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Understanding The Premium Tax Credits under the ACA

Understanding The Premium Tax Credits under the ACA

The Affordable Care Act (ACA) introduced several changes to the US healthcare system, one of which was the creation of the Premium Tax Credits (PTCs). These tax credits were designed to make health insurance more affordable for individuals and families who earn between 100% and 400% of the federal poverty line and who are not eligible for employer-sponsored health insurance. In this article, we will delve into the basics of the Premium Tax Credits, how they work, and who is eligible for them.

What are Premium Tax Credits?

The Premium Tax Credits are a form of financial assistance provided by the federal government to help eligible individuals and families pay for health insurance. The credits can be used to reduce the monthly cost of health insurance purchased through the Health Insurance Marketplace, also known as the Exchange. The credits are based on a sliding scale, meaning the amount of assistance provided will vary depending on the individual’s or family’s income.

How do Premium Tax Credits work?

Premium Tax Credits are advanceable, meaning that individuals can receive the credits in advance, directly from the government, to lower their monthly premium payments. The advance payments are made on a monthly basis and can be used to lower the cost of health insurance purchased through the Health Insurance Marketplace.

At the end of the year, individuals who received the credits must reconcile their advance payments with their actual income. If the individual received more credits than they were eligible for based on their actual income, they will have to pay back the excess. On the other hand, if the individual received less credits than they were eligible for, they will receive a refundable tax credit on their tax return.

Who is eligible for Premium Tax Credits?

To be eligible for Premium Tax Credits, individuals must meet the following criteria:

  • Must be a US citizen or legally present in the country
  • Must not be eligible for employer-sponsored health insurance that is considered affordable and provides minimum value
  • Must have an income between 100% and 400% of the federal poverty line
  • Must purchase health insurance through the Health Insurance Marketplace

How to apply for Premium Tax Credits

To apply for Premium Tax Credits, individuals must first create an account on the Health Insurance Marketplace and then follow the instructions to complete an application. During the application process, individuals will need to provide information about their household size, income, and any employer-sponsored health insurance offered to them.

Once the application is complete, the Health Insurance Marketplace will determine the individual’s eligibility for the Premium Tax Credits and any other forms of financial assistance, such as Cost Sharing Reductions. The individual will then be able to select a health insurance plan and use their Premium Tax Credits to lower their monthly premium payments.

Conclusion

The Premium Tax Credits are an important component of the Affordable Care Act, providing financial assistance to individuals and families who are not eligible for employer-sponsored health insurance and who earn between 100% and 400% of the federal poverty line. By making health insurance more affordable, the Premium Tax Credits have helped millions of Americans access the care they need to stay healthy and maintain their quality of life. If you think you may be eligible for the Premium Tax Credits, be sure to visit the Health Insurance Marketplace and complete an application to see what financial assistance may be available to you.

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