For many people — for example, the self-employed, seasonal workers, or those with multiple jobs — income fluctuates throughout the year, and also from year to year.
Or maybe you got a promotion or raise, took on another job, or lost work. These are other examples of when your income will not be the same as you anticipated.
Having an uneven income can make it difficult to accurately report your income and to predict your eligibility for a premium tax credit for health insurance.
Here are some common questions about what to do if your income is hard to estimate:
Q. I thought my income was going to be below 400% of the federal poverty level (FPL), so applied for and got a premium subsidy. What happens if my income actually turns out to be greater than 400% FPL?
A. If your actual income differs from what you anticipated when you applied for a subsidy, any change in your subsidy amount will be reconciled when you file your federal income tax return.
If you elected to have your subsidy applied directly to your monthly health insurance premium payments and your income goes up, you likely will have to repay a portion or all of the subsidy you received. The amount you owe back will be added to your tax bill (or taken out of any refund you may be due).
You should notify your state’s exchange of any change in income — or other change that would affect the calculation of your subsidy — during the year.
Q. Yikes! I wasn’t expecting to have to pay anything back. Is there a limit to how much I will need to repay?
A. It depends. If your actual income turns out to be over 400% FPL, you will have to pay back the full amount of advance premium tax credit you received throughout the year.
If your income turns out to be more than you thought but still less than 400% FPL, there are limits on the amount you will need to repay, based upon your income:
- Income under 200% FPL: repay max of $300 for single, $600 for married filing jointly
- Income 200% – 299% FPL: repay max of $750 for single, $1,500 for married filing jointly
- Income 300% – 399% FPL: repay max of $1,250 for single, $2,500 for married filing jointly
- Income 400% FPL or over: must repay full amount
Q. Can I ask for an adjustment to the amount of subsidy I receive when my income goes up or down?
A. Yes, when you notify your state’s exchange of a change in expected annual income, you can also request an adjustment be made to the amount of your premium credit. The exchange will verify your new information and then send you a redetermination notice detailing your new eligibility information.
Q. When will a premium subsidy adjustment take effect?
A. Your subsidy adjustment will take effect by the first of the month after the redetermination notice. For example, if you report a change in income on May 27, and you receive a redetermination notice on June 3, the new subsidy amount will be effective on July 1.
Q. How many times during a year can I adjust the amount of premium tax credit I receive?
A. You can adjust the amount of credit you receive as many times as necessary. Each time you have an income change or other eligibility change that may impact the amount of subsidy you can get, you should report it to your state’s exchange.