Marketplace Health Insurance: Why Your Refund Can Go Up or Down

If you had health insurance through the Marketplace, your income can make a big difference at tax time.

When you sign up, you estimate your household income for the year. The Marketplace uses that estimate to determine how much assistance you receive toward your monthly premiums.

When we prepare your tax return, we calculate what you actually qualified for based on your final income and eligibility. Sometimes that means good news. Other times, it means paying some assistance back.

Earned Less Than Expected?

You may qualify for an additional premium tax credit, which can increase your refund or reduce what you owe.

In practical terms, you could get some of the premiums you paid back through your tax return. This can be especially helpful if your business income dropped or you worked less than expected.

Earned More Than Expected?

It can work the other way, too. If your income was higher than projected, you may have received more assistance than you qualified for.

You could need to repay some or all of that assistance through your tax return. That can mean a smaller refund or a larger balance due. The repayment rules depend on the tax year and your circumstances.

This Is Why We Ask for Form 1095-A

Form 1095-A shows your Marketplace coverage, premiums, and assistance received during the year. We use it to reconcile those amounts on your return.

Even if you paid little or nothing for your coverage, we still need the form. You can generally download it from your Marketplace account. Please upload all Forms 1095-A, including any corrected versions, to your Secure Portal before we finalize your return.

Help Avoid a Surprise

If your income changes during the year, update your Marketplace application. This is particularly important for business owners whose income can vary from one year to the next.

Also report changes in household size or access to employer health coverage, since those can affect eligibility.

Your monthly assistance is based on an estimate. Your tax return is where we settle the difference.