What to Know about Advanced Premium Tax Credit (APTC)

4 Tips to Avoid Paying Back APTCs

What are APTCs?

Advanced Premium Tax Credit is an amount of money determined by the federal government to help lower your monthly health insurance premium.

How do I qualify for APTCs?

There are several qualifying factors for receiving APTCs, including the following: 

  • Apply for a “subsidized” health insurance program to get this type of help through the Massachusetts Marketplace, MA Health Connector*. 
  • Be a tax filer. If married, you must file taxes jointly with your spouse (unless you qualify for certain circumstances of domestic violence or spousal abandonment).

Household income must meet the federal poverty level thresholds according to the Affordable Care Act and the Commonwealth of MA.

What’s New for Open Enrollment 2024?

The state of Massachusetts has expanded their ConnectorCare program allowing more consumers to qualify for subsidies at a higher income level.  This means an individual earning up to $72,900 or a family of 4 with an income maximum of $150,000 will now qualify for lower monthly premiums, $0 deductibles, and more plan options.  

Does MassHealth have APTCs?

Folks eligible for MassHealth, Massachusetts’ Medicaid program, do not receive APTC’s. The Commonwealth already subsidizes MassHealth coverage without a tax reconciliation process

How do APTCs work?

Advanced Premium Tax Credit is an amount of money determined by the federal government to help lower your monthly health insurance premium.

The amount of APTCs you receive is on a sliding scale based on your household size and income. The lower your income, the more credits you may receive. For more information on how APTC’s are calculated, visit: https://www.mahealthconnector.org/help-center-answers/aptc/what-is-an-advance-premium-tax-credit-aptc

You must reconcile your APTCs when you file your Federal Tax Return for the coverage year.  Form 1095-A or 1095-B is provided by the Health Connector and explains the breakdown of the amount of tax credits used vs. the amount of premium you paid. You must file IRS Form 8962 with your Federal Tax Return to see if the amount of tax credits you received was appropriate for your actual tax filing income.  In some cases, you may have to pay back some or all the tax credits and in other cases you may get some money back in the form of a refund.  

Here are some tips to avoid paying back APTCs in the future (which may result in a refund)

  1. Adjust the amount of APTCs applied to your premium. You are NOT required to use all of them. Before you enroll in your plan, you have the option to change the amount of tax credits you take and can therefore adjust your premium to an amount that you’re comfortable paying each month.
  2. Over-project your income in your MA Health Connector application. Many people have a difficult time projecting their income for the entire year, especially self-employed and seasonal workers such as fishermen, landscapers, or restaurant workers.  Over-projecting increases your monthly premium and may change the amount of APTCs you are eligible for.
  3. Update your income as frequently as necessary. Your application can be changed at ANY time throughout the year.  Maintaining an accurate up-to-date application helps you stay on track so that the income reported on your application is as close as possible to the amount determined in your tax filing.

Help! This sounds confusing.

Keep in touch with Fishing Partnership Navigators throughout the year for help. We are always here for you and are able to answer or help find an answer to your health insurance questions.

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*To find this type of assistance in other states, please visit healthcare.gov

Massachusetts maintains a mandate for all individuals to have health insurance.


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