What if you don’t tell Covered CA in advance that you want the credit, can you still get the deduction when you file taxes, as long as you got your coverage though Covered CA?
Arguments – No
When a Covered CA application is submitted, clients are asked if they want to see if they qualify for medi-cal or premium assistance.
If the question is answered “No” then the income and tax information will be skipped and no Premium assistance will be applied. They can not claim any assistance regardless of where the income falls under the FPL when they file taxes.
If they want to be considered to get Premium assistance, the answer to that question needs to be “Yes.”
If clients want to pay the full amount but be considerer for Premium assistance, they need to select “yes” on the help paying insurance question and then adjust the premium assitance to $0. When they do their taxes, if they should have been receiving premium assistance, they get a credit . Response By Email (Argelia) (09/08/2016 11:56 AM)
- Page 4 of publication 974 gives the rules for taking the credit, nowhere does it say you have to get permission from Covered CA first!
- IRS.Gov FAQ’s # 3 When you apply for coverage in the Marketplace…If you do not opt for advance credit payments or the Marketplace determines that you were not eligible for advance payments at the time of enrollment, you may be eligible to claim the credit when you file your tax return for the year, which will either lower the amount of taxes owed on that return or increase your refund.
- In bottom third of Publication 974 flow chart, it’s only an issue if your income winds up at less than 100% of poverty level.
- Nowhere on Form 8962 Premium Tax Credit (PTC) does it ask if you told Covered CA or any Market Place that you wanted the APTC credit in advance.
- Covered CA is mandated to give you a 1095 A, if nothing else so that you don’t have to pay the mandate penalty. We are talking about PTC not APTC.
- CFR 1.36 B-2 Eligibility for Premium Tax Credit
One should NEVER rely on anything Covered CA or any Insurance Company says! Even if it’s in print!!! Insure Me Kevin.com where Covered CA gave the wrong answer about Social Security counting for MAGI.
View the discussion InsureMeKevin.com blog.
The original bill H.R. 2775 was introduced into the House of Representatives on July 22, 2013, and was called the No Subsidies Without Verification Act. It sought to declare that no premium tax credits or reductions in cost-sharing for the purchase of qualified health benefit plans under the Patient Protection and Affordable Care Act (PPACA, often informally referred to as “Obamacare”) shall be allowed before theSecretary of Health and Human Services (HHS) certifies to Congress that there is a program in place, consistent with PPACA requirements, that verifies the household income and coverage requirements of individuals applying for such credits and cost-sharing reduction. The bill passed the House on September 12, 2013. Wikipedia
42 U.S. Code § 18081 – Procedures for determining eligibility for Exchange participation, premium tax credits and reduced cost-sharing, and individual responsibility exemptions
(a)Establishment of program The Secretary shall establish a program meeting the requirements of this section for determining—