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Flow Chart - Can you take the PTC Premium Tax Credit
Flow Chart – Can you take the PTC Premium Tax Credit Publication #974

FAQ’s about the Premium Tax Credit

The premium tax credit is a refundable credit that helps eligible individuals and families with low or moderate income afford health insurance purchased through Covered CA.   To get this credit, you must meet certain eligibility requirements and file a tax return.

What is included in household income?

For purposes of the PTC, household income is the modified adjusted gross income of you and your spouse if filing a joint return, plus the modified AGI of each individual in your tax family whom you claim as a dependent and who is required to file a tax return because their income meets the income tax return filing threshold.  Household income does not include the modified AGI of those individuals you claim as dependents and who are filing a return only to claim a refund of withheld income tax or estimated tax.  For this and other detailed premium tax credit questions and answers visit

The IRS is asking to see my 1095-A. What should I do?

You should follow the instructions on the correspondence that you received from the IRS.  You may be asked for a copy of Form 1095-A in order to verify information that has been entered on your tax return.  Visit our Health Insurance Marketplace Statements webpage for more information about Form 1095-A and how to obtain a copy,

If I got advance payments of the PTC, do I have to file even if I never had a filing requirement before?

Yes. If you received the benefit of advance payments of the premium tax credit, you must file a tax return to reconcile the amount of advance credit payments made on your behalf with the amount of your actual premium tax credit.  You must file a return and submit a Form 8962 for this purpose even if you are otherwise not required to file a return.

Marketplace says I did not file, but I did file before the extended due date.  What should I do?

In advance of the open enrollment period that runs through…, the Marketplace sent Marketplace Open Enrollment and Annual Redetermination letters to individuals who might not have filed a tax return. Follow the instructions in the letter you received.

  • Log in to your Marketplace account to update your … Marketplace application.
  • Check the box telling the Marketplace you reconciled your premium tax credits by filing a … tax return and Form 8962.
  • Update your Marketplace application by …
  • If you don’t update your Marketplace application, any help with costs you currently get will stop on … and you’ll be responsible for the full upfront costs of your Marketplace plan and covered services.
  • For more help visit email us [email protected] 


What are my options to receive help with filing a return and reconciling?

Filing electronically is the easiest way to file a complete and accurate tax return as the software guides you through the filing process. Electronic filing options include:

free Volunteer Assistance,

IRS Free File,

commercial software,

and professional assistance.

For information about filing a return and reconciling advance credit payments, visit

Brochures – Answers

Kaiser Foundation – Subsidies and Enhanced Silver  FAQ’s
Center on Budget and Policy Priorities  FAQ’s
Covered CA Application See Bookmarks for Income and Other Income
Explanation of how tax credit works and when to take it
2014 & 2015 Tax Forms
Video Individual Financial Assistance – Sample Scenarios
The premium tax credit is refundable so taxpayers who have little or no income tax liability can still benefit.  FAQ’s
Turbo Tax Calculator   Tax Policy

LA Times 9.9.2013 Subsidy might have to be paid back at tax time, if new income not reported.

FAQ’s on Covered CA Website  ♦   Kaiser Foundation 2014 Taxes

Premium and Tax Credit Calculators

How the Credit gets calculated CFR 1.36 B or just use our 

quote engine

and enter your expected Household Income for 2015 – Modified Adjusted Gross Income – Line 37 MAGI .

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