Advanced Premium Tax Credit

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DEFINITION of 'Advanced Premium Tax Credit'

A type of federal subsidy that reduces the amount individuals pay for their monthly health insurance premiums. Advanced Premium Tax Credits are a provision in the Patient Protection and Affordable Care Act, signed into law on March 23, 2010 by President Barack Obama. The tax credits are sent directly from the government to eligible individuals’ health insurers to reduce monthly premium payments. If eligible, the tax credit amount a person receives depends on his/her income; you will pay more for the monthly premium if your income falls near the top of the range, and less if your income is closer to the bottom.

BREAKING DOWN 'Advanced Premium Tax Credit'

Since it is a direct payment made to the insurance provider, individuals who qualify for the Advanced Premium Tax Credit do not need to pay the entire amount of their premium up front. To qualify for the Advance Premium Tax Credit, you must be ineligible for public coverage (Medicaid and Children’s Health Insurance Plan - CHIP), be unable to get qualified health insurance through an employer, and have a modified adjusted gross income that falls between 100% and 400% of the federal poverty level (FPL), as shown in the following table (as of 2014):

 

 

Family Size

100% FPL

400% FPL

1

$11,490

$45,960

2

$15,510

$62,040

3

$19,530

$78,120

4

$23,550

$94,200

5

$27,570

$110,280

6

$31,590

$126,360

7

$35,610

$142,440

8

$39,630

$158,520

 

Advanced Premium Tax Credits are not automatic, and individuals must apply for them on the Health Insurance Marketplace. Eligible individuals can decide how much advance credit payments will be applied to their premiums each month – up to a maximum amount. A refundable credit will be given on an individual’s federal income tax return if the amount of advance-credit payments is less than the tax credit they should have received. Conversely, individuals will have to repay any excess advance payments with their tax returns if the advance payments for the year are more than the credit amount.

To qualify for Advanced Premium Tax Credits (and/or Cost-Sharing Reductions, the second federal subsidy designed to help lower costs for health insurance coverage), you must purchase coverage through the Health Insurance Marketplace.

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