There has been a lot conversation about who can enroll in a Marketplace to plan who actually qualifies for an Advanced Premium Tax Credit (APTC) which lowers the monthly premium for you and your family.  Anyone over 18 can have their own plan, regardless of income, employment or marital status, but not everyone will qualify for the tax credit, which is the “deal breaker” for most people in most cases.  So in order to qualify for a tax credit, you must meet the following requirements: 

• File taxes as Married Filing Jointly, if married.  There are very few exceptions, but if you and your spouse prefer to file individually, you will not be eligible for a premium discount. 
• You cannot be claimed as a dependent on someone else’s tax return.  This means that if you have an adult child who needs to enroll at a lower premium, you will not be able to claim him/ her on your taxes for that tax year.   
• Earn between 118% and 400% of the Federal Poverty Level (FPL).  This means that not only can you make too much to not qualify for a tax credit, but you can also make too little.  If you do not make enough to qualify for the premium discount, you should contact your state’s Medicaid Division to see if you qualify for Medicaid becobnefits. If at the end of the year you’ve taken more premium tax credit in advance than you’re due based on your final income, you’ll have to pay back the excess when you file your federal tax return.  If you’ve taken less than you qualify for, you’ll get the difference back. 

• You must not be eligible for insurance through your employer or spouse’s employer if you are married.  Even if your employer group plan is too expensive for you and/ or your spouse, eligibility alone makes you ineligible for an advanced premium tax credit.  This is often known as “the family glitch”.   

Florida Link: https://www.healthsherpa.com/?_agent_id=michael-bradley 

Georgia Link: https://www.healthsherpa.com/?_agent_id=michael-bradley