skip navigation
Search Help
Navigation Help

Tax Map Index
ABCDEFGHI
JKLMNOPQR
STUVWXYZ#

Tax Reform
Tax Topic Index

International
Tax Topic Index

Affordable Care Act
Tax Topic Index

Exempt Organization
Tax Topic Index

FAQs
Forms
Publications
Tax Topics
Worksheets

Comments
About Tax Map

IRS.gov Website
Publication 974
taxmap/pubs/p974-003.htm#en_us_publink100036270

Terms You May Need To Know(p4)

rule
The terms defined below are generally the same as those in the Form 8962 instructions. However, additional information is provided below on what documentation to keep if you are a victim of domestic abuse or spousal abandonment and on Minimum Essential Coverage, later.
taxmap/pubs/p974-003.htm#en_us_publink100037421

Tax family.(p4)

rule
For purposes of the PTC, your tax family consists of the following individuals.
Your family size equals the number of qualifying individuals in your tax family (including yourself).
Note.Listing your dependents by name and SSN or individual taxpayer identification number (ITIN) on your tax return is the same as claiming them as a dependent. If you have more than four dependents, see the instructions for Form 1040 or Form 1040NR.
taxmap/pubs/p974-003.htm#en_us_publink100037422

Household income.(p6)

rule
For purposes of the PTC, household income is the modified adjusted gross income (modified AGI) of you and your spouse (if filing a joint return) (see Line 2a in the Form 8962 instructions) plus the modified AGI of each individual whom you claim as a dependent and who is required to file an income tax return because his or her income meets the income tax return filing threshold (see Line 2b in the Form 8962 instructions). Household income does not include the modified AGI of those individuals whom you claim as dependents and who are filing a 2018 return only to claim a refund of withheld income tax or estimated tax.
taxmap/pubs/p974-003.htm#en_us_publink100041097
Modified AGI.(p6)
For purposes of the PTC, modified AGI is the AGI on your tax return plus certain income that is not subject to tax (foreign earned income, tax-exempt interest, and the portion of social security benefits that is not taxable). Use Worksheet 1-1 and Worksheet 1-2, in the Form 8962 instructions, to determine your modified AGI.
taxmap/pubs/p974-003.htm#en_us_publink100037429
Taxpayer's tax return including income of a dependent child.(p6)
A taxpayer who includes the gross income of a dependent child on the taxpayer’s tax return must include on Worksheet 1-2 the child’s tax-exempt interest and the portion of the child’s social security benefits that is not taxable.
taxmap/pubs/p974-003.htm#en_us_publink100037430

Coverage family.(p6)

rule
Your coverage family includes all individuals in your tax family who are enrolled in a qualified health plan and are not eligible for MEC (other than individual market coverage). The individuals included in your coverage family may change from month to month. If an individual in your tax family is not enrolled in a qualified health plan, or is enrolled in a qualified health plan but is eligible for MEC (other than individual market coverage), he or she is not part of your coverage family. Your PTC is available to help you pay only for the coverage of the individuals included in your coverage family.
taxmap/pubs/p974-003.htm#en_us_publink100037434

Monthly credit amount.(p6)

rule
The monthly credit amount is the amount of your tax credit for a month. Your PTC for the year is the sum of all of your monthly credit amounts. Your credit amount for each month is the lesser of:
To qualify for a monthly credit amount, at least one individual in your tax family must be enrolled in a qualified health plan on the first day of that month. Generally, if coverage in a qualified health plan began after the first day of the month, you are not allowed a monthly credit amount for the coverage for that month. However, if an individual in your tax family enrolled in a qualified health plan in 2018 and the enrollment was effective on the date of the individual's birth, adoption, or placement for adoption or in foster care, or on the effective date of a court order placing the individual with your family, the individual is treated as enrolled as of the first day of that month. Therefore, the individual may be a member of your tax family and coverage family for the entire month for purposes of computing your monthly credit amount.
taxmap/pubs/p974-003.htm#en_us_publink100037440
Enrollment premiums.(p6)
The enrollment premiums are the total amount of the premiums for the month, reduced by any premium amounts for that month that were refunded, for one or more qualified health plans in which any individual in your tax family enrolled. Form 1095-A, Part III, column A, reports the enrollment premiums.
You generally are not allowed a monthly credit amount for the month if any part of the enrollment premiums for which you are responsible that month has not been paid by the due date of your tax return (not including extensions). However, if you became eligible for APTC because of a successful eligibility appeal and you retroactively enrolled in the plan, the portion of the enrollment premium for which you are responsible must be paid on or before the 120th day following the date of the appeals decision. Premiums another person pays on your behalf are treated as paid by you.
If your share of the enrollment premiums is not paid, the issuer may terminate coverage. The termination generally is effective no sooner than the second month of nonpayment. For any months you were covered but did not pay your share of the premiums, you are not allowed a monthly credit amount.
taxmap/pubs/p974-003.htm#en_us_publink100037443
Applicable SLCSP premium.(p6)
The applicable SLCSP premium is the second lowest cost silver plan premium offered through the Marketplace where you reside that applies to your coverage family (described earlier). The SLCSP premium is not the same as your enrollment premium unless you enroll in the applicable SLCSP. Form 1095-A, Part III, column B, generally reports the applicable SLCSP premium. If no APTC was paid for your coverage, Form 1095-A, Part III, column B, may be wrong or blank or may report your applicable SLCSP premium as -0-. Also, if you had a change in circumstances during 2018 that you did not report to the Marketplace, the SLCSP premium reported on Form 1095-A in Part III, column B, may be wrong. In either case, you must determine your correct applicable SLCSP premium. You do not have to request a corrected Form 1095-A from the Marketplace. See Missing or incorrect SLCSP premium on Form 1095-A under Line 10 in the Form 8962 instructions.
taxmap/pubs/p974-003.htm#en_us_publink100037446
Monthly contribution amount.(p6)
Your monthly contribution amount is used to calculate your monthly credit amount. It is the amount of your household income you would be responsible for paying as your share of premiums each month if you enrolled in the applicable SLCSP. It is not based on the amount of premiums you paid out of pocket during the year. You will compute your monthly contribution amount in Part I of Form 8962.
taxmap/pubs/p974-003.htm#en_us_publink100037447

Qualified health plan.(p6)

rule
For purposes of the PTC, a qualified health plan is a health insurance plan or policy purchased through a Marketplace at the bronze, silver, gold, or platinum level. Throughout this publication, a qualified health plan also is referred to as a policy. Catastrophic health plans and stand-alone dental plans purchased through the Marketplace, and all plans purchased through the Small Business Health Options Program (SHOP), are not qualified health plans for purposes of the PTC. Therefore, they do not qualify a taxpayer to take the PTC.
taxmap/pubs/p974-003.htm#en_us_publink100041099

Applicable taxpayer.(p7)

rule
You must be an applicable taxpayer to take the PTC. Generally, you are an applicable taxpayer if your household income for 2018 (described earlier) is at least 100% but not more than 400% of the federal poverty line for your family size (provided in Tables 1-1, 1-2, and 1-3, in the Form 8962 instructions) and no one can claim you as a dependent for 2018. In addition, if you were married at the end of 2018, you must file a joint return to be an applicable taxpayer unless you meet one of the exceptions described under Married taxpayers, later.
For individuals with household income below 100% of the federal poverty line, see Household income below 100% of the federal poverty line under Line 6 in the Form 8962 instructions. However, the exception described under Estimated household income at least 100% of the federal poverty line in the Form 8962 instructions does not apply if, with intentional or reckless disregard for the facts, you provide incorrect information to the Marketplace for the year of coverage. You provide information with intentional disregard for the facts if you know that the information provided is inaccurate. You provide information with a reckless disregard for the facts if you make little or no effort to determine whether the information provided is accurate and your lack of effort to provide accurate information is substantially different from what a reasonable person would do under the circumstances.
taxmap/pubs/p974-003.htm#en_us_publink100041100

Individuals who are incarcerated.(p7)

rule
Individuals who are incarcerated (other than pending disposition of charges, for example awaiting trial) are not eligible for coverage in a qualified health plan through a Marketplace. However, these individuals may be applicable taxpayers and take the PTC for the coverage of individuals in their tax families who are eligible for coverage in a qualified health plan.
taxmap/pubs/p974-003.htm#en_us_publink100041101

Individuals who are not lawfully present. (p7)

rule
Individuals who are not lawfully present in the United States are not eligible for coverage in a qualified health plan through a Marketplace. They cannot take the PTC for their own coverage and are not eligible for the repayment limitations in Table 5 (in the Form 8962 instructions) for APTC paid for their own coverage. However, these individuals may be applicable taxpayers and take the PTC for the coverage of individuals in their tax families, such as their children, who are lawfully present and eligible for coverage in a qualified health plan. For more information about who is treated as lawfully present for this purpose, visit HealthCare.gov. See Individuals Not Lawfully Present in the United States Enrolled in a Qualified Health Plan, later, for more information on reconciling APTC when an unlawfully present person is enrolled individually or with lawfully present family members.
taxmap/pubs/p974-003.htm#en_us_publink100041102

Married taxpayers.(p7)

rule
If you are considered married for federal income tax purposes, you must file a joint return with your spouse to take the PTC unless one of the two exceptions below applies to you.
You are not considered married for federal income tax purposes if you are divorced or legally separated according to your state law under a decree of divorce or separate maintenance. In that case, you cannot file a joint return but may be able to take the PTC on your separate return. See Pub. 501, Dependents, Standard Deduction, and Filing Information.
If you are considered married for federal income tax purposes, you may be eligible to take the PTC without filing a joint return if one of the two exceptions below applies to you. If Exception 1 applies, you can file a return using head of household or single filing status and take the PTC. If Exception 2 applies, you are treated as married but can take the PTC with the filing status of married filing separately.
taxmap/pubs/p974-003.htm#en_us_publink100041103
Exception 1—Certain married persons living apart.(p7)
You may file your return as if you are unmarried and take the PTC if one of the following applies to you.
taxmap/pubs/p974-003.htm#en_us_publink100041104
Exception 2—Victim of domestic abuse or spousal abandonment. (p7)
If you are a victim of domestic abuse or spousal abandonment, you can file a return as married filing separately and take the PTC for 2018 if all of the following apply to you.
taxmap/pubs/p974-003.htm#en_us_publink100042940
Domestic abuse.(p7)
Domestic abuse includes physical, psychological, sexual, or emotional abuse, including efforts to control, isolate, humiliate, and intimidate, or to undermine the victim's ability to reason independently. All the facts and circumstances are considered in determining whether an individual is abused, including the effects of alcohol or drug abuse by the victim’s spouse. Depending on the facts and circumstances, abuse of an individual’s child or other family member living in the household may constitute abuse of the individual.
taxmap/pubs/p974-003.htm#en_us_publink100042941
Spousal abandonment. (p8)
A taxpayer is a victim of spousal abandonment for a tax year if, taking into account all facts and circumstances, the taxpayer is unable to locate his or her spouse after reasonable diligence.
taxmap/pubs/p974-003.htm#en_us_publink100050910
Records of domestic abuse and spousal abandonment.(p8)
If you checked the box in the upper right corner of Form 8962 indicating that you are eligible for the PTC despite having a filing status of married filing separately, you should keep records relating to your situation, like with all aspects of your tax return. What you have available may depend on your circumstances. However, the following list provides some examples of records that may be useful. (Do not attach these records to your tax return.)
taxmap/pubs/p974-003.htm#en_us_publink100041107

Married filing separately.(p8)

rule
If you file as married filing separately and are not a victim of domestic abuse or spousal abandonment (see Exception 2—Victim of domestic abuse or spousal abandonment under Married taxpayers above), then you are not an applicable taxpayer and you cannot take the PTC. You generally must repay all of the APTC paid for a qualified health plan that covered only individuals in your tax family. If the policy also covered at least one individual in your spouse’s tax family, you generally must repay half of the APTC paid for the policy. See Line 9 in the Form 8962 instructions. However, the amount of APTC you have to repay may be limited. See Line 28 in the Form 8962 instructions.