Be Careful Stating Income For Health Insurance Subsidy
You’ll Have To Pay The Extra Back!
Calculating Your Insurance Subsidy
The “Advanced Premium Tax Credit” (APTC) is the “subsidy” (the monthly amount the government is paying to help you pay your premiums) that helps you afford your health insurance plan. Receiving a subsidy is great, but you must get your income correct. When you claim you will make a certain amount of money in a year (and receive a subsidy), you must try to be as accurate as possible and notify them of any changes that may occur throughout the year. Be honest in stating your income. There are very serious consequences to playing games with your income.
Why Reporting the Correct Income Matters
If you are applying for a government subsidy, please note, anyone living in the household (that is working) needs to provide their income. So, if you have a 21-year-old adult child that is working and is going to be on their parents plan, you must include their income as part of your “Household Income”. Even if they do not live at home. If they are on their parents plan, they will need to provide their income.
The term “household income” means, with respect to any taxpayer, an amount equal to the sum of the modified adjusted gross income of the taxpayer, plus the aggregate modified adjusted gross incomes of all other individuals who were considered in determining the taxpayer’s family size and were required to file a tax return imposed by section 1 for the taxable year.
IMPORTANT! Household Income is defined in 26 US Code 36B(d)(2)(A):
You’ll Have To Pay The Extra Back!
Whenever your income increases or decreases, it’s very important to contact your health insurance agent to update your new income. This way you can have your health insurance subsidy adjusted so you receive the amount you are entitled to. You don’t want to owe the IRS money at the end of the year because you received too much subsidy.
Also, any “Life Event” will affect your subsidy and you must let them know of the changes. The subsidy you receive to help pay for your health insurance is calculated on family size and income and adjusts to any changes in these calculations. It can be an on-going process. When you fill out a health insurance application through their website and get a subsidy, you are responsible to contact them and make corrections if you have any changes throughout the year.
continued below ⇓
Recent Posts
Is Health Insurance Worth The Cost?
If you experience a more extensive medical emergency and require hospitalization, hospital bills may quickly become a burden. A three-day stay, for example, could set you back about $60,000 depending on what tests are ordered and what happens during your stay.
Surrogacy Laws in Nevada
Generally speaking, the intended parents are responsible for covering pregnancy-related expenses, including complications that may arise over the course of the pregnancy and delivery. The standard way to control health care costs is to purchase health insurance for the woman acting as the gestational surrogate.
Will Health Insurance Cover Rhinoplasty?
As is the case with all elective surgeries, rhinoplasty is not covered by health insurance when the procedure is not medically necessary. Cosmetic rhinoplasty changes the overall appearance of the individual’s nose by reshaping it or reducing its size.
1). By Phone
(702) 898-0554
get a quote
2). Online Quote
3). In Person
4260 W. Craig Road #150-A
N. Las Vegas, NV 89032
2025 Health Insurance Subsidy Chart
by household size and income
⇓
The chart below lists the income numbers the IRS will use for “subsidy” eligibility.
* The annual subsidy amounts change in January of each year
* NOTE: You can buy a plan outside of the “Marketplace” that doesn’t have a subsidy
Search This Website
Most Popular Pages
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog
#5) Request a Quote
Subsidies Directly Tied to Your Tax Returns
The subsidies you receive are directly tied to your tax returns, so if you have income changes or life events, you must make certain that these changes get reported. If you forget to make an adjustment to your income or your family size, and the government keeps subsidizing your health insurance, you will have that money taken out of your tax refund when you file your taxes. The IRS at the end of the year will adjust what you’ve received, and what you should have received, and that will be taken from your tax refund, or worse, you’ll have to pay the IRS back. If your income went down, or you had more people in your family to support on the same income, then you may be entitled to get a larger tax refund or receive a larger subsidy.
For example: If your health insurance premiums are $1,000/month and you get a Government Subsidy of $800/month you’ll only have to pay $200/month. At the end of the year when you do your taxes, the Government will check your income. IF you were only supposed to have received an Advanced Premium Tax Credit (Subsidy) of $700/month instead of $800/month, you’ll owe the Government an extra $100/month X 12 months which equals $1,200. Ouch!
Have Changes? Simply Call Us
We suggest that any time you have a change to your income or your family, that you call us. Let us know of the changes and we will take care of making the adjustments to your account to keep your account updated and out of trouble.
Does Your Income Change Regularly?
If you have an income that goes up and down monthly, you’ll want to make those changes monthly, or try to average the income out monthly and divide by 12 months. You can also estimate your yearly income and at the end of the year, the IRS will calculate if you were over-subsidized (received too much subsidy and you owe money), or under-subsidized (you get a refund).
What’s The Most I Would Have to Repay the IRS?
Repayment Limits for Advanced Premium Tax Credits: 2024 Tax Year
You must repay the difference between the amount of premium tax credit you received and the amount you were eligible for. There are also dollar caps on the amount of repayment if your income is below 4 times the poverty level.
The IRS States You Are Responsible
The IRS stated that people who miscalculated their incomes, or if the website (Nevada Health Link) miscalculated their “Subsidy”, whether intentional or not…would be responsible. People who enrolled into a health insurance plan and received a government subsidy, if their subsidy was miscalculated and you were given more than entitled, you will be required to pay this money back.
We gently warn our customers to be honest and careful when doing your health insurance plans through Nevada Health Link. If you intentionally or unintentionally miscalculate your income, there will be a settlement with the IRS when you do your taxes. This notice is not meant to scare you, but to educate and inform you.
This just solidifies our long-held view that you need to be very careful and accurate when you apply for a subsidy from the Government to help pay your premiums. Ensuring that you accurately state your “MAGI” (modified adjusted gross income) is very crucial. If you don’t know your MAGI, you can ask your accountant, or click for definition. After you have your MAGI, you can call us for assistance in obtaining your health insurance plan.
Discussing Subsidies With Nevada Insurance Enrollment
Navigating through the many options of insurance can be confusing and difficult, but speaking with a local, licensed insurance agent will help you to obtain the coverage you need and receive subsidy you deserve. We have licensed health insurance agents ready to assist you with all of your health insurance concerns. We will guide you and help you choose a health insurance plan based on your needs and budget. Call us today!
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Health Insurance During Pregnancy and for New Babies
For many women, pregnancy and childbirth are among the most expensive health care costs that they will face in their lifetimes, and without adequate health insurance coverage, they can end up with tens of thousands of medical debt.
Does Health Insurance Cover Chiropractic Treatment?
The Affordable Care Act includes 10 essential health benefits. Among these is coverage for habilitative and rehabilitative services that help those with injuries or illnesses regain physical skills.
Group vs. Individual or Family Health Insurance
Trying to determine what insurance you or your family need or qualify for can be a struggle. Do you need employer group insurance, private insurance, or Obamacare insurance?
Can You Have Two Health Plans?
Having two health insurance plans is legal and, in some cases, very beneficial. There are several scenarios in which you may have two health insurance plans. While it would be nice if you got double reimbursements for all your medical bills, that is not what happens when you have more than one health insurance policy.