Hello Tom_N_GA, I'm so glad you participated in our event today. This is actually quite a complicated situation, and lots of people struggle with it. First of all though, congratulations on your marriage! Best wishes to both of you.
There are several elements here, not just the question of which month you add her to your coverage. But lets start there. Your wife is not eligible for a Premium Tax Credit if she is eligible to be covered under your employer's plan and the IRS considers the plan "affordable". Their definition of affordable is the cost for employee-only coverage (for the least-expensive plan available from the employer) does not exceed 9.61% of household income in 2022. This is true regardless of the total amount that must be paid to cover family members on the policy. Therefore, if she is eligible to be added to your plan in December, you should do so, as her eligibility for the premium tax credit for her current plan ends. If a premium subsidy is paid for that month, you would most likely be required to repay it in full.
The second issue is the calculation of her premium tax credit repayment on your joint tax return. You are correct that you cannot file as married filing separately, as that would make her entirely ineligible for the premium tax credit. I understand your concern about the status of the credit, as your combined income for the year may well be higher than the threshold for the premium tax credit. The federal poverty limit for a family of 2 is not double the limit for a family of 1, so adding a spouse and their income often puts somebody above the eligibility limit, even though they were under the limit when they received the aptc subsidies. Unfortunately, this could cause a large repayment to be due at tax time. However, this is an issue regardless of whether you add her to your insurance plan in December or January. The good news is that there is an 'alternative calculation for year of marriage' in the premium tax credit rules. This means that for the months prior to your marriage she could use a family size of 1, and half of your combined income in the calculations. I can't make any determinations without knowing the specifics of your financial situation, but for many people, this may eliminate or significantly reduce the repayment. Obviously, if your income is tremendously higher than hers, half the combined income may still put her over the limit. Here is a link to IRS publication 974, and the alternative calculation section is on page 38.
As far as the prescription your wife received, that's a bit beyond our scope here. In my personal experience, I've never known an insurance company try to reclaim costs for a prescription they have already paid out on once coverage ends. But the only way to know for sure would be to call the insurance provider.
I wish you the best of luck as you sort through this situation. Rest assured, Turbotax can handle your premium tax credit calculations on form 8962. The software will prompt you to enter the information from the 1095-a, and it should be fairly straightforward. If you do need assistance, we're always here for you.
