If your income is less than 400% of the Federal Poverty Level for your family size, you can qualify for the Premium Tax Credit. If you underestimated your income when you signed up for the marketplace insurance, you would be liable to pay some or all of the Advanced Premium Tax Credit back even if you do not get sick or injured or use the insurance at all during the year.
Basically, when you file your taxes at the end of the year, if you have Marketplace insurance and received the credit, you will include form 8962 with your return which reconciles what you received with what you were eligible to receive. If you received too much, you have to pay it back when you file your taxes. If you received too little, then you would get a refund (or a reduction in what you owe) of what you didn't get but should have.
What is the Premium Tax Credit (PTC) and What is Tax Form 8962?
How to Reconcile Your Premium Tax Credit
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