You can enter the health insurance premium assistance you paid back as medical expenses.
From IRS Publication 502:
- You can't include in medical expenses the amount of health insurance premiums paid by or through the premium tax credit.
- You also can't include in medical expenses any amount of advance payments of the premium tax credit made that you did not have to pay back.
- However, any amount of advance payments of the premium tax credit that you did have to pay back can be included in medical expenses.
Example 1.
You are under age 65 and unmarried. The cost of your health insurance premiums in 2024 is $8,700. Advance payments of the premium tax credit of $4,200 are made to the insurance company and you pay premiums of $4,500. On your 2024 tax return, you are allowed a premium tax credit of $3,600 and must repay $600 excess advance credit payments (which is less than the repayment limitation). You are treated as paying $5,100 ($8,700 less the allowed premium tax credit of $3,600) for health insurance premiums in 2024. You will enter $5,100 on Schedule A (Form 1040), line 1.
Example 2.
The facts are the same as in Example 1, except you are allowed a premium tax credit of $4,900 on your tax return and receive a net premium tax credit of $700. You are treated as paying $3,800 ($8,700 less the allowed premium tax credit of $4,900) for health insurance premiums in 2024. You will enter $3,800 on Schedule A (Form 1040), line 1.
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