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Premium Tax Credit Eligibility (Health Insurance Premiums)

I am married and self employed; my spouse does not work.  I purchase a health insurance plan through Ambetter from Sunshine Health in Florida for my spouse and myself each year.  My annual business adjusted income will be ~$200,000 this year.   I received a 1095-A Health Insurance Marketplace statement (as I usually do) this year.

 

In TT, I searched for 1095-A and jumped to the form to enter the numbers.  All of the box A column has my premiums listed on the form, so I enter them.  All of the box B column is blank (and C as well) on the form, so I leave them blank in TT.  Turbo tax rejects this and requires a non-zero number in the box B column.  The help tells me that if box B column has zeros, I need to contact my carrier for the proper numbers or go to the healthcare.gov website to use their online tool to get the numbers.

 

I go to the website and get their numbers for my household size (2) and zip code and fill in the box B column in TT.  I check the box saying I'm self employed and purchased a marketplace plan (not sure if that's correct since I purchased a plan through Ambetter but received a 1095-A "marketplace" premiums statement, and I also select the business I am associating the plan with.

 

Now TT tells me I'm getting a $3,000+ premium tax credit for my health insurance premiums!  However, when I read about the premium tax credit on the IRS site, it says to be eligible for this tax credit, the household income can be no more than 400% of the federal poverty line for my family size.  According to the healthcare.gov web site, the FPL for 2022 for a family of 2 is about $18,000.  Four times that would be less than $80,000.  How can I be eligible for a tax credit when my income clearly exceeds the eligibility requirements?


Am I ineligible because my Ambetter marketplace plan was not actually purchased through the marketplace.gov website?   I figured if I received a 1095-A I was required to enter that information for my return, but if I do, TT requires me to fill in box B column, which then generates this refund that seems incorrect for my income.

 

Can anyone provide any clarity for my confusion regarding the reporting of self-employed health care premiums with a 1095-A in TurboTax? 

Thanks!

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1 Reply
MinhT1
Expert Alumni

Premium Tax Credit Eligibility (Health Insurance Premiums)

TurboTax calculations seem correct. You are correct in filling column B with the numbers given by the Tax tool.

 

For tax years 2021 and 2022, households with income higher than 400% of the poverty level may receive a premium tax credit if the total SLCSP in column B is more than 8.5% of the household income.

 

Please read this IRS document for more information.

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