ACA PTC Credit when below 100% of FPL

[rtonkinson]

I am completing the 2024 tax return for my 28-year-old son who has some learning disabilities.  In 2023, he did not qualify for discounts to his ACA premiums (which were about $360 per month) and received a full rebate of them when his 2023 return was filed.  At the time of his 2024 renewal, we put in his anticipated income for the year, and again he had to pay what appears to be a full premium ($3,924 for the year with the Silver plan calculation $4,890, and no Advance payment of the PTC shown).   Unfortunately, he went through a period of unemployment and so his 2025 income was just 85% of the FPL.  Because he was not 100% of the FPL and because it appears that he did not receive any APTC, TurboTax is showing that he is not eligible to get the premiums paid returned.  This does not seem to make sense.  Last year, he made more money and had the full premium return.  This year, he made less and gets nothing?  Is that correct?  If so, was there a process that was missed in doing some kind of update on the marketplace site that would have prevented this terrible outcome?

[MarilynG1 · Accepted solution]

It sounds like his 1095-A may be incorrect, if he did pay ACA premiums throughout the year and had less income than last year. 

If you believe that you entered his 1095-A correctly into TurboTax (with the SLCSP amount in Column B)  you could reach out to the Marketplace to verify the correct amounts for the 1095-A. 

If you're using TurboTax Online, be sure to clear your Cache and Cookies first. 

Here's more info on How is the Premium Tax Credit Calculated and Form 8962. 

@rtonkinson 

[joannjacques1ce]

Also, you may want to check the income requirement(s) for MEDICARE/AID. I believe the ACA will not cover you if you qualify for that. 

[rtonkinson]

Yes, both are true. And, we fully expected he would make enough income to exceed the poverty level, but he was out of work longer than anticipated. 

[Vanessa A]

If he did NOT get the APTC, then he will not get it refunded if his income is less than Poverty line.  He would not have to pay the credit back, but he cannot claim it on his return if he did not get it. 

You may qualify for the PTC if your household income is less than 100% of the federal poverty line a...
 

•  No one can claim you as a dependent for the year.
• You or an individual in your tax family enrolled in a
  qualified health plan through a Marketplace.
• The Marketplace estimated at the time of enrollment
  that your household income would be at least 100% of the
  federal poverty line for your family size for 2024.
• APTC was paid for the coverage of 1 or more months
  during 2024.
• You otherwise qualify as an applicable taxpayer (except
  for the federal poverty line percentage).