When completing the Premium Tax Credit (Form 8962) section of your return, you may be asked whether your household income is below the Federal Poverty Level (FPL).
This question applies to a special rule that may allow certain taxpayers to claim the Premium Tax Credit even when their actual household income is below 100% of the Federal Poverty Level.
Answer this question carefully. An incorrect answer could cause the program to calculate your Premium Tax Credit incorrectly.
When Should I Answer "Yes"?
You should answer Yes only if all of the following are true:
- You, your spouse, or a member of your tax family was enrolled in a Qualified Health Plan through the Health Insurance Marketplace.
- Advance Premium Tax Credit (APTC) payments were made on your behalf for one or more months during the tax year.
- You're considered an applicable taxpayer for Premium Tax Credit purposes.
- The Marketplace estimated when you enrolled that your household income would be at least 100% of the Federal Poverty Level.
If any of these requirements aren't met, answer No.
What Is a Qualified Health Plan?
A Qualified Health Plan (QHP) is a health insurance plan certified by HealthCare.gov or a state Marketplace that provides essential health benefits and is eligible for the Premium Tax Credit.
If you received Form 1095-A, you were generally enrolled in a Qualified Health Plan.
What Is Advance Premium Tax Credit (APTC)?
The Advance Premium Tax Credit is the subsidy paid directly to your insurance company to help lower your monthly Marketplace premiums.
You can verify whether you received APTC by reviewing Form 1095-A. If amounts appear in Column C, Advance Premium Tax Credit payments were made on your behalf.
What Is an Applicable Taxpayer?
Generally, you're considered an applicable taxpayer if:
- No one else can claim you as a dependent.
- You meet the eligibility requirements for the Premium Tax Credit.
- If married, you generally file Married Filing Jointly unless an exception applies.
- You may qualify under certain special rules for taxpayers who:
- Are considered unmarried for Premium Tax Credit purposes, or
- Are victims of domestic abuse or spousal abandonment and meet the IRS exception requirements.
Federal Poverty Level Guidelines
The Marketplace compares your estimated household income to the Federal Poverty Level when determining eligibility for Marketplace assistance.
2025 Federal Poverty Level Guidelines
For 2025, the Federal Poverty Level amounts are:
- Family of 1: $15,650
- Family of 2: $21,150
- Family of 3: $26,650
- Family of 4: $32,150
- Family of 5: $37,650
- Family of 6: $43,150
- Family of 7: $48,650
- Family of 8: $54,150
- Family of 9 or more: Add $5,500 for each additional person
2026 Federal Poverty Level Guidelines
For 2026, the Federal Poverty Level amounts are:
- Family of 1: $15,950
- Family of 2: $21,550
- Family of 3: $27,150
- Family of 4: $32,750
- Family of 5: $38,350
- Family of 6: $43,950
- Family of 7: $49,550
- Family of 8: $55,150
- Family of 9 or more: Add $5,600 for each additional person
Note: Federal Poverty Level amounts are higher for residents of Alaska and Hawaii.
Important Reminder About Current Premium Tax Credit Rules
Although this question references the 100% Federal Poverty Level threshold, current Premium Tax Credit eligibility isn't strictly limited to taxpayers whose income falls between 100% and 400% of the Federal Poverty Level.
This question is specifically designed to determine whether you qualify for a special Form 8962 provision that may allow you to claim the Premium Tax Credit when your actual income falls below 100% of the Federal Poverty Level, provided the Marketplace originally estimated your income would meet the minimum threshold.
How Do I Know What the Marketplace Estimated?
You can review:
- Your Marketplace application,
- Eligibility notices from HealthCare.gov or your state Marketplace, and
- Form 1095-A and related Marketplace correspondence.
If the Marketplace approved Advance Premium Tax Credit payments based on an estimated income at or above 100% of the Federal Poverty Level, you may qualify to answer Yes, assuming all other requirements are met.
Key Takeaway
Answer Yes only if you received Marketplace coverage, received Advance Premium Tax Credit payments, qualify as an applicable taxpayer, and the Marketplace estimated your income would be at least 100% of the Federal Poverty Level when you enrolled. If you're unsure, review your Marketplace records and Form 1095-A before completing the Premium Tax Credit section of your return.