When completing Form 8962, Premium Tax Credit, you may be asked whether your estimated household income was at least 100% of the Federal Poverty Level (FPL).
For most taxpayers, the answer is Yes if the Marketplace determined when you enrolled that your household income would be at least 100% of the Federal Poverty Level and you received Advance Premium Tax Credit (APTC) payments during the year.
This question helps determine whether you qualify for special Premium Tax Credit rules that may allow you to claim the credit even if your actual household income ends up being lower than expected.
When Should I Answer "Yes"?
You should answer Yes only if all of the following are true:
- You 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 paid on your behalf for one or more months during the tax year.
- You're considered an applicable taxpayer for Premium Tax Credit purposes.
- When you enrolled in Marketplace coverage, the Marketplace estimated that your household income would be at least 100% of the Federal Poverty Level.
If all of these conditions apply, you may qualify for the Premium Tax Credit even if your actual income was lower than initially estimated.
What Is a Qualified Health Plan?
A Qualified Health Plan (QHP) is a health insurance plan that has been certified by the Health Insurance Marketplace and provides essential health benefits.
If you purchased coverage through HealthCare.gov or your state's Marketplace and received Form 1095-A, you were generally enrolled in a qualified health plan.
What Is the Advance Premium Tax Credit (APTC)?
The Advance Premium Tax Credit is a subsidy that helps pay your monthly health insurance premiums throughout the year.
Rather than waiting to claim the entire Premium Tax Credit on your tax return, eligible taxpayers can have part or all of the credit sent directly to their insurance company each month.
If you received APTC payments, you'll need to reconcile those payments on Form 8962 when filing your tax return.
What Is an Applicable Taxpayer?
For Premium Tax Credit purposes, an applicable taxpayer generally must meet all of the following requirements:
- No one else can claim you as a dependent.
- If you're married, you generally must file Married Filing Jointly.
- If you're married and filing separately, you must qualify for a limited exception.
- You may qualify under the certain married persons living apart rule.
- You may qualify if you're a victim of domestic abuse or spousal abandonment and meet the IRS requirements for that exception.
If you don't meet the applicable taxpayer requirements, you generally aren't eligible for the Premium Tax Credit.
Federal Poverty Level (FPL) Guidelines
To answer Yes to this question, the Marketplace must have estimated during enrollment that your household income was at least 100% of the Federal Poverty Level (FPL) for your family size.
For taxpayers who enrolled in Marketplace coverage, the applicable poverty guidelines vary depending on the coverage year and Marketplace determination.
2025 Federal Poverty Level Guidelines
| Family Size | 2025 Federal Poverty Level |
| 1 | $15,650 |
| 2 | $21,150 |
| 3 | $26,650 |
| 4 | $32,150 |
| 5 | $37,650 |
| 6 | $43,150 |
| 7 | $48,650 |
| 8 | $54,150 |
| 9+ | Add $5,500 for each additional person |
2026 Federal Poverty Level Guidelines
| Family Size | 2026 Federal Poverty Level |
| 1 | $15,950 |
| 2 | $21,550 |
| 3 | $27,150 |
| 4 | $32,750 |
| 5 | $38,350 |
| 6 | $43,950 |
| 7 | $49,550 |
| 8 | $55,150 |
| 9+ | Add $5,600 for each additional person |
How the Income Test Works
For purposes of this question, you generally meet the income test if:
- You enrolled in a Marketplace health plan.
- You received Advance Premium Tax Credit (APTC) payments for one or more months of the year.
- The Marketplace estimated that your household income would be at least 100% of the Federal Poverty Level when you enrolled in coverage.
- You otherwise qualify as an applicable taxpayer for the Premium Tax Credit.
Important: The Premium Tax Credit is no longer limited solely to taxpayers whose income falls between 100% and 400% of the Federal Poverty Level. However, this question relates to a special Form 8962 rule that may allow certain taxpayers to claim the Premium Tax Credit even when their actual household income is less than 100% of the Federal Poverty Level, provided the Marketplace originally estimated their income would meet the minimum threshold when coverage was obtained.
Special Rule for Certain Lawfully Present Noncitizens
If you are lawfully present in the United States but are not eligible for Medicaid because of your immigration status, you may still qualify for the Premium Tax Credit.
Generally, you can answer Yes if all of the following apply:
- You or a member of your tax family was enrolled in Marketplace coverage.
- You were lawfully present in the United States during the coverage period.
- You're not eligible for Medicaid because of your immigration status.
- You meet the applicable taxpayer requirements discussed above.
How Do I Know if Advance Premium Tax Credits Were Paid?
You can find this information on Form 1095-A, Health Insurance Marketplace Statement.
Review:
- Column A for monthly premiums.
- Column B for the Second Lowest Cost Silver Plan (SLCSP).
- Column C for Advance Premium Tax Credit payments.
If Column C shows amounts for one or more months, Advance Premium Tax Credit payments were made on your behalf.
How Do I Enter This Information in the Program?
If you received Form 1095-A:
- Go to Health Insurance in the program.
- Answer Yes when asked whether you purchased coverage through HealthCare.gov or a state Marketplace.
- Enter the information from Form 1095-A exactly as shown.
- Answer the questions regarding household income, filing status, and Marketplace coverage.
The program will complete Form 8962 and determine whether you qualify for the Premium Tax Credit.
Key Takeaway
You should answer Yes to the "Estimated Household Income at Least 100% of the Federal Poverty Level" question only if you received Marketplace coverage, received Advance Premium Tax Credit payments, qualify as an applicable taxpayer, and the Marketplace estimated your income would meet the minimum Federal Poverty Level requirement when you enrolled. Entering your Form 1095-A accurately will help ensure the program calculates the correct Premium Tax Credit and any repayment obligation.