By Dez Duran-Lamanilao

The premium tax credit (subsidy), also known as PTC, is a refundable tax credit in the US paid by the Internal Revenue Service (IRS) to help eligible individuals and families cover the premiums for their health insurance when purchasing insurance through the state or federal Health Insurance Marketplace (also known as the Health Insurance Exchange). The Affordable Care Act (ACA) has a subsidy system in place for low and some middle- income families based upon the income of the person or family in relation to the Federal Poverty Level (FPL). Check out the table below to find out if you qualify for cost assistance.

Image Source: Obamacare Facts

According to IRS, you are eligible for PTC if you meet the following requirements:

  1. Are within specific income limits
  2. You and your spouse file a tax return separately.
  3. Cannot be claimed as a dependent by another person
  4. In the same month, you or a family member:
  • Have health insurance coverage with the aid of a Health Insurance Exchange
  • Have no affordable coverage through an eligible employer-sponsored plan offering minimum value
  • Are not eligible for coverage by means of a government program
  • Pay the share premiums not covered by advance payments of the premium tax credit, also known as advance credit payments

Important reminder: If your employer provides what can be described as an affordable comprehensive insurance, you will not be eligible to receive a subsidy in the exchange.

Enrolling for health insurance is possibly the best decision that you could make for you and your family. Some of the benefits covered in the Health Insurance Marketplace include outpatient care, emergency room (ER) trips, prescription drugs, and preventive services such as screenings, counseling, and vaccines, among several others. Health care benefits may vary by state.

Talk to an insurance expert now and find out the best way to protect yourself and your loved ones.