What Happens If My Income Changes After I Receive An Insurance Subsidy?
Q. If I鈥檓 unemployed at the beginning of the year and sign up for health insurance through my state鈥檚 health insurance exchange, I鈥檇 probably get a subsidy because my income would be low. But what happens if I get a job later in the year and start earning a good salary? Will I have to pay the money back?聽
A. You may have to repay some of the money, but the amount you鈥檇 owe would likely be capped. Every individual鈥檚 circumstances are different, but here鈥檚 how it might work in a typical situation.
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When you apply for health insurance on your state鈥檚 marketplace, you鈥檒l be asked about your income. If 聽and you live in聽the District of Columbia or聽one of the 25 states聽expanding Medicaid to adults with incomes up to ), you鈥檒l probably qualify for coverage under that program and won鈥檛 have to buy a plan on the exchange.
If you live in a state that鈥檚 not expanding Medicaid, however, you can shop for subsidized coverage on your state鈥檚 marketplace. Premium tax credits are available to individuals with incomes between 100 and 400 percent of the federal poverty level ($11,490 to $45,960 for an individual in 2013).
If you鈥檙e collecting $300 a week in unemployment benefits, you鈥檇 probably qualify聽for a premium credit. If you choose to receive the credit up front rather than at tax time next year, your insurance premium would be reduced by the amount of your tax credit, and the government would send that amount to the insurer.
Let鈥檚 say you land a job in July with a $60,000 annual salary, but it doesn鈥檛 offer health insurance. At that point, you鈥檇 need to inform the marketplace about your change in circumstance.
鈥淭he key is to reach out immediately when things change,鈥 says Brian Haile, senior vice president for tax policy at Jackson Hewitt Tax Service.
At your new salary, you鈥檇 no longer qualify for a premium tax credit, and you鈥檇 have to pay the full premium. At tax time, the government will reconcile the amount that you received in tax credits against your income for the year, in our example, roughly $38,000, including six months of salary and six months of unemployment insurance.
If the amount you received in tax credits is higher than it should have been based on your annual income, you鈥檒l have to pay back the difference. But 聽your liability is limited if your income is less than 400 percent of the federal poverty level. Someone like you with income between 300 and 400 percent of poverty ($34,470 to $45,960 in 2013) would be liable to repay no more than $1,250.