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Submitting Claims for Premium Tax Credit Adjustments

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This article explains how to submit a reimbursement claim for a payment made to the IRS due to an overstated advanced premium tax credit.

If your actual total annual income is different than the estimate you used when applying for health insurance on the marketplace, you may be required to make adjustments when filing your taxes. Specifically, if your income is higher than expected, you may be responsible for paying for an additional portion of your premium because you no longer qualify for the same tax credit amount. You can submit this expense as a reimbursable health insurance claim in your ZaneHealth account by filling out the normal claim form with the information below.

 

1. Date of Service

The portion of the previous year that you were covered by the plan that was paid for by the advanced premium tax credit.

For Example: if I enrolled in a marketplace plan with advance premium tax credits on 2/1/14 and coverage lasted for the remainder of the year, my period of coverage would be 2/1/14-12/31/14.

 

2. Nature of Expense

Select “Health Insurance Premium” and add a note in the comment box that your claim is for a premium tax credit adjustment.  
 

3. Recipient of Service

Name of the primary policy holder
 

4. Provider Name

Name of Health Insurance Provider
 

5. Amount 

Dollar amount from line 29 of IRS Form 8962
 

6. Documentation

You will need to submit IRS Form 1095-A and IRS Form 8962 (completely filled out). Click Here to learn more about these forms and the tax filing process.


Note: You will get a warning stating that your claim may not be approved if one of your coverage dates is more than 180 days before the day you are submitting your claim. As long as you are submitting your claim within 90 days of the end of your plan year, your claim is approvable (pending proper documentation).

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Disclaimer: The information provided on this website is general in nature and does not apply to any specific U.S. state except where noted. Health insurance regulations differ in each state. See a licensed agent for detailed information on your state. Zane Benefits, Inc. does not sell health insurance. None of this information should be taken as legal or tax advice.