How much is your ACA Health Insurance Subsidy?
Calculate your estimated Premium Tax Credit (PTC) for 2025 and check your risk of refund or repayment due to income changes to make smarter tax plans.
1. Enter Household Information
This is for your 2025 health coverage.
2. Year-End Reconciliation Simulation
Prepare for differences between estimated and actual income.
Simulation Results Summary
Income as % of Federal Poverty Level (FPL)
0%
Estimated Monthly Subsidy (Initial APTC)
$0
Final Year-End Reconciliation
Premium Tax Credit (PTC) Key Information
What is the PTC and how can I receive it?
The PTC is a refundable tax credit to help eligible households afford health insurance through the Marketplace. 'Refundable' means you can get the full amount back, even if you owe no tax.
- Advance Payments (APTC): Based on your estimated income, the government sends a monthly subsidy directly to your insurer to lower your premium. Most people choose this option.
- Lump Sum Credit: You pay the full premium each month and claim the entire credit when you file your tax return next year.
What are the eligibility requirements for 2025?
Key requirements include:
- You must enroll in a plan through the official Health Insurance Marketplace.
- Your household income must be at least 100% of the Federal Poverty Level (FPL).
- You cannot be eligible for other minimum essential coverage, like Medicare, Medicaid, or an 'affordable' job-based plan.
- If married, you must file a joint tax return (with few exceptions).
- You cannot be claimed as a dependent on someone else's tax return.
Important: Through 2025, a temporary rule allows households with income over 400% of FPL to still receive a subsidy, ensuring their premium does not exceed 8.5% of their income.
How is the subsidy (PTC) amount calculated?
Your PTC amount is determined by two key factors:
- Benchmark Premium (SLCSP): The subsidy is based on the premium for the Second-Lowest Cost Silver Plan (SLCSP) in your area, regardless of the plan you actually choose.
- Expected Contribution: Based on your income (as a % of FPL), the law sets an 'applicable percentage' that determines the maximum premium you are expected to pay. The lower your income, the lower your contribution percentage.
The Formula: (Monthly SLCSP Premium) - (Your Monthly Expected Contribution) = Your Monthly PTC
Most Important: Why must I report income changes immediately?
Advance payments (APTC) are based on your **estimated income**. Your final, true credit (PTC) is based on your **actual income** at the end of the year. Reconciling this difference can lead to unexpected tax consequences.
- If your income increases: You may have received too much subsidy in advance. You will have to pay back this excess APTC when you file taxes, which can lead to a surprise tax bill.
- If your income decreases: You may have received too little subsidy. You will get the difference back as an additional refund.
Therefore, it is crucial to report any changes in income or household size to the Marketplace immediately. This is the best way to adjust your APTC and minimize financial shocks at tax time.