MLR

Getting married? Divorced? Could affect premium tax credit

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If you’re getting married – or divorced – and you or your spouse is insured through the Health Insurance Marketplace, you need to inform the Marketplace of your change of status.

This is especially important if you receive premium assistance through advance payments of the premium tax credit through a Health Insurance Marketplace.

Other changes in circumstances that you should report to the Marketplace include:

  • Birth or adoption of a child
  • A new job
  • Loss of a job
  • A new address
  • Gained or lost eligibility for employer or government-sponsored healthcare coverage
  • Any change that might affect family composition, family size, income or your enrollment

Informing the Marketplace about any changes in your status enables the Marketplace to ensure that you have the right coverage for you and your family as well as to adjust the amount of advance credit payments that the government sends to your health insurer.

By reporting the changes, you can prevent having too much or not enough premium assistance paid to reduce your monthly health insurance premiums.

Getting too little could mean missing out on monthly premium assistance that you deserve. Or, receiving too much premium assistance could mean you will owe money or get a smaller refund when you file your taxes.

A change in status can also affect eligibility for coverage through your employer or your spouse’s employer because that will affect your eligibility for the premium tax credit.

Some life events – such as marriage – give you and your spouse the opportunity to sign up for health care during a special enrollment period. That means that if one or both of you are uninsured, you may be able to get coverage now.

The special enrollment period for Marketplace coverage is typically open for 60 days from the date of the life event.

For more information, see www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home. IRS Publication 5152 contains information about reporting changes in circumstances to the Marketplace.