What Happens If My Income Changes After I Receive An Insurance Subsidy?

Q. If Im unemployed at the beginning of the year and sign up for health insurance through my states health insurance exchange, Id 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?

A. You may have to repay some of the money, but the amount youd owe would likely be capped. Every individuals circumstances are different, but heres how it might work in a typical situation.

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What Happens If My Income Changes After I Receive An Insurance Subsidy?

When you apply for health insurance on your states marketplace, youll be asked about your income. If and you live inthe District of Columbia orone of the 25 statesexpanding Medicaid to adults with incomes up to ), youll probably qualify for coverage under that program and wont have to buy a plan on the exchange.

If you live in a state thats not expanding Medicaid, however, you can shop for subsidized coverage on your states 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 youre collecting $300 a week in unemployment benefits, youd probably qualifyfor 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.

Lets say you land a job in July with a $60,000 annual salary, but it doesnt offer health insurance. At that point, youd need to inform the marketplace about your change in circumstance.

The key is to reach out immediately when things change, says Brian Haile, senior vice president for tax policy at Jackson Hewitt Tax Service.

At your new salary, youd no longer qualify for a premium tax credit, and youd 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, youll have to pay back the difference. But 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.

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