Did You Know? – Advance Premium Tax Credit

A consumer is eligible to have an Advance Premium Tax Credit (APTC) for health insurance on the Marketplace paid on their behalf if they meet all of the following requirements:

  • Is not claimed as a dependent by another person
  • For one or more months of the year, the consumer or another member of the consumer’s tax family (spouse, if filing jointly, and dependents) is enrolled in coverage (excluding catastrophic coverage) through the Individual Marketplace
  • Is not eligible for or enrolled in other minimum essential coverage (MEC); for example, is not offered “affordable” coverage through an eligible employer-sponsored plan that provides minimum value or enrolled in employer-sponsored coverage (ESC) regardless of affordability or provision of minimum value
    •  An employer-sponsored plan is affordable if the self-only premium is no more than 9.78 percent of annual household income in 2020
    •  It provides minimum value if the plan covers at least 60 percent of the total cost of medical services for a standard population and includes substantial coverage of physician and inpatient hospital services
  • Is not eligible for coverage through a government program like Medicaid, Medicare, CHIP or TRICARE