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Topic: ACA and APTC  (Read 302 times)

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ACA and APTC
« on: October 21, 2025, 06:38:06 PM »
I worked in FL and enrolled in Obama Care for the months of April to mid-October, (where I then cancelled my policy on return to the U.K). I just received a prorated refund from my insurance company for mid-October through to the 31st. I received APTC for all those complete months and wonder if I’ll also receive APTC for the prorated 15 days I had coverage in October.
Perhaps others may have similar circumstances to mine, or may know the answer? Thanks!
« Last Edit: October 21, 2025, 06:41:46 PM by Barcrest »


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Re: ACA and APTC
« Reply #1 on: October 21, 2025, 09:33:39 PM »
Well, I find nothing specifically that addresses a partial-month credit, so I'll offer a guess if that's at all helpful?

https://www.healthcare.gov/glossary/advanced-premium-tax-credit/
https://www.cms.gov/marketplace/technical-assistance-resources/aptc-csr-basics.pdf
https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-premium-tax-credit

When you complete your tax return, you will figure your credit and compare it to the amount of APTC on Form 8962. If your actual allowable credit on your return is less than your APTC, called excess APTC, the difference, subject to certain repayment caps, will be subtracted from your refund or added to your balance due. If your actual allowable credit is more than your APTC, the difference will be added to your refund or subtracted from your balance due.

The regs say that normally you have to be enrolled at the start of a month to get credit (which you were). But I don't see anything about partial month APTC repayments. I would ~ assume ~ that if you had coverage for part of the month you'd have a proportional APTC amount for that part of the month as well, and  ~ assume ~  that if the credit was paid directly to your insurance carrier they would have had to have returned to the government the proportional payment that would have covered the part of the month after you discontinued coverage.

Sorry I can't be of more help.
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Re: ACA and APTC
« Reply #2 on: October 22, 2025, 10:52:41 AM »
Well, I find nothing specifically that addresses a partial-month credit, so I'll offer a guess if that's at all helpful?

https://www.healthcare.gov/glossary/advanced-premium-tax-credit/
https://www.cms.gov/marketplace/technical-assistance-resources/aptc-csr-basics.pdf
https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-premium-tax-credit

When you complete your tax return, you will figure your credit and compare it to the amount of APTC on Form 8962. If your actual allowable credit on your return is less than your APTC, called excess APTC, the difference, subject to certain repayment caps, will be subtracted from your refund or added to your balance due. If your actual allowable credit is more than your APTC, the difference will be added to your refund or subtracted from your balance due.

The regs say that normally you have to be enrolled at the start of a month to get credit (which you were). But I don't see anything about partial month APTC repayments. I would ~ assume ~ that if you had coverage for part of the month you'd have a proportional APTC amount for that part of the month as well, and  ~ assume ~  that if the credit was paid directly to your insurance carrier they would have had to have returned to the government the proportional payment that would have covered the part of the month after you discontinued coverage.

Sorry I can't be of more help.
Thank you for the reply, very helpful indeed. I did also discover the below via an extended Google search, which does make sense.

https://www.dchealthlink.com/faqs/if-i-end-my-plan-part-way-through-month-will-my-premium-be-prorated

ACA was generally a stressful experience. Signing up was very tricky and it was touch and go to whether I would qualify for APTC, as I had no U.S sourced income for this current year and U.K income was very confusing to the 'Navigators' Its a chicken and egg, as I was not qualified for APTC until I could prove my first weeks pay, which could then be used to prorate an annual income for MAGI.

Annual deductibles and maximum out of pocket are very high and all of this with the enhanced tax credits, which are slated to end in December.

For two of us, $45,000 had to be paid in premiums/put back as our share towards care!


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