Is this normal? Healthcare 1095-A reduced my tax refund by $1350 - seems really high!
I'm pretty shocked by what just happened with my taxes. I was expecting a decent refund but after entering my 1095-A information, my refund dropped by $1350! This can't be right, can it? Some background: I'm filing as SINGLE in Ohio. I had marketplace health insurance from January through August 2021, then switched to my employer's plan in September when I got a new job. My income breakdown: Wages/Salary: $30,240 Capital Gains: $415 Unemployment (after exclusion): $16,780 Total Income: $47,435 Standard Deduction: $12,400 Taxable Income: $34,835 Total Tax: $5,123 Total Payments: $6,598 When I entered my 1095-A info, everything went downhill: - Monthly enrollment premium (column A): $288 - Monthly SLCSP premium (column B): $285 - Monthly contribution amount: $362 - Monthly advance payment of PTC (column C): $175 After entering this, my refund plummeted from about $2,800 to only $1,475. The software shows "Excess advance premium tax credit repayment" on Schedule 2, line 2 for $1,350. Did I completely mess up? I barely even used the marketplace insurance and only got it because I thought I had to during unemployment. There wasn't anywhere to indicate I switched to employer coverage in September. Does this all sound correct? I'm really frustrated that trying to do the right thing with health insurance cost me so much money!
23 comments


Ravi Sharma
What you're experiencing is unfortunately normal with the Premium Tax Credit reconciliation. When you signed up for marketplace coverage, they gave you an advance premium tax credit (APTC) based on your estimated income for the year. At tax time, this gets reconciled with your actual income. What likely happened is that your actual income for the year (including unemployment) was higher than what you estimated when you applied for marketplace coverage. Since your income was higher than estimated, you weren't eligible for as much premium tax credit as you received in advance, so now you have to pay back the difference. The fact that you switched to employer coverage in September was automatically factored in since your 1095-A only shows marketplace coverage through August. That's why columns A, B, and C on your 1095-A should only show values for January through August. The $1,350 repayment amount does seem to align with about 8 months of receiving roughly $175 per month in advance credits that you ended up not qualifying for based on your final income. This is one of the more frustrating aspects of the ACA marketplace system.
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Freya Thomsen
•Thanks for explaining, but I'm confused about one thing. If my income was higher than expected, wouldn't that just reduce my subsidy going forward? Why do I have to pay back the whole amount for months I already used? Also, is there any cap on how much they can make you repay?
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Ravi Sharma
•The subsidies are always provisional based on your estimated income, and reconciliation happens when you file taxes. It's not just about adjusting future subsidies - the law requires reconciliation of the entire year's worth of advance payments against what you were actually eligible for. There are repayment caps based on your income as a percentage of the federal poverty level. For incomes below 400% FPL, repayment is capped (ranging from $300 to $2,700 for single filers). However, if your income is above 400% FPL, you must repay the entire excess amount with no cap.
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Omar Zaki
I went through almost the EXACT same situation last year! I had marketplace coverage then got a job with benefits, and my tax refund got absolutely decimated. I was so confused and upset. Then I found https://taxr.ai which helped me understand exactly what was happening with my Premium Tax Credit reconciliation. When I uploaded my 1095-A to their system, they explained everything in plain English and showed me how the repayment was calculated. They even found that I had incorrectly entered some of my monthly premium amounts which saved me about $200. Apparently a lot of people make mistakes with these forms because they're so confusing! The tool also showed me how my unemployment income affected my marketplace subsidies - something I had no idea about. Definitely worth checking out if you're dealing with marketplace insurance forms. They analyze everything automatically.
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AstroAce
•Does this tool actually help you find deductions you missed? I entered my 1095-A info and my refund dropped too, but I'm wondering if there are other things I can claim to offset this hit. Also, does it give recommendations for next year to avoid this problem?
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Chloe Martin
•Looks interesting but I'm skeptical of tax tools that aren't the major brands. How secure is it with your tax docs? And can it actually change anything or is it just explaining what's already happened? Because explaining doesn't help if I still owe the money.
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Omar Zaki
•It definitely helped me find deductions I missed! The tool flagged that I could deduct some health expenses I paid out of pocket that I had no idea were eligible. It also gives optimization tips for the future based on your specific situation. Regarding security, they use bank-level encryption and don't store your documents after analysis. And while it can't change the basic rules about PTC reconciliation, it can identify errors in how you've entered information or calculated things. In my case, finding those entry errors made a real difference in the amount I had to repay.
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AstroAce
Just wanted to follow up - I used taxr.ai and it was super helpful! I uploaded my 1095-A and tax documents and it showed me that I had actually made a mistake when entering my SLCSP amount. My tax software had pulled the wrong numbers from one of the months. The tool also showed me that I qualified for a higher deduction because of some medical expenses I paid that were related to my marketplace plan's high deductible. I was able to go back and correct everything in my tax software, and got back about $340 of what I thought I had lost. It also gave me some really clear advice about estimating my income more accurately for next year if I end up on marketplace coverage again. Really glad I gave it a try after feeling completely confused by this whole 1095-A situation!
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Diego Rojas
I literally spent 3 WEEKS trying to get through to someone at the IRS to explain this exact issue to me. Would call, wait on hold for hours, then get disconnected. So frustrating! Finally I tried https://claimyr.com and watched their demo at https://youtu.be/_kiP6q8DX5c - they basically call the IRS for you and then call you when an agent is on the line. Got connected to an actual IRS rep in about 2 hours (instead of the 15+ hours I wasted trying myself). The agent explained that the Premium Tax Credit reconciliation is required by law and confirmed my repayment amount was calculated correctly. They also told me I could set up a payment plan if needed since the amount was large. The most helpful part was learning about Form 8962 worksheet and how the calculations work. If you're struggling to understand your specific situation or just can't get through to the IRS, definitely try this service. Saved me so much time and frustration.
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Isabella Ferreira
•How much does their service cost? I've been trying to reach the IRS about my 1095-A issue too and keep getting disconnected. Did the IRS agent actually help solve anything or just confirm what you already knew?
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Anastasia Sokolov
•This sounds like a scam. Why would I pay a third party to call the IRS? Plus the IRS probably won't even tell you anything useful besides "yes that's how the law works." Did they actually help you reduce what you owed or just confirm you're screwed?
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Diego Rojas
•They don't advertise the price on their site, but I thought it was reasonable considering how much time it saved me. I was spending 3-4 hours each attempt just to get disconnected. The agent was actually very helpful. While they confirmed I did have to repay the excess credit, they walked me through exactly how it was calculated, explained which form line entries to verify, and set up a payment plan with much lower fees than I would have gotten if I'd just paid late. They also flagged that I could be eligible for an exemption based on a financial hardship situation I mentioned.
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Anastasia Sokolov
I need to apologize for my skeptical comment. I actually tried Claimyr after continued frustration with the IRS phone system. Got connected to an agent in about 90 minutes after trying for DAYS on my own. The IRS rep explained that in my case, I had made an error in how I reported my change in coverage. Turns out I needed to indicate the exact date I got employer coverage, not just the month. They helped me file an amended return and I'm getting $780 back that I thought was gone forever. The agent also explained how to better estimate my income for next year's marketplace application to avoid owing money again. This was way more helpful than I expected. Sometimes you need to talk to an actual human who can look at your specific situation. Definitely worth it and I take back my "scam" comment.
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Sean O'Donnell
Healthcare marketplace and taxes is a total nightmare combo. Here's what I learned after going through this exact situation: 1. When you get marketplace coverage, they ask for your ESTIMATED yearly income. If you underestimate, you get too much subsidy and have to pay it back. 2. If you get a job mid-year with insurance, you need to CANCEL your marketplace plan immediately. Don't just stop paying - formally cancel it. 3. Unemployment counts as income for calculating your subsidy eligibility, which screws a lot of people. 4. There are repayment caps based on income, but they only help if you're under 400% of federal poverty level. 5. Next time, try to overestimate your income slightly when applying for marketplace coverage. You might pay slightly more monthly but avoid a tax-time surprise. This system is brutal but at least your experience is "normal" - doesn't make it suck any less though!
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Zara Ahmed
•Do you know if there's any way to appeal this or get some kind of hardship exemption? $1350 is a huge hit for someone who was on unemployment part of the year. Seems like the system punishes people who try to do the right thing and get coverage.
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Sean O'Donnell
•There are some hardship exemptions, but unfortunately they don't typically apply to Premium Tax Credit repayments. The system is designed to reconcile at tax time no matter what. Your best option might be to set up a payment plan with the IRS if you can't pay the full amount. The interest is relatively low compared to credit cards. Also check if you're near a threshold for one of the repayment caps - sometimes adjusting your AGI slightly with an IRA contribution can put you under a cap and save hundreds.
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StarStrider
Is there any legitimate way to reduce this tax hit? I'm in almost the identical situation - had marketplace for 7 months, then employer coverage, and now owe $1200 back. My tax guy just says "that's how it works" but there must be something we can do?
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Luca Esposito
•I'm a tax preparer and there are a few potential strategies: 1. Make sure your Form 8962 is filled out correctly - common errors happen 2. If your income is near 400% FPL, contributing to a traditional IRA can lower your AGI and potentially put you under the repayment cap 3. Check if you qualify for any exemptions due to hardship 4. Verify the SLCSP (Second Lowest Cost Silver Plan) amount is correct on your 1095-A 5. If you had significant medical expenses that exceed 7.5% of your AGI, itemizing might help offset some of the hit None of these will eliminate the repayment completely, but they might reduce the impact.
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Luca Esposito
•You can verify the SLCSP by going to healthcare.gov and looking up what the second lowest silver plan would have cost in your area for your age and family size. Sometimes the amount on the 1095-A is incorrect. For itemizing medical expenses, remember you can only deduct the portion that exceeds 7.5% of your AGI. So if your AGI is $47,000, only medical expenses beyond $3,525 would start counting. Make sure to include premiums you paid out-of-pocket, deductibles, copays, prescription costs, and mileage to medical appointments.
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Nia Thompson
Random question: did anyone here get their 1095-A corrected? Mine had wrong values but I'm getting nowhere with the marketplace phone line. Been trying for weeks and I'm about to just file with the wrong form and deal with the mess later.
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Mateo Rodriguez
•YES! Mine had the wrong SLCSP premium amount for two months. I called the marketplace and after being transferred 3 times, they finally submitted a correction request. Took about 3 weeks to get the corrected form. If you're in a hurry to file, you can actually look up the correct SLCSP amounts yourself on healthcare.gov and use those instead of waiting. There's a tool specifically for this. You just need to know your county, age, and family size for each month.
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Nia Thompson
•Thank you so much for this tip! I didn't know I could look up the values myself. Just checked and my form definitely has the wrong amount for at least 3 months. Going to try both calling again and using the lookup tool. Really don't want to delay filing but also don't want to use wrong numbers.
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Yara Khalil
I feel your pain - this exact situation happened to me two years ago and it was such a shock! The $1,350 repayment does sound about right given your income and the advance credits you received. One thing that might help explain it: when you were unemployed and applied for marketplace coverage, you likely estimated a lower income for the year. But your final AGI of $47,435 (including that unemployment income) put you in a higher income bracket than expected, which reduced how much premium tax credit you were actually eligible for. The silver lining is that you did have health coverage when you needed it most - during unemployment. And switching to employer coverage in September was absolutely the right move. For next year, if you ever need marketplace coverage again, try to be conservative with your income estimates. It's better to get a smaller subsidy upfront and get money back at tax time than to owe a large repayment. Also, make sure to report income changes to the marketplace as soon as they happen. The system is frustrating but you didn't do anything wrong - this is just how the ACA reconciliation process works unfortunately.
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