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Reconciliation

Unpaid Marketplace premiums: when a month still gets PTC

Apply the federal coverage-month and unpaid-premium rules before entering a zero or reduced amount on Form 8962.

Ruling
For tax years beginning after 2024, a partly unpaid Marketplace premium does not automatically erase the month's PTC. The paid amount must preserve coverage under a specified federal rule, and unpaid taxpayer responsibility reduces the enrollment premium used in the credit calculation.

Test whether the month survived

A month may remain a coverage month when premiums paid, including APTC, are sufficient to avoid termination under the federal grace-period or payment-threshold rules. Premiums can also be paid by the unextended tax-return due date in circumstances described by the Form 8962 instructions. The insurer's final coverage record and Form 1095-A entries matter more than an account balance viewed midyear.

Reduce the amount used for PTC

When coverage remains effective but part of the taxpayer's required premium is still unpaid at the relevant filing deadline, the enrollment premium used to compute monthly PTC is reduced by that unpaid portion. If the month fails the coverage-month test, the applicable SLCSP entry for that month is zero for PTC purposes rather than a benchmark copied from another month.

Payment example and common errors

An enrollee pays enough during a permitted grace-period month to keep the policy from terminating, but leaves part of the enrollee share unpaid through the filing deadline. The month may qualify, using a reduced enrollment premium. Claiming the full column A amount overstates the credit; treating every late payment as disqualifying can understate it.

Resolve coverage status before calculating credit

Obtain the issuer's final record showing whether coverage terminated and which premium amounts remained unpaid at the filing deadline. Apply the post-2024 coverage-month exceptions only when their payment or grace-period conditions are met. For a retained month, reduce the enrollment premium by the unresolved taxpayer share before the lesser-of calculation.

Do not finalize Form 8962 while premium or termination status is disputed; the issuer's final month-level record determines which unpaid-premium rule applies.

Premium-payment evidence

  • Compare invoices, payments, refunds, and Form 1095-A monthly entries.
  • Identify the federal rule that kept a partly paid month active.
  • Use zero when the month does not satisfy the coverage-month test.

Continue with

When Form 8962 requires monthly calculationsForm 1095-A columns, missing forms, and correctionsWhy the PTC cannot exceed your Marketplace plan premium

Authorities used for this guide

Sources checked .