About this Form:

The premium tax credit form is used to figure the amount of your premium tax credit (PTC) and reconcile it with advance payment of the premium tax credit (APTC). You will also need the ‘Instructions for Form 8962’ to use as a reference. The instructions form has tables and worksheets for the year you are looking to figure your PTC contribution that you will need for your calculations.

How do I fill out Form 8962?

Part I—Annual and Monthly Contribution Amount At the very top, enter you name shown on your return and you social security number. On line 1 enter your tax family size. To do this you must determine the number of individuals in your tax family using your tax return. Your tax family generally includes you, your spouse if you are filing a joint return, and your dependents. On Line 2a enter your modified AG. Use the worksheet attached to this form to figure your modified AGI using information from your tax return. Next, on line 2b, enter the combined modified AGI for your dependents who are required to file an income tax return because their income meets the income tax return filing threshold. For line 3, add the amounts on lines 2a and 2b, even if one or both of them are negative. If the total is less than zero, enter 0 on line 3. Moving along to line 4, check the box to indicate your state of residence in 2018. Enter the amount from Table 1-1, 1-2, or 1-3 that reflects the federal poverty line for your state of residence for the family size you entered on line 1. For line 5, use Worksheet 2 to figure your household income as a percentage of the federal poverty line. If the amount on line 5 is at least 100% but not more than 400%, check the “No” box on line 6 and continue to line 7. If the amount on line 5 is less than 100%, see Household income below 100% of the federal poverty line next to determine if you qualify for the PTC. If the amount on line 5 is 401%, you are not eligible for the PTC, and should check the “Yes” box on line 6. For line 7, you need to enter the decimal number from Table 2 that applies to the amount you entered on line 5. This number is used to calculate your contribution amount. Multiply line 3 by line 7 and enter the result on line 8a, rounded to the nearest whole dollar amount. Divide line 8a by 12.0 and enter the result on line 8b, rounded to the nearest whole dollar amount. Part II—Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit Line 9 wants to know if you are allocating policy amounts with another taxpayer or if you want to use the alternative calculation for year of marriage? If yes, skip to Part IV, Allocation of Policy Amounts, or Part V, Alternative Calculation for Year of Marriage. If no, continue to line 10. For line 10, if you were enrolled in a qualified health plan for fewer than 12 months during 2018, check the “No” box and continue to lines 12–23. If you had full-year coverage with no changes on Form 1095-A, Part III, columns A or B, check the “Yes” box and continue to line 11. If you checked the “Yes” box on line 10 and you are completing line 11, do not complete lines 12 through 23. After you have completed line 11, skip to line 24. If you checked the “No” box on line 10 and you are completing lines 12 through 23, do not complete line 11. For column a, enter on lines 12 through 23 the amount of the monthly premiums reported on Form 1095-A, lines 21 through 32, column a, for the corresponding month. If you have more than one Form 1095-A for a particular month, add the amounts together for that month and enter the total. For column b, enter the amount of the monthly applicable SLCSP premium reported on Form 1095-A, lines 21 through 32, column b, for the corresponding month. If you did not complete Part V—Alternative Calculation for Year of Marriage, for lines 12 through 23 in column c, enter your monthly contribution amount from line 8b. If columns a and b of any of lines 12 through 23 are blank, leave column c of the corresponding line blank. For column d, subtract the amount in column c from column b. If the result is zero or less, enter a 0 in column d. In column e, enter the lesser amount of column a or column d for that month. Column f wants you to enter the amount of the monthly APTC reported on Form 1095-A, lines 21 through 32, column C. Moving to line 24, enter the amount from line 11e or add lines 12e through 23e and enter the total. Line 25 ask you to enter the amount from line 11f or add lines 12f through 23f and enter the total. For line 26, if line 24 is greater than line 25, subtract line 25 from line 24 and enter the result on line 26. If line 25 is greater than line 24, leave line 26 blank and go to Part III. Part III—Repayment of Excess Advance Payment of the Premium Tax Credit On line 27, if line 25 is greater than line 24, subtract line 24 from line 25 and enter the result. For line 28, refer to line 5 and enter the appropriate amount from Table 5. For line 29, enter the smaller of line 27 or line 28. If line 28 is blank, enter the amount from line 27 on line 29. Part IV—Allocation of Policy Amounts Complete lines 30-33 for up to four policy amount allocations. See the instructions for Line 1 and Line 9 to determine whether you need to complete Part IV. If you complete Part IV, check the “No” box on line 10. On lines 30 through 33 for column a, enter the Marketplace-assigned policy number from Form 1095-A, line 2. For lines 30 through 33 on column b, enter the social security number of the other taxpayer. For lines 30 through 33 in column c, enter the first month you are allocating policy amounts. Enter the last month you are allocating policy amounts in column d for lines 30-33. If your allocation situation requires you to allocate the enrollment premiums on Form 1095-A, lines 21 through 32, column A, enter your allocation percentage for that policy in column e. If your allocation situation requires you to allocate the applicable SLCSP premium on Form 1095-A, lines 21 through 32, column b, enter your allocation percentage for that policy in column f. Lines 30 through 33, column g. If your allocation situation requires you to allocate the APTC on Form 1095-A, lines 21 through 32, column C, enter your allocation percentage for that policy in column g. Line 34 If you have completed your required allocations of policy amounts shown on Forms 1095-A using lines 30 through 33, check the “Yes” box on line 34. If you must make more than four allocations of policy amounts shown on Forms 1095-A, check the “No” box on line 34 and attach a statement to your return providing the information shown on lines 30 through 33, columns (a) through (g) for each additional allocation. Part V—Alternative Calculation for Year of Marriage Complete line 35, columns a through d as indicated in Pub. 974 under Alternative Calculation for Year of Marriage. For line 36, complete columns a through d as indicated in Pub. 974 under Alternative Calculation for Year of Marriage. This data is found on the ‘Instructions for Form 8962.’ You have completed form 8962.