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            Department of the Treasury                        Contents
            Internal Revenue Service
                                                              Future Developments . . . . . . . . . . . . . . . . . . . . . . .          1
                                                              What’s New   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Publication 974
Cat. No. 66452Q                                               Reminders    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
                                                              Introduction  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2
                                                              What Is the Premium Tax Credit (PTC)? . . . . . . . . .                    3
Premium Tax 
                                                              Who Must File Form 8962 . . . . . . . . . . . . . . . . . . . .            4
Credit (PTC)                                                  Who Can Take the PTC . . . . . . . . . . . . . . . . . . . . . .           4
                                                              Terms You May Need To Know                . . . . . . . . . . . . . . . .  4
For use in preparing
                                                              Minimum Essential Coverage (MEC)                    . . . . . . . . . . .  8
2023 Returns                                                  Individuals Not Lawfully Present in the United 
                                                              States Enrolled in a Qualified Health Plan                        . . .    19
                                                              Determining the Premium for the Applicable 
                                                              Second Lowest Cost Silver Plan (SLCSP)                            . . .    27
                                                              Allocating Policy Amounts for Individuals With 
                                                              No One in Their Tax Family . . . . . . . . . . . . . . .                   27
                                                              Allocation of Policy Amounts Among Three or 
                                                              More Taxpayers            . . . . . . . . . . . . . . . . . . . . . . .    28
                                                              Alternative Calculation for Year of Marriage . . . . .                     38
                                                              Self-Employed Health Insurance Deduction 
                                                              and PTC       . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    47
                                                              How To Get Tax Help       . . . . . . . . . . . . . . . . . . . . . . .    63
                                                              Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  68

                                                              Future Developments
                                                              For  the  latest  information  about  developments  related  to 
                                                              Pub.  974,  such  as  legislation  enacted  after  it  was 
                                                              published, go to IRS.gov/Pub974.

                                                              What’s New
                                                              New Form 7206.          Form 7206, Self-Employed Health In-
                                                              surance Deduction, and its separate instructions have re-
                                                              placed  Worksheet  6-A,  Self-Employed  Health  Insurance 
                                                              Deduction  Worksheet,  that  was  previously  published  in 
                                                              Pub. 535, Business Expenses. Use Form 7206 and its in-
                                                              structions to determine any amount of the self-employed 
                                                              health insurance deduction you may be able to claim and 
                                                              report on Schedule 1 (Form 1040), line 17.
                                                              New  employer-coverage  affordability  rule  for  family 
                                                              members  of  employees.             For  tax  years  beginning  after 
                                                              December 31, 2022, for purposes of determining eligibility 
                                                              for the PTC, affordability of employer coverage for an em-
Get forms and other information faster and easier at:         ployee's spouse or dependent eligible to enroll in the em-
• IRS.gov (English)         • IRS.gov/Korean (한국어)            ployer  coverage  is  no  longer  based  on  the  employee’s 
• IRS.gov/Spanish (Español) • IRS.gov/Russian (Pусский) 
• IRS.gov/Chinese (中文)      • IRS.gov/Vietnamese (Tiếng Việt) share  of  the  premium  to  cover  only  the  employee. 

Feb 15, 2024

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Affordability of the employer coverage for these family are estimated to be able to take on your tax return. Adjust-
members is now based on the portion of the annual pre- ing your APTC when you re-enroll in coverage and during
mium the employee must pay for coverage of the em- the year can help you avoid owing tax when you file your
ployee and these other family members. tax return. Changes that you should report to the Market-
Applicable federal poverty line percentages. For tax place include the following.
years 2023 through 2025, taxpayers with household in- • Changes in household income.
come that exceeds 400% of the federal poverty line for
their family size may be allowed a PTC. • Moving to a different address.
• Gaining or losing eligibility for other health care cover-
age.
Reminders • Gaining, losing, or other changes to employment.
Health Coverage Tax Credit (HCTC). The HCTC ex- • Birth or adoption.
pired on December 31, 2021. Beginning in tax year 2022, • Marriage or divorce.
Form 8885 and its instructions have been discontinued by
• Other changes affecting the composition of your tax
the IRS.
family.
Health reimbursement arrangements (HRAs). Begin-
ning in 2020, employers can offer individual coverage For more information on how to report a change in
health reimbursement arrangements (individual coverage circumstances to the Marketplace, go to HealthCare.gov
HRAs) to help employees and their families with their or your state Marketplace website.
medical expenses. If you are offered an individual cover- Health insurance options. If you need health coverage,
age HRA, see Individual Coverage HRAs, later, for more go to HealthCare.gov to learn about health insurance op-
information on whether you can claim a PTC for you or a tions that are available for you and your family, how to pur-
member of your family for Marketplace coverage. chase health insurance, and how you might qualify to get
Qualified small employer health reimbursement ar- financial assistance with the cost of insurance.
rangement (QSEHRA). Under a QSEHRA, an eligible Additional information. For additional information about
employer can reimburse eligible employees for medical the tax provisions of the Affordable Care Act (ACA), in-
expenses, including premiums for Marketplace health in- cluding the individual shared responsibility provisions and
surance. If you were provided a QSEHRA, your employer the PTC, see IRS.gov/Affordable-Care-Act/Individuals-
should have reported the annual permitted benefit in and-Families or call the IRS Healthcare Hotline for ACA
box 12 of your Form W-2 with code FF. If the QSEHRA is questions (800-919-0452).
considered affordable coverage for a month, no premium
tax credit (PTC) is allowed for the month. If the QSEHRA Photographs of missing children. The Internal Reve-
is not considered affordable coverage for a month, you nue Service is a proud partner with the National Center for
may still be eligible for the PTC but you must reduce the Missing & Exploited Children® (NCMEC). Photographs of
monthly PTC (but not below -0-) by the monthly permitted missing children selected by the Center may appear in
benefit amount. For more information, see Qualified Small this publication on pages that would otherwise be blank.
Employer Health Reimbursement Arrangement, later. You can help bring these children home by looking at the
Requirement to reconcile advance payments of the photographs and calling 1-800-THE-LOST
premium tax credit. If you, your spouse with whom you (1-800-843-5678) if you recognize a child.
are filing a joint return, or a dependent was enrolled in
coverage through the Marketplace for 2023 and advance
payments of the premium tax credit (APTC) were made for Introduction
this coverage, you must file a 2023 return and attach Form
8962 to claim a net PTC. You (or whoever enrolled you) This publication covers the following general topics, relat-
should have received Form 1095-A, Health Insurance ing to the PTC, which are also covered in the Form 8962
Marketplace Statement, from the Marketplace with infor- instructions.
mation about your coverage and any APTC. You must at- What is the PTC?
•
tach Form 8962 even if someone else enrolled you, your
spouse, or your dependent. If you are a dependent who is • Who must file Form 8962.
claimed on someone else's 2023 return, you do not have • Who can take the PTC. (See Figure A, later.)
to attach Form 8962.
This publication also provides additional instructions for
Report changes in circumstances when you re-enroll taxpayers in the following special situations.
in coverage and during the year. If APTC is being paid
for an individual in your tax family (defined later) and you • Taxpayers who take the PTC and who are filing a sep-
have had certain changes in circumstances (see the ex- arate return from their spouses because of domestic
amples below), it is important that you report them to the abuse or spousal abandonment.
Marketplace where you enrolled in coverage. Reporting • Taxpayers who take the PTC and who are also provi-
changes in circumstances promptly will allow the ded a QSEHRA.
Marketplace to adjust your APTC to reflect the PTC you

2 Publication 974 (2023)

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• Taxpayers who need to calculate the PTC and APTC Useful Items
for a policy that covered an individual not lawfully You may want to see:
present in the United States.
• Taxpayers who need to determine the applicable sec- Form (and Instructions)
ond lowest cost silver plan (SLCSP) premium. 1095-A 1095-A Health Insurance Marketplace Statement
• Taxpayers who need to allocate policy amounts for in- 1095-B 1095-B Health Coverage
dividuals not included in any tax family. 1095-C 1095-C Employer-Provided Health Insurance Offer
• Taxpayers who need to allocate policy amounts be- and Coverage
cause one qualified health plan covers individuals 7206 7206 Self-Employed Insurance Deduction
from three or more tax families in the same month.
8962
• Taxpayers who married during the tax year and want 8962 Premium Tax Credit (PTC)
to use an alternative PTC calculation that may lower See How To Get Tax Help, at the end of this publication,
their taxes. for information about getting publications and forms.
• Self-employed taxpayers who wish to take the PTC
and the self-employed health insurance deduction.
This publication also provides additional information to What Is the Premium Tax Credit
help you determine if your health care coverage is mini-
mum essential coverage (MEC). (PTC)?

Comments and suggestions. We welcome your com- Premium tax credit (PTC). The PTC is a tax credit for
ments about this publication and suggestions for future certain people who enroll, or whose family member en-
editions. rolls, in a qualified health plan offered through a Market-
You can send us comments through IRS.gov/ place. The credit provides financial assistance to pay the
FormComments. Or, you can write to the Internal Revenue premiums for the qualified health plan by reducing the
Service, Tax Forms and Publications, 1111 Constitution amount of tax you owe, giving you a refund, or increasing
Ave. NW, IR-6526, Washington, DC 20224. your refund amount. You must file Form 8962 to compute
Although we can’t respond individually to each com- and take the PTC on your tax return.
ment received, we do appreciate your feedback and will
Advance payments of the premium tax credit (APTC).
consider your comments and suggestions as we revise
The APTC is a payment made during the year to your in-
our tax forms, instructions, and publications. Don’t send
surance provider that pays for part or all of the premiums
tax questions, tax returns, or payments to the above ad-
for a qualified health plan covering you or an individual in
dress.
your tax family. Your APTC eligibility is based on the Mar-
Getting answers to your tax questions. If you have ketplace’s estimate of the PTC you will be able to take on
a tax question not answered by this publication or the How your tax return. If APTC was paid for you or an individual in
To Get Tax Help section at the end of this publication, go your tax family, you must file Form 8962 to reconcile (com-
to the IRS Interactive Tax Assistant page at IRS.gov/ pare) this APTC with your PTC. If the APTC is more than
Help/ITA where you can find topics by using the search your PTC, you have excess APTC and you must repay the
feature or viewing the categories listed. excess, subject to certain limitations. If the APTC is less
than the PTC, you can get a credit for the difference, which
Getting tax forms, instructions, and publications.
reduces your tax payment or increases your refund.
Go to IRS.gov/Forms to download current and prior-year
forms, instructions, and publications. Changes in circumstances. The Marketplace deter-
Ordering tax forms, instructions, and publications. mined your eligibility for, and the amount of, your 2023
Go to IRS.gov/OrderForms to order current forms, instruc- APTC using projections of your income and the number of
tions, and publications; call 800-829-3676 to order individuals you certified to the Marketplace would be in
prior-year forms and instructions. The IRS will process your tax family (yourself, spouse, and dependents) when
your order for forms and publications as soon as possible. you enrolled in a qualified health plan. If this information
Don’t resubmit requests you’ve already sent us. You can changed during 2023 and you did not promptly report it to
get forms and publications faster online. the Marketplace, the amount of APTC paid may be sub-
stantially different from the amount of PTC you can take on
Questions about Form 1095-A, Health Insurance your tax return. See Report changes in circumstances
Marketplace Statement. If you or a member of your tax when you re-enroll in coverage and during the year, ear-
family was enrolled in a qualified health plan through a lier, for changes that can affect the amount of your PTC.
Marketplace in 2023, you should have received a Form
1095-A by early February 2024. Contact your Marketplace
if you do not receive a Form 1095-A or if you have ques-
tions about the accuracy of your Form 1095-A.

Publication 974 (2023) 3

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became eligible for APTC because of a successful
eligibility appeal and you retroactively enrolled in
Who Must File Form 8962 the plan, then the portion of the enrollment pre-
mium for which you are responsible must be paid
You must file Form 8962 with your income tax return (Form on or before the 120th day following the date of
1040, 1040-SR, or 1040-NR) if any of the following apply the appeals decision.
to you.
2. No one can claim you as a dependent for the year.
• You are taking the PTC.
3. You are an applicable taxpayer for 2023. To be an ap-
• APTC was paid for you or another individual in your
plicable taxpayer, you must meet all of the following
tax family.
requirements.
• APTC was paid for an individual you told the Market-
place would be in your tax family and neither you nor a. Your household income for 2023 is at least 100%
anyone else included that individual in a tax family. of the federal poverty line for your family size (see
See Individual you enrolled who is not included in a Line 4 in the Form 8962 instructions). However,
tax family under Lines 12 Through 23—Monthly Cal- having household income below 100% of the fed-
culation in the Form 8962 instructions. eral poverty line will not disqualify you from taking
the PTC if you meet certain requirements descri-
If any of the circumstances above apply to you, you bed under Household income below 100% of the
must file an income tax return and attach Form 8962 even federal poverty line under Line 5 in the Form 8962
if you are not otherwise required to file. You must use instructions.
Form 1040, 1040-SR, or 1040-NR. For help in determining
which of these forms to file, see the Instructions for Form b. If you were married at the end of 2023, you must
1040 or the Instructions for Form 1040-NR. generally file a joint return. However, filing a sepa-
rate return from your spouse will not disqualify you
from being an applicable taxpayer if you meet cer-
If you are filing Form 8962, you cannot file Form
tain requirements described under Married tax-
! 1040-SS or 1040-PR. payers, later.
CAUTION
You are not entitled to the PTC for health coverage for
If someone else enrolled an individual in your tax family an individual for any period during which the individual is
in coverage, and APTC was paid for that individual’s cov- not lawfully present in the United States.
erage, you must file Form 8962 to reconcile the APTC. You
need to obtain a copy of the Form 1095-A from the person For additional requirements and more details, see Ap-
who enrolled the individual. plicable taxpayer, later.
If you are claimed as a dependent, the person
TIP who claims you will file Form 8962 to take the PTC
and, if necessary, repay excess APTC for your Terms You May Need To Know
coverage. You do not need to file Form 8962.
The terms defined below are generally the same as those
in the Form 8962 instructions. However, additional infor-
mation is provided below on what documentation to keep
Who Can Take the PTC if you are a victim of domestic abuse or spousal abandon-
ment, and on MEC, later.
You can take the PTC for 2023 if you meet the conditions
under (1), (2), and (3) below. Tax family. For purposes of the PTC, your tax family con-
sists of the following individuals.
1. For at least 1 month of the year, all of the following
were true. • You, if you file a tax return for the year and you can't be
claimed as a dependent on someone else's 2023 tax
a. An individual in your tax family was enrolled in a return.
qualified health plan offered through the Market-
place on the first day of the month. • Your spouse if filing jointly and they can't be claimed
as a dependent on someone else's 2023 tax return.
b. That individual was not eligible for MEC for the
month, other than individual market coverage. An • Your dependents whom you claim on your 2023 tax re-
turn. If you are filing Form 1040-NR, you should in-
individual is generally considered eligible for MEC
clude your dependents in your tax family only if you
for the month only if they were eligible for every
are a U.S. national; a resident of Canada, Mexico, or
day of the month (see Minimum Essential Cover-
South Korea; or a resident of India who was a student
age, later).
or business apprentice.
c. The portion of the enrollment premiums (descri- Your family size equals the number of qualifying individ-
bed later) for the month for which you are respon- uals in your tax family (including yourself).
sible was paid by the due date of your tax return
(not including extensions). However, if you

4 Publication 974 (2023)

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Figure A. Can You Take the PTC?
This flowchart can help you determine whether you can take the PTC. But do not rely on this flowchart alone. Be sure you 
read Who Can Take the PTC, earlier, or in the Form 8962 instructions.

                                                           Start here
                       Were any of the individuals included in your tax family enrolled in a qualied              No
                       health plan through the Marketplace for at least 1 month during 2023?
                                                                 Yes

                No     Were any of these individuals eligible for MEC (other than individual           Yes
                       market coverage) for the months they were enrolled in the qualied health
                       plan? (See Minimum Essential Coverage, later.)

Can someone else claim you asa dependent            No                  Were all of these individuals eligible for MEC for
on another tax return for 2023?                                         all of the months they were enrolled in the
                                                                        qualied health plan?
          No                         Yes                                                                             Yes

Were the premiums paid by the due date of
your tax return (not including extensions)?         No                                                      You cannot take the PTC.
(A different due date applies in the case of a
successful eligibility appeal. See Enrollment
premiums.)
                                              Yes
                                   No
                                      Were you married at the end of 2023?
                                                               Yes
                                   Yes
                                      Are you and your spouse ling a joint return?
                                                               No

                                              Do you meet the requirements for Married persons who live apart 
                                   Yes        under Head of Household in the Instructions for Form 1040, or 
                                              Married Filing Separately under Filing Status in the Form 1040-NR 
                                              instructions?
                                                               No
                                                                                                                   No
                                              Are youa victim of domestic abuse or spousal abandonment?
                                                               Yes

            Yes        Was your household income at least 100% of the federal poverty 
                       line for your family size? (See the Form 8962 instructions.)
                                                               No
            At the time of enrollment, did the Marketplace estimate that your household income would be at least 
            100% of the federal poverty line for your family size for 2023?
                                                               Yes                           No                              Yes
         Yes
             Was APTC paid for 1 or more months during 2023?               No   Was everyone in your tax family a U.S. citizen?
                                                                                             No
You may be able to take the PTC.                                           Was at least one individual enrolled ina qualied    No
                                                                           health plan lawfully present in the United States?
                                                                                             Yes
                                                           Yes          Was at least one enrolled individual ineligible         No
                                                                        for Medicaid due to immigration status?

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Note. Listing your dependents by name and social se- in your tax family enrolled in a qualified health plan in 2023
curity number (SSN) or individual taxpayer identification and the enrollment was effective on the date of the individ-
number (ITIN) on your tax return is the same as claiming ual's birth, adoption, or placement for adoption or in foster
them as a dependent. If you have more than four depend- care, or on the effective date of a court order placing the
ents, see the Instructions for Form 1040 or the Instructions individual with your family, the individual is treated as en-
for Form 1040-NR. rolled as of the first day of that month. Therefore, the indi-
vidual may be a member of your tax family and coverage
Household income. For purposes of the PTC, house- family for the entire month for purposes of computing your
hold income is the modified adjusted gross income (modi- monthly credit amount.
fied AGI) of you and your spouse (if filing a joint return)
(see Line 2a in the Form 8962 instructions) plus the modi- Enrollment premiums. The enrollment premiums are
fied AGI of each individual whom you claim as a depend- the total amount of the premiums for the month, reduced
ent and who is required to file an income tax return be- by any premium amounts for that month that were refun-
cause their income meets the income tax return filing ded in the same tax year as the premium liability was in-
threshold (see Line 2b in the Form 8962 instructions). curred, for one or more qualified health plans in which any
Household income does not include the modified AGI of individual in your tax family enrolled. Form 1095-A, Part III,
those individuals whom you claim as dependents and who column A, reports the enrollment premiums.
are filing a 2023 return only to claim a refund of withheld You are generally not allowed a monthly credit amount
income tax or estimated tax. for the month if any part of the enrollment premiums for
which you are responsible that month has not been paid
Modified AGI. For purposes of the PTC, modified AGI by the due date of your tax return (not including exten-
is the AGI on your tax return plus certain income that is not sions). However, if you became eligible for APTC because
subject to tax (foreign earned income, tax-exempt interest, of a successful eligibility appeal and you retroactively en-
and the portion of social security benefits that is not taxa- rolled in the plan, the portion of the enrollment premium
ble). Use Worksheet 1-1 and Worksheet 1-2 in the Form for which you are responsible must be paid on or before
8962 instructions to determine your modified AGI. the 120th day following the date of the appeals decision.
Taxpayer's tax return including income of a de- Premiums another person pays on your behalf are treated
pendent child. A taxpayer who includes the gross in- as paid by you.
come of a dependent child on the taxpayer’s tax return If your share of the enrollment premiums is not paid, the
must include on Worksheet 1-2 the child’s tax-exempt in- issuer may terminate coverage. The termination is gener-
terest and the portion of the child’s social security benefits ally effective no sooner than the second month of nonpay-
that is not taxable. ment. For any months you were covered but did not pay
your share of the premiums, you are not allowed a monthly
Coverage family. Your coverage family includes all indi- credit amount.
viduals in your tax family who are enrolled in a qualified
Applicable SLCSP premium. The applicable SLCSP
health plan and are not eligible for MEC (other than indi-
premium is the second lowest cost silver plan premium of-
vidual market coverage). The individuals included in your
fered through the Marketplace where you reside that ap-
coverage family may change from month to month. If an
plies to your coverage family (described earlier). The
individual in your tax family is not enrolled in a qualified
SLCSP premium is not the same as your enrollment pre-
health plan, or is enrolled in a qualified health plan but is
mium unless you enroll in the applicable SLCSP. Form
eligible for MEC (other than individual market coverage),
1095-A, Part III, column B, generally reports the applicable
they are not part of your coverage family. Your PTC is
SLCSP premium. If no APTC was paid for your coverage,
available to help you pay only for the coverage of the indi-
Form 1095-A, Part III, column B, may be wrong or blank or
viduals included in your coverage family.
may report your applicable SLCSP premium as -0-. Also, if
Monthly credit amount. The monthly credit amount is you had a change in circumstances during 2023 that you
the amount of your tax credit for a month. Your PTC for the did not report to the Marketplace, the SLCSP premium re-
year is the sum of all of your monthly credit amounts. Your ported on Form 1095-A in Part III, column B, may be
credit amount for each month is the lesser of: wrong. In either case, you must determine your correct ap-
plicable SLCSP premium. You do not have to request a
• The enrollment premiums (described next) for the corrected Form 1095-A from the Marketplace. See Miss-
month for one or more qualified health plans in which ing or incorrect SLCSP premium on Form 1095-A under
you or any individual in your tax family enrolled, or Line 10 in the Form 8962 instructions.
• The amount of the monthly applicable SLCSP pre- Monthly contribution amount. Your monthly contri-
mium (described later) less your monthly contribution bution amount is used to calculate your monthly credit
amount (described later). amount. It is the amount of your household income you
To qualify for a monthly credit amount, at least one indi- would be responsible for paying as your share of premi-
vidual in your tax family must be enrolled in a qualified ums each month if you enrolled in the applicable SLCSP. It
health plan on the first day of that month. Generally, if cov- is not based on the amount of premiums you paid out of
erage in a qualified health plan began after the first day of pocket during the year. You will compute your monthly
the month, you are not allowed a monthly credit amount contribution amount in Part I of Form 8962.
for the coverage for that month. However, if an individual

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Qualified health plan. For purposes of the PTC, a quali-             son is enrolled individually or with lawfully present family 
fied health plan is a health insurance plan or policy pur-           members.
chased through a Marketplace at the bronze, silver, gold, 
or platinum level. Throughout this publication, a qualified          Married  taxpayers. If  you  are  considered  married  for 
health  plan  is  also  referred  to  as  a  “policy.”  Catastrophic federal  income  tax  purposes,  you  must  file  a  joint  return 
health  plans  and  stand-alone  dental  plans  purchased            with your spouse to take the PTC unless one of the two 
through the Marketplace, and all plans purchased through             exceptions below applies to you.
the Small Business Health Options Program (SHOP), are                 You are not considered married for federal income tax 
not qualified health plans for purposes of the PTC. There-           purposes if you are divorced or legally separated accord-
fore, they do not qualify a taxpayer to take the PTC.                ing to your state law under a decree of divorce or separate 
                                                                     maintenance. In that case, you cannot file a joint return but 
Applicable  taxpayer. You  must  be  an  applicable  tax-            may be able to take the PTC on your separate return. See 
payer  to  take  the  PTC.  Generally,  you  are  an  applicable     Pub. 501, Dependents, Standard Deduction, and Filing In-
taxpayer  if  your household  income  for  2023  (described          formation.
earlier) is at least 100% of the federal poverty line for your        If  you  are  considered  married  for  federal  income  tax 
family  size  (provided  in  Tables  1-1,  1-2,  and  1-3  in  the   purposes, you may be eligible to take the PTC without fil-
Form  8962  instructions)  and  no  one  can  claim  you  as  a      ing a joint return if one of the two exceptions below applies 
dependent for 2023. In addition, if you were married at the          to you. If Exception 1 applies, you can file a return using 
end of 2023, you must file a joint return to be an applicable        head of household or single filing status and take the PTC. 
taxpayer unless you meet one of the exceptions described             If Exception 2 applies, you are treated as married but can 
under Married taxpayers, later.                                      take the PTC with the filing status of married filing sepa-
For individuals with household income below 100% of                  rately.
the  federal  poverty  line,  see Household  income  below 
                                                                      Exception 1—Certain married persons living apart. 
100% of the federal poverty line under Line 5 in the Form 
                                                                     You may file your return as if you are unmarried and take 
8962  instructions.  However,  the  exception  described  un-
                                                                     the PTC if one of the following applies to you.
der Estimated household income at least 100% of the fed-
eral  poverty  line  in  the  Form  8962  instructions  does  not    • You file a separate return from your spouse on Form 
apply if, with intentional or reckless disregard for the facts,        1040 or 1040-SR because you meet the requirements 
you  provide  incorrect  information  to  the  Marketplace  for        for Married persons who live apart under Head of 
the year of coverage. You provide information with inten-              Household in the Instructions for Form 1040.
tional disregard for the facts if you know that the informa-           You file as single on your Form 1040-NR because you 
                                                                     •
tion provided is inaccurate. You provide information with a            meet the requirements for Married persons who live 
reckless disregard for the facts if you make little or no ef-          apart under Married Filing Separately in the Instruc-
fort to determine whether the information provided is accu-            tions for Form 1040-NR.
rate and your lack of effort to provide accurate information 
is  substantially  different  from  what  a  reasonable  person       Exception 2—Victim of domestic abuse or spousal 
would do under the circumstances.                                    abandonment.  If you are a victim of domestic abuse or 
                                                                     spousal abandonment, you can file a return as married fil-
Individuals who are incarcerated.   Individuals who are              ing separately and take the PTC for 2023 if all of the fol-
incarcerated  (other  than  pending  disposition  of  charges,       lowing apply to you.
for example, awaiting trial) are not eligible for coverage in 
a  qualified  health  plan  through  a  Marketplace.  However,       • You are living apart from your spouse at the time you 
                                                                       file your 2023 tax return.
these  individuals  may  be  applicable  taxpayers  and  take 
the PTC for the coverage of individuals in their tax families        • You are unable to file a joint return because you are a 
who are eligible for coverage in a qualified health plan.              victim of domestic abuse (described next) or spousal 
                                                                       abandonment (described below).
Individuals who are not lawfully present.      Individuals 
who are not lawfully present in the United States are not            • You check the box on your Form 8962 to certify that 
eligible  for  coverage  in  a  qualified  health  plan  through  a    you are a victim of domestic abuse or spousal aban-
Marketplace. They cannot take the PTC for their own cov-               donment.
erage and are not eligible for the repayment limitations in          • You have not used this exception to take the PTC in 
Table 5 (in the Form 8962 instructions) for APTC paid for              each of 2020, 2021, and 2022.
their  own  coverage.  However,  these  individuals  may  be 
applicable taxpayers and take the PTC for the coverage of             Domestic  abuse.   Domestic  abuse  includes  physical, 
individuals in their tax families, such as their children, who       psychological,  sexual,  or  emotional  abuse,  including  ef-
are lawfully present and eligible for coverage in a qualified        forts to control, isolate, humiliate, and intimidate, or to un-
health plan. For more information about who is treated as            dermine  the  victim's  ability  to  reason  independently.  All 
lawfully  present  for  this  purpose,  go  to HealthCare.gov.       the facts and circumstances are considered in determin-
See Individuals Not Lawfully Present in the United States            ing whether an individual is abused, including the effects 
Enrolled in a Qualified Health Plan, later, for more informa-        of alcohol or drug abuse by the victim’s spouse. Depend-
tion on reconciling APTC when an unlawfully present per-             ing on the facts and circumstances, abuse of an individu-
                                                                     al’s  child  or  other  family  member  living  in  the  household 

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may constitute abuse of the individual. If you have con- • Most coverage through government-sponsored pro-
cerns about your safety, please consider contacting the grams (including Medicaid coverage, Medicare Part A
confidential 24-hour National Domestic Violence Hotline or C, the Children's Health Insurance Program (CHIP),
at 1-800-799-SAFE (7233), or 1-800-787-3224 (TTY), or certain benefits for veterans and their families, TRI-
1-855-812-1001 (video phone, only for deaf callers). For CARE, and health coverage for Peace Corps volun-
additional information and resources, see Pub. 3865, Tax teers).
Information for Survivors of Domestic Abuse, available at
• Most types of employer-sponsored coverage.
IRS.gov/Pub3865; and Part V of Form 8857, Request for
Innocent Spouse Relief, available at IRS.gov/Form8857. • Grandfathered health plans.
Spousal abandonment. A taxpayer is a victim of • Other health coverage designated by the Department
spousal abandonment for a tax year if, taking into account of Health and Human Services (HHS) as MEC.
all facts and circumstances, the taxpayer is unable to lo- MEC does not include coverage consisting solely
cate their spouse after reasonable diligence. TIP of excepted benefits. Excepted benefits include
Records of domestic abuse and spousal abandon- vision and dental coverage not part of a compre-
ment. If you checked the box in the upper right corner of hensive health insurance plan, workers’ compensation
Form 8962 indicating that you are eligible for the PTC de- coverage, and coverage limited to a specified disease or
spite having a filing status of married filing separately, you illness.
should keep records relating to your situation, like with all
aspects of your tax return. What you have available may For more information on what is MEC, see IRS.gov/
depend on your circumstances. However, the following list Affordable-Care-Act/Individuals-and-Families/Individual-
provides some examples of records that may be useful. Shared-Responsibility-Provision.
(Do not attach these records to your tax return.)
Note. Your MEC may be reported to you on Form
• Protective and/or restraining order. 1095-A, 1095-B, or 1095-C.

• Police report. MEC eligibility when Marketplace does not discon-
• Doctor’s report or letter. tinue APTC. If an individual in your tax family is enrolled
in a qualified health plan for which APTC was made and
• A statement from someone who was aware of, or who
the individual is or will soon become eligible for other
witnessed, the abuse or the results of the abuse. The
MEC, you must notify the Marketplace about the other
statement should be notarized if possible.
MEC and that the APTC for the individual’s coverage
• A statement from someone who knows of the aban- should be discontinued. If the Marketplace does not dis-
donment. The statement should be notarized if possi- continue APTC for the first calendar month beginning after
ble. the month you notify the Marketplace, the individual is
treated as eligible for the other MEC no earlier than the
Married filing separately. If you file as married filing first day of the second calendar month beginning after the
separately and are not a victim of domestic abuse or first month the individual may enroll in the other MEC. A
spousal abandonment (see Exception 2—Victim of do- different rule applies to Medicaid and CHIP eligibility, dis-
mestic abuse or spousal abandonment under Married tax- cussed later under Government-Sponsored Programs.
payers, earlier), then you are not an applicable taxpayer
and you cannot take the PTC. You must generally repay all
of the APTC paid for a qualified health plan that covered Expatriate Health Plans
only individuals in your tax family. If the policy also cov-
In general, an expatriate health plan is certain health in-
ered at least one individual in your spouse’s tax family, you
surance coverage that is offered to foreign nationals who
must generally repay half of the APTC paid for the policy.
are temporarily assigned for work in the United States,
See Line 9 in the Form 8962 instructions. However, the
U.S. residents who are temporarily working outside of the
amount of APTC you have to repay may be limited. See
United States, and certain nonemployees (such as stu-
Line 28 in the Form 8962 instructions.
dents and missionaries) who are traveling internationally.
To qualify, the health insurance coverage must generally
offer a minimum level of benefits in the region in which the
Minimum Essential Coverage covered individual is temporarily located and be offered by
a qualifying expatriate health insurance issuer. An expatri-
(MEC) ate health plan is considered employer-sponsored cover-
age for a primary insured who receives it through their em-
Under the health care law, certain health coverage is ployer (and for that employee’s covered dependents). It is
called MEC. You generally cannot take the PTC for an indi- considered individual market coverage for any other pri-
vidual in your tax family for any month that the individual is mary insured.
eligible for MEC, except for individual market coverage
(defined below). MEC includes the following.
• Individual market coverage (including qualified health
plans).

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Individual Market Coverage b. Coverage for a line-of-duty-related injury, illness,
or disease for individuals who have left active duty.
A health plan offered in the individual market is health in- 6. The following coverage administered by the Depart-
surance coverage provided to an individual by a health in- ment of Veterans Affairs.
surance issuer licensed by a state, including a qualified
health plan offered through the Marketplace. Even though a. Coverage consisting of the medical benefits pack-
these plans are MEC, eligibility for individual market cover- age for eligible veterans.
age does not prevent an individual from qualifying for the b. Civilian Health and Medical Program of the De-
PTC for coverage in a qualified health plan purchased partment of Veterans Affairs (CHAMPVA).
through the Marketplace.
c. Comprehensive health care for children suffering
Individual market coverage also includes coverage un- from spina bifida who are the children of Vietnam
der certain expatriate health plans offered to students and veterans and veterans of covered service in Ko-
religious missionaries traveling internationally. See Expa- rea.
triate Health Plans, earlier. 7. Health coverage provided to Peace Corps volunteers.
8. Refugee Medical Assistance.
Government-Sponsored Programs
9. Coverage through a Basic Health Program (BHP)
The following government-sponsored programs are MEC. standard health plan.
1. Medicare Part A coverage. In general, you cannot get the PTC for your coverage in
a qualified health plan if you are eligible for govern-
2. Medicare Advantage plans.
ment-sponsored MEC. You are generally considered eligi-
3. Medicaid, except for the following programs. ble for a government-sponsored program if you meet the
criteria for coverage under the program. But see Excep-
a. Optional coverage of family planning services. tions, later. However, you will not lose the PTC for your
b. Optional coverage of tuberculosis-related serv- coverage until the first day of the first full month you can
ices. receive benefits under the government-sponsored pro-
gram. If you can be covered under a government-spon-
c. Coverage of pregnancy-related services in states sored program, you must complete the requirements nec-
that do not provide full Medicaid benefits on the essary to receive benefits (for example, submitting an
basis of pregnancy. application or providing required information) by the last
d. Coverage limited to the treatment of emergency day of the third full calendar month following the event that
medical conditions. establishes eligibility (for example, becoming eligible for
Medicare when you turn 65). If you do not complete the
e. Coverage of medically needy individuals (except necessary requirements in this time, you will lose the PTC
for coverage for medically needy individuals that for your coverage in a qualified health plan beginning with
HHS has designated as MEC—see Other Cover- the first day of the fourth calendar month following the
age Designated by the Department of Health and event that makes you eligible for the government cover-
Human Services, later). age.
f. Coverage under a section 1115 demonstration
Example 1. Ellen was enrolled in a qualified health
waiver program (except for coverage under a sec-
plan with APTC. She turned 65 on June 3 and became eli-
tion 1115 demonstration program that HHS has
gible for Medicare. Ellen must apply to Medicare to re-
designated as MEC—see Other Coverage Desig-
ceive benefits. She applied to Medicare in September and
nated by the Department of Health and Human
was eligible to receive Medicare benefits beginning on
Services, later).
December 1. Ellen completed the requirements necessary
Call your state Medicaid office if you have any to receive Medicare benefits by September 30 (the last
questions about the coverage you have. day of the third full calendar month after the event that es-
tablished her eligibility, turning 65). She was eligible for
4. CHIP, except certain CHIP coverage for pregnancy
Medicare coverage on December 1, the first day of the
services. (Certain coverage often called a CHIP
first full month that she could receive benefits. Thus, Ellen
buy-in program is not considered a government-spon-
can get the PTC for her coverage in the qualified health
sored program and is discussed later under Other
plan for January through November. Beginning in Decem-
Coverage Designated by the Department of Health
ber, Ellen cannot get the PTC for her coverage in the quali-
and Human Services.)
fied health plan because she is eligible for Medicare.
5. Coverage under the TRICARE program, except for the
following programs. Example 2. The facts are the same as in Example 1,
except that Ellen did not apply for the Medicare coverage
a. Coverage on a space-available basis in a military by September 30. Ellen is considered eligible for govern-
treatment facility for individuals who are not eligi- ment-sponsored coverage beginning on October 1. She
ble for TRICARE coverage for private sector care. can get the PTC for her coverage for January through

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September. She cannot get the PTC for her coverage in a of coverage under a qualified health plan if, when the indi-
qualified health plan as of October 1, the first day of the vidual enrolled in the qualified health plan, the Market-
fourth month after she turned 65. place determined that the individual was ineligible for
Medicaid or CHIP based on the applicable Medicaid and
Exceptions. While you are generally considered eligible CHIP income standards. However, this exception does not
for government-sponsored MEC (and are ineligible for the apply if you, or the individual you are including in your tax
PTC) if you are able to enroll in that coverage, you are family, with intentional or reckless disregard for the facts,
considered eligible for government-sponsored coverage provided incorrect information to the Marketplace for the
under the following programs only if you are enrolled in year of coverage. You provide information with intentional
the program. disregard for the facts if you know that the information pro-
1. A veteran’s health care program listed in (6), earlier. vided is inaccurate. You provide information with a reck-
less disregard for the facts if you make little or no effort to
2. The following TRICARE programs. determine whether the information provided is accurate
a. The Continued Health Care Benefit Program. and your lack of effort to provide accurate information is
substantially different from what a reasonable person
b. Retired Reserve. would do under the circumstances.

c. Young Adult. Example. In November, Catelyn enrolled in a qualified
d. Reserve Select. health plan for the following year and got APTC for her
coverage. The Marketplace determined that Catelyn was
3. Medicaid coverage for comprehensive pregnancy-re- ineligible for Medicaid and estimated that her household
lated services and CHIP coverage based on preg- income will be 140% of the federal poverty line for her
nancy, if the individual is enrolled in a qualified health family size for purposes of determining APTC. During the
plan at the time the individual becomes eligible for year, Catelyn lost her job and her household income for
Medicaid or CHIP. 2023 is 130% of the federal poverty line (within the Medic-
4. Coverage under Medicare Part A for which the individ- aid income threshold). For purposes of the PTC, Catelyn
ual must pay a premium. is treated as ineligible for Medicaid for 2023. Catelyn may
be eligible for the PTC for the entire year.
In addition, an individual is considered eligible for MEC
under a Medicaid or Medicare program for which eligibility Medicaid or CHIP eligibility when Marketplace does
requires a determination of disability, blindness, or illness not discontinue APTC. If a determination is made that
only when the responsible agency makes a favorable eligi- an individual who is enrolled in a qualified health plan for
bility determination. which APTC is made is eligible for Medicaid or CHIP but
the Marketplace does not discontinue APTC for the first
Retroactive coverage. If APTC is being paid for cover- calendar month beginning after the eligibility determina-
age in a qualified health plan and you become eligible for tion, the individual is treated as eligible for Medicaid or
government-sponsored coverage that is effective retroac- CHIP no earlier than the first day of the second calendar
tively (such as Medicaid or CHIP), you will not retroac- month beginning after the eligibility determination.
tively lose the PTC for your coverage. You can get the PTC
for your coverage until the first day of the first calendar
month after you are approved for the government cover- Employer-Sponsored Plans
age.
The following employer-sponsored plans are MEC.
Example. In November, Freda enrolled in a qualified
1. Group health insurance coverage for employees un-
health plan for the following year and got APTC for her
der:
coverage. Freda lost her part-time job and on April 10 ap-
plied for coverage under the Medicaid program. Freda’s a. An insured plan or coverage offered in the small or
application was approved on May 15, with Medicaid cov- large group market within a state;
erage retroactively effective April 1. For purposes of the
b. A governmental plan, such as the Federal Employ-
PTC, Freda is considered eligible for government-spon-
ees Health Benefits Program; or
sored coverage on June 1, the first day of the first calen-
dar month after her application was approved. Freda may c. A grandfathered health plan offered in a group
be eligible for the PTC for January through May. market.
Termination for nonpayment of premiums. If Med- 2. A self-insured group health plan for employees.
icaid or CHIP coverage for you or a family member is ter-
3. Coverage under certain expatriate health plans for
minated due to nonpayment of premiums, you cannot get
employees (discussed earlier).
the PTC for the coverage of that individual (for the remain-
der of the year of the termination). 4. The Nonappropriated Fund Health Benefits Program
of the Department of Defense.
Determining eligibility for Medicaid or CHIP at enroll-
ment. An individual is treated as ineligible for Medicaid, In general, these employer-sponsored plans may also
CHIP, and similar programs (such as a BHP) for the period include retiree or COBRA coverage.

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Employer-sponsored plans that are MEC are also refer-               child under age 26) is considered eligible for the employer 
red to as “eligible employer-sponsored plans.”                      coverage for PTC purposes only for the months the indi-
                                                                    vidual is enrolled in the employer coverage.
Exceptions.  The following paragraphs discuss when em-
ployer-sponsored plans are not considered MEC and the               How to determine if the plan is affordable.          Your em-
circumstances  in  which  you  may  be  eligible  for  the  PTC     ployer coverage is generally considered affordable for you 
even  if  you  have  an  offer  of  coverage  under  an  em-        if  your  share  of  the  annual  cost  for  self-only  coverage, 
ployer-sponsored plan.                                              which is sometimes referred to as the “employee required 
                                                                    contribution,” is not more than 9.12% of your tax family’s 
Excepted  benefits.    Employer-sponsored  health  cov-
                                                                    household  income  for  2023.  Your  employer  coverage  is 
erage that is limited to excepted benefits is not MEC. Ex-
                                                                    generally considered affordable for the other members of 
cepted  benefits  include  stand-alone  vision  and  dental 
                                                                    your  tax  family  eligible  to  enroll  in  the  coverage  if  your 
plans,  workers'  compensation  coverage,  and  coverage 
                                                                    share  of  the  annual  cost  for  coverage  for  you  and  your 
limited to a specified disease or illness.
                                                                    other tax family members is not more than 9.12% of your 
Affordability  and  minimum  value.       Even  if  you  had        family’s household income for 2023. If your employer cov-
the opportunity to enroll in coverage offered by your em-           erage is affordable for you but not affordable for your other 
ployer that qualifies as MEC, you are considered eligible           family members, you may be able to take the PTC for your 
for an employer-sponsored plan (and cannot get the PTC              other family members if they enroll in a Marketplace quali-
for your coverage in a qualified health plan) only if the em-       fied health plan. For 2024, this annual cost threshold will 
ployer-sponsored  coverage  is affordable  (defined  later)         decrease to 8.39%. However, employer-sponsored cover-
and the coverage provides minimum value (defined later).            age is not considered affordable if, when you or a family 
Your  tax  family  members  may  also  be  unable  to  get  the     member enrolled in a qualified health plan, you gave accu-
PTC for coverage in a qualified health plan for months they         rate  information  about  the  availability  of  employer  cover-
were eligible to enroll in employer-sponsored coverage of-          age to the Marketplace, and the Marketplace determined 
fered  to  them  by  your  employer  but  only  if  the  coverage   that you were eligible for APTC for the individual’s cover-
qualifies as MEC and was affordable and provided mini-              age in the qualified health plan. See Determining afforda-
mum value. In addition, if you or your family member en-            bility at the time of enrollment, later, for more information 
rolls in the employer coverage that qualifies as MEC, the           on this rule.
individual  enrolled  cannot  get  the  PTC  for  coverage  in  a 
                                                                    Certain employer arrangements.        An employee’s re-
qualified health plan, even if the employer coverage is not 
                                                                    quired contribution for employer-sponsored coverage may 
affordable or does not provide minimum value.
                                                                    be  affected  by  various  arrangements  offered  by  the  em-
Waiting periods and other periods without access                    ployer.
to benefits. You are not considered eligible for employer 
                                                                    Wellness  program  incentives.  If  the  employer  that 
coverage,  and  can  get  the  PTC  for  your  coverage  in  a 
                                                                    offered you (or your spouse) employer-sponsored cover-
qualified  health  plan  if  you  are  otherwise  eligible,  for  a 
                                                                    age for 2023 also offered a wellness incentive that poten-
month  when  you  cannot  receive  benefits  under  the  em-
                                                                    tially affected the amount that you had to pay toward cov-
ployer coverage (for example, you are in a waiting period 
                                                                    erage,  the  following  rules  apply:  If  the  condition  for 
before  the  employer  coverage  becomes  effective).  How-
                                                                    satisfying the wellness incentive (in other words, the con-
ever, if you could have enrolled in employer coverage that 
                                                                    dition the employee must meet to pay the smaller amount 
is MEC and is affordable and provides minimum value and 
                                                                    for coverage) relates exclusively to tobacco use, your re-
you did not enroll during an enrollment period, you cannot 
                                                                    quired  contribution  is  based  on  the  amount  you  would 
get the PTC for your coverage in a qualified health plan for 
                                                                    have paid for coverage if you had satisfied the condition 
the remainder of the plan year to which the enrollment pe-
                                                                    for the wellness incentive. Wellness incentives relating ex-
riod  related.  If  the  enrollment  period  related  to  coverage 
                                                                    clusively to tobacco use are treated as satisfied in deter-
for more than one plan year, and you do not have another 
                                                                    mining  your  required  contribution  regardless  of  whether 
opportunity  to  enroll  in  the  employer  coverage  for  plan 
                                                                    you would have actually earned the incentive had you en-
years following the initial plan year, you can take the PTC 
                                                                    rolled  in  the  coverage.  If  factors  other  than  tobacco  use 
for your coverage in a qualified health plan during those 
                                                                    are part of the condition for satisfying the wellness incen-
later plan years, if you are otherwise eligible.
                                                                    tive,  your  required  contribution  is  based  on  the  amount 
Coverage  after  employment  ends.        If  your  employ-         you  would  have  paid  for  coverage  had  you  not  satisfied 
ment with an employer ends and you are offered employer             the wellness incentive.
coverage by your former employer (for example, COBRA 
                                                                    Example.     George  can  enroll  in  employer  coverage. 
or  retiree  coverage),  you  are  considered  eligible  for  that 
                                                                    George’s  monthly  premiums  for  self-only  coverage  are 
employer coverage for PTC purposes only for the months 
                                                                    $450. If George, who is a smoker, attends a smoking ces-
that you are enrolled in the employer coverage. This same 
                                                                    sation  class,  his  monthly  premiums  will  be  reduced  by 
rule applies to an individual who may enroll in the cover-
                                                                    $100.  If  George  completes  a  cholesterol  screening,  his 
age by reason of a relationship to a former employee.
                                                                    monthly premiums will be reduced by $50. Whether or not 
Individual not in your tax family.        An individual who         George  actually  completes  either  of  these  wellness  pro-
can enroll in your employer coverage who is not a member            gram incentives, for purposes of determining whether the 
of  your  tax  family  (for  example,  an  adult  non-dependent     coverage  is  affordable  for  George,  his  required 

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contribution will be considered to be the amount reduced            contribution  for  employer-sponsored  coverage  is  in-
by  the  $100  incentive  for  attending  a  smoking  cessation     creased by amounts that the employer offered to pay you 
class but not reduced by the $50 incentive for completing           for  declining  the  coverage.  In  some  cases,  an  employer 
a cholesterol screening. Therefore, for purposes of deter-          may make this opt-out payment only if the employee both 
mining  whether  his  coverage  is  considered  affordable,         declines the coverage and also satisfies another condition 
George’s required contribution is $350.                             (such as enrolling in coverage offered by the employee's 
                                                                    spouse). If your employer imposed other conditions on re-
Health reimbursement arrangements (HRAs).   If the 
                                                                    ceiving  the  opt-out  payment  (in  addition  to  declining  the 
employer  that  offered  you  employer-sponsored  coverage 
                                                                    employer's  health  coverage),  you  may  treat  the  opt-out 
for  2023  also  contributed  (or  offered  to  contribute)  to  an 
                                                                    payment as increasing the employee's required contribu-
HRA  that  may  be  used  to  pay  premiums  for  the  em-
                                                                    tion only if you can demonstrate that you met the condi-
ployer-sponsored coverage, your required contribution for 
                                                                    tions (such as enrolling in coverage offered by your spou-
the  employer-sponsored  coverage  is  reduced  by  the 
                                                                    se's employer).
amount the employer contributed (or offered to contribute) 
to the HRA for 2023, as long as you were informed of the            More  information  about  employer  arrangements. 
HRA  contribution  offer  by  a  reasonable  time  before  you      You  should  contact  your  employer  if  you  have  questions 
had to decide whether to enroll in the coverage. Employ-            about the effect of the employer arrangements described 
ers may offer you alternative or additional HRA coverage.           above on your required contribution.
See Individual coverage HRAs next.
                                                                            If your employer or the employer of a family mem-
Individual coverage HRAs.   Starting in 2020, employ-               !       ber  offered  MEC  providing  minimum  value  and 
ers can offer individual coverage HRAs to help employees            CAUTION provided  you  a  Form  1095-C  and  the  employer 
and their families with their medical expenses. Under an            also  offered  a  non-health  flex  contribution  or  an  opt-out 
individual coverage HRA, employers can reimburse eligi-             payment, the amount reported on line 15 of Form 1095-C 
ble employees for medical expenses, including premiums              may  not  accurately  reflect  the  amount  of  your  required 
for Marketplace health insurance.                                   contribution  for  purposes  of  the  PTC.  If  you  have  ques-
If you were covered under an individual coverage HRA                tions about the amount reported on line 15, contact your 
for 2023, you are not allowed a PTC for your 2023 Market-           employer using the contact number provided on the Form 
place  health  insurance.  Also,  if  another  member  of  your     1095-C.
tax family was covered under an individual coverage HRA 
for 2023, you are not allowed a PTC for the family mem-             Determining affordability at the time of enrollment. 
ber's 2023 Marketplace health insurance. If you or a family         Your  employer  coverage  is  not  considered  affordable  if, 
member could have been covered by an individual cover-              when you enroll in a qualified health plan, the Marketplace 
age  HRA  for  2023,  but  you  opted  out  of  receiving  reim-    determines  that  your  required  contribution  for  employer 
bursements under the individual coverage HRA, you may               coverage  will  be  more  than  9.12%  of  what  the  Market-
be  allowed  a  PTC  for  your,  and  your  family  member's,       place estimates will be your household income and there-
Marketplace  health  insurance  if  the  individual  coverage       fore  that  you  are  eligible  for  APTC  for  coverage  in  the 
HRA is considered unaffordable.                                     qualified  health  plan.  Eligibility  for  employer  coverage  in 
                                                                    this situation does not disqualify you from taking the PTC 
Qualified small employer health reimbursement ar-                   when you file your tax return, even if your required contri-
rangements (QSEHRAs).  If your employer provided you                bution  for  coverage  was  not  more  than  9.12%  of  the 
with a QSEHRA, special rules apply. See Qualified Small             household  income  on  your  return.  However,  you  will  be 
Employer  Health  Reimbursement  Arrangement,  later,  for          treated as eligible for affordable employer coverage based 
more details.                                                       on the household income on your tax return if:
Health flex contributions.  If the employer that offered            • You did not provide current information to the Market-
you  (or  your  spouse)  employer-sponsored  coverage  for            place relating to your household income and the re-
2023 also made (or offered to make) a health flex contri-             quired contribution for your employer coverage during 
bution  for  2023,  your  required  contribution  for  the  em-       each annual re-enrollment period, or
ployer-sponsored  coverage  is  reduced  by  the  amount  of 
the health flex contribution (or offer). A health flex contri-      • You provided incorrect information to the Marketplace 
bution is an employer contribution to a cafeteria plan that           about your required contribution with intentional or 
may be used only to pay for medical care (and not taken               reckless disregard for the facts.
as cash or other taxable benefits) and is available for use         You  provide  information  with  intentional  disregard  for 
toward the purchase of MEC. Cafeteria plan contributions            the facts if you know that the information provided is inac-
that  may  be  used  for  expenses  other  than  medical  care      curate. You provide information with a reckless disregard 
are not health flex contributions and so do not reduce your         for  the  facts  if  you  make  little  or  no  effort  to  determine 
required contribution.                                              whether  the  information  provided  is  accurate  and  your 
                                                                    lack  of  effort  to  provide  accurate  information  is  substan-
Opt-out  payments.     If  the  employer  that  offered  you 
                                                                    tially  different  from  what  a  reasonable  person  would  do 
(or your spouse) employer-sponsored coverage for 2023 
                                                                    under the circumstances.
offered you an additional payment if you declined to enroll 
in  the  coverage  (an  “opt-out  payment”),  your  required 

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The employer coverage offered by the various employ- Example 5. Elsa is married and has two dependent
ers in the following examples qualifies as MEC. children. Her household income for 2023 was $39,000. El-
sa’s employer offered only self-only coverage to employ-
Example 1. Celia is single and has no dependents.
ees. No family coverage was offered. The plan had a re-
Her household income for 2023 was $47,000. Celia’s em-
quired contribution of $3,000 for self-only coverage for
ployer offered its employees a health insurance plan that
2023 (7.69% of Elsa’s household income) and provided
provided minimum value and for which the required contri-
minimum value. Because Elsa’s required contribution for
bution was $3,450 for self-only coverage for 2023 (7.34%
self-only coverage was not more than 9.12% of household
of Celia’s household income). Because Celia’s required
income, her employer’s plan is considered affordable for
contribution for self-only coverage did not exceed 9.12%
Elsa. Thus, Elsa is considered eligible for the employer
of household income, her employer’s plan is considered
coverage for 2023 and cannot get the PTC for coverage in
affordable for Celia, and Celia is considered eligible for
a qualified health plan. However, because Elsa’s employer
the employer coverage for all months in 2023. Celia can-
did not offer coverage to Elsa’s spouse and children, Elsa
not get the PTC for coverage in a qualified health plan.
could take the PTC for her spouse and two children if they
Example 2. The facts are the same as in Example 1, enrolled in a qualified health plan and otherwise qualify.
except that Celia is married to Jon, they file a joint return
Determining affordability for part-year period. If
for 2023, and the employer’s plan required Celia to con-
you are employed for part of a year or employed by differ-
tribute $5,300 for coverage for Celia and Jon for 2023
ent employers during the year, you determine whether
(11.28% of Celia’s household income). Because Celia’s
your coverage is affordable by looking separately at each
required contribution for coverage for herself and Jon ex-
coverage period that is less than a full calendar year. For
ceeds 9.12% of household income, her employer’s plan is
each period, the coverage is affordable if your required
considered not affordable for Jon and Jon is considered
contribution for the entire year would not be more than
not eligible for the employer coverage. Celia is, however,
9.12% of your household income for the year.
considered eligible for the employer coverage for all
months in 2023 and cannot get the PTC for coverage in a Example. Elvis was enrolled in a qualified health plan
qualified health plan because her cost to enroll in the cov- without APTC beginning in January 2023. He began work-
erage does not exceed 9.12% of their household income. ing for a new employer in May that offers health insurance
Jon is allowed a PTC if he does not enroll in the employer coverage with a calendar year plan year. Elvis’ required
coverage, enrolls in a qualified health plan through the contribution for the employer coverage for the remainder
Marketplace for 1 or more months in 2023, and is other- of the year was $200/month, which would be $2,400 for
wise allowed a PTC. the full plan year. Elvis does not enroll in the employer
coverage or inform the Marketplace of the offer of em-
Example 3. Don was eligible to enroll in employer cov-
ployer coverage. Elvis’ household income for the year is
erage in 2023. Don’s required contribution for self-only
$20,000. Elvis’ employer coverage is considered unafford-
coverage that provided minimum value was $3,550. Don
able for the period May through December because his
applied for coverage in a qualified health plan through the
required contribution for the full plan year, $2,400, is more
Marketplace. The Marketplace projected that Don’s 2023
than 9.12% of his household income. As a result, Elvis
household income would be $37,000 and determined that
could take the PTC for January through December if he
Don’s employer coverage was unaffordable because
otherwise qualifies.
Don’s required contribution was more than 9.12% of Don’s
household income. Don enrolled in a qualified health plan Coverage year not a calendar year. If your employ-
through the Marketplace with APTC and not in the em- er’s plan year is not the calendar year and you are a calen-
ployer coverage. In December, Don received an unexpec- dar year taxpayer, you determine whether your coverage
ted $2,500 bonus, which increased his 2023 household is affordable by looking separately at the portion of the cal-
income to $39,500. Although Don’s required contribution endar year in each plan year. A coverage period in 2023
for the employer coverage was not more than 9.12% of the that falls in a plan year beginning in 2022 is considered af-
household income on Don’s tax return, Don is considered fordable if your required contribution for the entire plan
not eligible for the employer coverage for 2023 because year is not more than 9.61% of your household income for
the Marketplace estimated that the employer coverage 2023. A coverage period in 2023 that falls in a plan year
would cost more than 9.12% of Don’s household income. beginning in 2023 is considered affordable if your required
Don can get the PTC if he otherwise qualifies. contribution for the entire plan year is not more than
9.12% of your household income for 2023.
Example 4. Hal was eligible for employer coverage for
2023. His required contribution for self-only coverage was The employer coverage offered by the various employ-
$3,400, and Hal enrolled in the coverage. His household ers in the following examples qualifies as MEC.
income for 2023 was $33,000, which means that his re-
Example 1. Tim’s employer offers health insurance
quired contribution was more than 9.12% of his household
coverage with a plan year of July 1 through June 30. His
income. Even though the employer coverage was not af-
required contribution for the plan year that began on July
fordable, Hal cannot get the PTC for coverage in a quali-
1, 2022, was $250 per month ($3,000 for the entire plan
fied health plan because he enrolled in the employer cov-
year). Tim enrolled in a qualified health plan on January 1,
erage.
2023, and did not apply for APTC. Tim’s household
income for 2023 is $30,000. Tim’s required contribution for

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the plan year, $3,000, is 10% of his household income for Qualified Small Employer Health
2023. Because 10% is more than 9.61% (the required
contribution percentage for the plan year beginning in Reimbursement Arrangement
2022), Tim’s employer coverage for January 1, 2023, (QSEHRA)
through June 30, 2023, is not considered affordable, and
Tim can take the PTC for those months if he is otherwise Under a QSEHRA, an eligible employer can reimburse eli-
eligible. gible employees for medical expenses, including premi-
For the plan year that began on July 1, 2023, Tim’s re- ums for a qualified health plan purchased through the
quired contribution was reduced to $200 per month (or Marketplace. An eligible employer is one that, in general,
$2,400 for the entire plan year). Tim’s required contribu- employs fewer than 50 full-time employees and does not
tion of $2,400 is 8% of his 2023 household income. Be- offer a group health plan.
cause 8% is not more than 9.12% (the required contribu- A QSEHRA is an arrangement that meets all the follow-
tion percentage for the plan year beginning in 2023), Tim’s ing requirements.
employer coverage for July 1, 2023, through December
31, 2023, is considered affordable and he is not eligible 1. The arrangement is funded solely by the employer,
for the PTC for those months. and no salary reduction contributions may be made
under the arrangement.
Example 2. Maria’s employer offers health insurance
coverage with a plan year of September 1 through August 2. The arrangement provides, after the eligible employee
31. Maria’s required contribution for the employer cover- provides proof of coverage, for the payment or reim-
age for the plan year September 1, 2023, through August bursement of the medical expenses incurred by the
31, 2024, is $3,700. Maria’s household income for 2023 is employee or the employee's family members.
$37,000. Maria’s employer coverage is considered unaf- 3. The amount of payments and reimbursements
fordable for the period September 1 through December doesn’t exceed $5,850 ($11,800 for family coverage)
31, 2023, because her required contribution for the plan for 2023.
year, $3,700, is more than 9.12% of her 2023 household
income. If Maria enrolls in a qualified health plan for 2024 4. The arrangement is generally provided on the same
and requests APTC, the Marketplace will determine terms to all eligible employees. However, the employ-
whether the employer coverage is considered affordable er's QSEHRA may exclude employees who haven't
for the period January 1, 2024, through August 31, 2024, completed 90 days of service, employees who haven't
by comparing Maria’s required contribution for the plan attained age 25 before the beginning of the plan year,
year beginning in 2023, $3,700, to her estimated 2024 part-time or seasonal employees, employees covered
household income. by a collective bargaining agreement if health benefits
were the subject of good-faith bargaining, and em-
How to determine if a plan provides minimum value. ployees who are nonresident aliens with no earned in-
An employer-sponsored plan provides minimum value come from sources within the United States.
only if the plan pays at least 60% of the total allowed costs
If you are provided a QSEHRA, and it is considered af-
of benefits for a standard population and provides sub-
fordable coverage for a month, no PTC is allowed for that
stantial coverage of inpatient hospitalization services and
month. If the QSEHRA is not considered affordable cover-
physician services. A plan meets the 60% rule only if an
age for 1 or more months, you may still be eligible for the
employee’s expected cost-sharing (deductibles, co-pays,
PTC. If you are eligible for the PTC for any month for which
and co-insurance) under the plan is no more than 40% of
you are provided a QSEHRA, you must reduce your PTC
the cost of the benefits. This percentage is based on ac-
(but not below -0-) for that month by the monthly QSEHRA
tuarial principles using benefits provided to a standard
permitted benefit amount. The monthly permitted benefit
population and is not based on what you actually pay for
amount is the maximum QSEHRA benefit amount an eligi-
cost sharing.
ble employee is allowed per month. See Permitted benefit
Your employer must provide you with a summary of
reported on Form W-2, later, and Worksheet Q for more
benefits and coverage (SBC) on or before the first day of
information.
the open enrollment period for the plan you are enrolled in
for the current coverage period. The employer must also Written notice of QSEHRA. If you were provided a
provide you with SBCs you request for other plans in QSEHRA during 2023, your employer should have provi-
which you can enroll. If you are not enrolled in a plan, the ded written notice to you by the later of October 3, 2022,
employer must provide you with the SBCs for all plans in or 90 days before the first day of the plan year of the
which you can enroll. The SBC will tell you whether an QSEHRA, or if you're an employee who is not eligible to
employer-sponsored plan provides minimum value. If your participate at the beginning of the year, the date on which
employer sent you a Form 1095-C, line 14 of that form will you're first eligible to participate in the QSEHRA. The in-
include an indicator code telling you if your employer of- formation in this notice is necessary to determine how the
fered you a health plan in the previous year that provided QSEHRA affects your PTC. The permitted benefit for
minimum value. self-only coverage as reported by the employer in the
written notice is used to determine whether the QSEHRA
is considered affordable coverage, regardless of whether
the permitted benefit provided to you is for self-only or

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family coverage. If the notice provided to you does not in-
clude a permitted benefit amount for self-only coverage,
you must contact your employer to get that information.
Use Worksheet N to determine whether your QSEHRA is
considered affordable coverage for the months of the year
that you were provided the QSEHRA. You will need the
notice provided by your employer and the permitted bene-
fit for self-only coverage to complete Worksheet N.

Permitted benefit reported on Form W-2. Your em-
ployer should have reported your annual permitted benefit
(self-only or family amount, as applicable) in box 12 of
your Form W-2 with code FF. Your permitted benefit
amount, as reported to you by your employer on Form
W-2, is used to calculate the amount by which you must
reduce your PTC, if you are otherwise eligible for the PTC.
Use Worksheet Q to figure your monthly PTC for months
in which you were provided a QSEHRA.

APTC for 2023 and 2024. If APTC was paid for your
2023 Marketplace coverage, your QSEHRA permitted
benefit for 2023 was not considered by the Marketplace in
calculating the amount of your 2023 APTC. Furthermore, if
you requested APTC for your 2024 Marketplace coverage,
the Marketplace did not consider your 2024 permitted
benefit in calculating the amount of your 2024 APTC. If
you are provided a QSEHRA for 2024, you should contact
the Marketplace and ask the Marketplace to reduce the
amount of APTC to be paid on your behalf for 2024 to limit
the risk of having excess APTC for 2024.

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Worksheet N. Worksheet To Determine if the QSEHRA Is 
Considered Affordable                                                                                      Keep for Your Records
Note. See Special instructions for Worksheet N if your SLCSP premium was not the same for all months of 2023 or you 
changed employers during 2023.
1. Enter the amount from Form 8962, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  1.  
2. Multiply line 1 by 0.0912 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        2.  
3. Enter the number of months you were provided the QSEHRA in 2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                    3.  
4. Divide line 2 by 12.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      4.  
5. If you enrolled in a qualified health plan, enter the monthly premium you would pay for self-only coverage under 
    the SLCSP offered by the Marketplace where you enrolled in coverage. If you did not enroll in a qualified health 
    plan, enter the monthly premium that the oldest member of your coverage family who is enrolled in a qualified 
    health plan would pay for self-only coverage under the SLCSP offered by the Marketplace where that family 
    member enrolled. See Applicable SLCSP premium tools, later, to learn how to retrieve the applicable 
    SLCSP premium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         5.  
6. Enter the self-only coverage permitted benefit from the written notice provided by your employer. If you were 
    provided the QSEHRA for less than 12 months in 2023, see Part-year coverage, later, for what amount to enter 
    on line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.  
7. Divide line 6 by line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      7.  
8. Subtract line 7 from line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        8.  
9. Compare lines 4 and 8.
     • If line 4 is less than line 8, the QSEHRA is not considered affordable. Stop here. Complete Worksheet Q.
     • If line 4 is greater than or equal to line 8, the QSEHRA is considered affordable. Skip Worksheet Q. Stop here 
       and do not file Form 8962 if you were provided a QSEHRA for every month you were covered by a qualified 
       health plan and no APTC was paid for you or another individual in your tax family. Otherwise, enter 
       "QSEHRA" in the top margin of Form 8962. If you are completing Form 8962, lines 12 through 23, stop here 
       and enter -0- on lines 12 through 23, column (e), for each month you were provided the QSEHRA. If you are 
       completing Form 8962, line 11, and you were provided the QSEHRA for all of 2023, stop here and enter -0- 
       on line 11, column (e). If you were not provided the QSEHRA for all of 2023, complete lines 10 through 13 
       below.
10. Enter the smaller of Form 8962, line 11, column (a) or (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                      10.  
11. Divide line 10 by 12.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      11.  
12. Multiply line 11 by line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      12.  
13. Subtract line 12 from line 10. Enter the result here and on Form 8962, line 11, column (e) . . . . . . . . . . . . . . . . . .                                      13.  

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Special instructions for Worksheet N if you did not Enter the smaller of the 2 amounts on each line in column
have the same SLCSP for all months of 2023 or A for the months you were provided a QSEHRA.
changed employers during 2023. You must complete a
separate worksheet through line 8 for each part of the year Column B. The amount you enter in column B depends
in which you had a different SLCSP premium for self-only on whether the QSEHRA is considered affordable cover-
coverage while provided a QSEHRA, or you were provi- age for the month. For the months the QSEHRA is consid-
ded a QSEHRA from different employers with different ered affordable coverage, enter in column B the amount
self-only permitted benefits. For example, Bob was em- you entered in column A. For the months the QSEHRA is
ployed for all of 2023 by an employer that provides a not considered affordable coverage, complete column B
QSEHRA to its employees. Bob changed Marketplace as follows.
policies in May of 2023 because of a change in residence. • If you completed Part I, enter the amount from line 3
As a result, Bob’s SLCSP premium for self-only coverage on the lines for the months you completed column A.
was different for the period January through May than for
the period June through December. To determine the af- • If you skipped Part I, enter the monthly permitted ben-
fordability of the QSEHRA provided to Bob, Bob must efit amount (the amount from box 12, code FF, of Form
complete a separate Worksheet N for the period January W-2, divided by the number of months you were provi-
through May and the period June through December. ded the QSEHRA) on the lines for the months you
Once you have completed the separate worksheets completed column A.
through line 8, read the following. To determine whether the QSEHRA is considered af-
fordable coverage for any month, see Worksheet N.
• If the Worksheets N show that the QSEHRA is unaf-
fordable for at least 1 month (line 4 is less than line 8 Self-only permitted benefit for some months and
on at least one of the worksheets), skip lines 9 through family permitted benefit for others. Your permitted
13 and complete Worksheet Q. benefit is reported in box 12 of Form W-2 using code FF.
• If the Worksheets N show that the QSEHRA is afforda- However, if you received a self-only permitted benefit for
ble for all months of 2023 (line 4 is greater than or part of the year and a family permitted benefit for another
equal to line 8 on all the worksheets), follow the in- part of the year, the amount reported on your Form W-2
structions on line 9 of the worksheet relating to “If reflects that change. For purposes of this worksheet, di-
line 4 is greater than or equal to line 8.” Complete lines vide the self-only permitted benefit as described in the
10 through 13 if you are instructed to do so. written notice from your employer by 12.0 to determine
your column B monthly permitted benefit for the months in
Part-year coverage—Instruction for line 6. If you were which you were provided a permitted benefit for self-only
provided a QSEHRA for less than 12 months in 2023, the coverage. Divide the family permitted benefit as described
written notice your employer sent to you may have provi- in the written notice from your employer by 12.0 to deter-
ded the self-only coverage permitted benefit for only the mine your column B monthly permitted benefit for the
months you were provided the QSEHRA or the self-only months in which you were provided a permitted benefit for
coverage permitted benefit for the entire year (if the notice family coverage. If you were provided the QSEHRA for
provided to you does not include a permitted benefit less than 12 months in 2023, see Part-year coverage for
amount for self-only coverage, you must contact your em- taxpayers with changes in permitted benefits next for what
ployer to get that information). If the notice provided the amount to enter on line 6 of Worksheet N.
permitted benefit amount just for the months you were Part-year coverage for taxpayers with changes in
provided the QSEHRA, then enter that amount on line 6. If permitted benefits. If you received a self-only permitted
the notice provided the self-only coverage permitted bene- benefit for part of the year and a family permitted benefit
fit for the entire year, figure the amount to enter on line 6 for another part of the year and you were provided a
as follows. QSEHRA for less than 12 months in 2023, you should
1. Divide the self-only coverage permitted benefit for the consult the written notice your employer sent to you to de-
entire year by 12.0. termine the amount to enter in column B. The notice your
employer sent to you may have included the permitted
2. Multiply the result by the number of months you were benefit for only the months you were provided the
provided the QSEHRA. QSEHRA or the permitted benefit for the entire year. If the
notice provided the permitted benefit for the entire year,
Instructions for Worksheet Q, Part III divide the self-only coverage permitted benefit for the en-
tire year by 12.0 and enter that amount in column B for the
Column A. If you completed Form 8962, lines 12 through months you received a self-only permitted benefit. Then,
23, enter the smaller of column (a) or (d) on the lines in divide the family coverage permitted benefit for the entire
Part III for the months you were provided a QSEHRA. If year by 12.0 and enter that amount in column B for the
you completed Form 8962, line 11, and were instructed to months you received a family permitted benefit. If the no-
complete Part III in the second bullet under Before you be- tice provided the permitted benefit for only the months you
gin, divide the amount on line 11, column (a), by 12.0. were provided the QSEHRA, divide that amount by the
Then, divide the amount on line 11, column (d), by 12.0.

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Worksheet Q. Worksheet To Figure Monthly Credit Amount if 
You Have a QSEHRA                                                                                              Keep for Your Records
Before you begin:
 •  See Worksheet N to determine whether the QSEHRA is considered affordable coverage for any month. If the QSEHRA is considered affordable 
    coverage for some months but not others, see the instructions for column B below for the amount you enter in column B for the affordable 
    months. 
 •  If the monthly permitted benefit was the same for each month you were provided the QSEHRA and the QSEHRA was not considered affordable 
    for all of those months, go to Part I. If the monthly permitted benefit was not the same for each month you were provided the QSEHRA or the 
    QSEHRA was considered affordable for some but not all the months it was provided, go to Part III. Skip Parts I and II.
 
Caution. If you received a self-only permitted benefit for part of the year and a family permitted benefit for another part of the year, you must 
complete Part III even though the amount reported on your Form W-2 reflects this change.
Part I: Monthly Permitted Benefit
 1. Enter the amount from box 12, code FF, of Form W-2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    1.   
 2. Enter the number of months you were provided the QSEHRA in 2023 . . . . . . . . . . . . . . . . . . . . . . . . . .                               2.   
 3. Divide line 1 by line 2. Then, do one of the following . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              3.   
    •    If you are completing Form 8962, line 11, go to Part II below.
    •    If you are completing Form 8962, lines 12 through 23, go to Part III below. Skip Part II.
Part II: Annual Calculation
 4. Enter the smaller of Form 8962, line 11, column (a) or (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  4.   
 5. Divide line 4 by 12.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.   
 6. Enter the smaller of line 3 or line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       6.   
 7. Multiply line 6 by line 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.   
 8. Subtract line 7 from line 4. Enter the result here and on Form 8962, line 11, column (e). Enter “QSEHRA” 
    in the top margin of Form 8962. Skip Part III below . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               8.   
    Note. If the result is -0- and the amount you will enter on line 11, column (f), is also -0-, stop here. Do not 
    file Form 8962.
Part III: Monthly Calculation
    Month            A. Tentative monthly premium tax credit           B. Monthly permitted benefit (see                                              C. Subtract col. B from col. A. If less 
                             (see instructions)                             instructions)                                                                  than zero, enter -0-.
 9. January
10. February
11. March
12. April
13. May
14. June
15. July
16. August
17. September
18. October
19. November
20. December
21. If you are completing Form 8962, lines 12 through 23, stop here and enter the amounts from column C in 
    column (e) for the months you completed column A. Enter “QSEHRA” in the top margin of Form 8962.
    Note. If all entries in columns (e) and (f) are -0- or blank, do not file Form 8962.
22. If you are completing Form 8962, line 11, add the amounts in column C above and enter the result here. If 
    line 22 is -0- and no APTC was paid for you or another individual in your tax family, stop here and do not 
    file Form 8962. Otherwise, do one of the following . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                22.  
    •    If you were provided the QSEHRA for all of 2023, stop here and also enter the result on Form 8962, 
         line 11, column (e). Enter “QSEHRA” in the top margin of Form 8962.
    •    If you were not provided the QSEHRA for all of 2023, complete lines 23 through 27 below to figure 
         the amount to enter on Form 8962, line 11, column (e).
23. Enter the smaller of Form 8962, line 11, column (a) or (d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  23.  
24. Divide line 23 by 12.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  24.  
25. Multiply line 24 by the number of months you were provided the QSEHRA in 2023 . . . . . . . . . . . . . . . .                                     25.  
26. Subtract line 25 from line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     26.  
27. Add lines 22 and 26. Enter the result here and on Form 8962, line 11, column (e). Enter “QSEHRA” in the 
    top margin of Form 8962  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      27.  

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number of months you were provided that permitted bene-
fit under the QSEHRA and enter the amount in column B
for the appropriate months. Individuals Not Lawfully

Present in the United States
Grandfathered Health Plan
Enrolled in a Qualified Health
A grandfathered health plan means any group health plan,
group health insurance coverage, or individual health in- Plan
surance coverage to which section 1251 of the ACA ap-
plies (in general, certain group health plans and health in- The PTC is not allowed for the coverage of an individual
surance coverage existing as of March 23, 2010, for as who is not lawfully present in the United States. All APTC
long as the coverage maintains that status under the ap- paid for an individual not lawfully present who enrolls in a
plicable rules). Health plans must disclose if they are qualified health plan must be figured. If all family members
grandfathered. For more information about grandfathered enrolled in a qualified health plan are not lawfully present,
health plans, see HealthCare.gov/Health-Care-Law- see the discussion immediately below. If you or a member
Protections/Grandfathered-Plans/. of your family is not lawfully present and was enrolled in a
qualified health plan with family members who are lawfully
Other Coverage Designated by the present for 1 or more months of the year, you must use the
instructions under Lawfully Present and Not Lawfully
Department of Health and Human Present Family Members Enrolled, later, to find out how
Services (HHS) much APTC, if any, was allowable.
HHS has designated the following health benefit plans or For more information about who is treated as law-
arrangements as MEC. TIP fully present for this purpose, go to
HealthCare.gov/Immigrants/Immigration-Status/.
1. Employer coverage provided to business owners who
are not employees.
All Enrolled Family Members Not
2. Coverage under a group health plan provided through
insurance regulated by a foreign government if: Lawfully Present

a. A covered individual is physically absent from the If all family members enrolled in a qualified health plan are
United States for at least 1 day during the month, not lawfully present, no PTC is allowed. Complete lines on
or Form 8962 as explained below. Leave all other lines
blank.
b. A covered individual is physically present in the
United States for a full month and the coverage Lines 1, 2a, 3, 4, and 5. Enter -0-.
provides health benefits within the United States
while the individual is on expatriate status. Line 9. Complete line 9 as provided in the Form 8962 in-
structions to determine whether you must complete Part
3. Coverage of pregnancy-related services that consists
IV for an allocation of policy amounts. Complete Part IV if
of full Medicaid benefits.
instructed to do so by Table 3 in the Form 8962 instruc-
4. Other specific programs listed at CMS.gov/CCIIO/ tions. Do not complete Part V.
Programs-and-Initiatives/Health-Insurance-Market-
Reforms/Minimum-Essential-Coverage.html (click on Line 11, column (f) (or lines 12 through 23, column
the link for “Approved Plans”). These programs in- (f), if you complete Part IV). If you checked the “No”
clude certain: box on line 9, enter the total of your Form(s) 1095-A, Part
III, line 33C, on line 11, column (f). If you checked the
a. Self-insured university student health plans; and “Yes” box on line 9, complete lines 12 through 23, column
b. Coverage resembling coverage under a state’s (f), as provided in the Form 8962 instructions.
CHIP program that generally requires the payment
Line 24. Enter -0-.
of premiums with little or no government subsidy,
often called CHIP buy-in programs. Lines 25, 27, and 29. Enter the amount from line 11, col-
In general, if you were eligible for coverage that HHS has umn (f), (or the total of lines 12 through 23, column (f)) on
designated as MEC, you are not eligible to claim the PTC each line. Then, follow the instructions for line 29.
for coverage through the Marketplace. However, you are
considered as eligible for MEC under a self-insured uni-
versity student health plan or a CHIP buy-in program that
has been designated as MEC only if you are enrolled in
the coverage.

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Lawfully Present and Not Lawfully age family. Situation 1 applies if you have family mem-
bers who are not lawfully present that are enrolled for all or
Present Family Members Enrolled a part of the year, there are no changes in your coverage
Before you read the following discussion, first fa- family during the year (counting only lawfully present fam-
TIP miliarize yourself with the definitions of tax family ily members), and there are no enrollment changes involv-
and coverage family discussed under Terms You ing your lawfully present family members enrolled in the
May Need To Know, earlier. coverage during the year. If Situation 1 applies, you should
enter on Form 8962 for every month of the year the enroll-
If you or a member of your family is not lawfully present ment premiums and applicable SLCSP premium the Mar-
and was enrolled in a qualified health plan with family ketplace reports on Form 1095-A for the months when
members who are lawfully present for 1 or more months of only lawfully present individuals were enrolled in the cov-
the year, you may take the PTC only for the coverage of erage. If a not lawfully present family member was enrol-
the lawfully present family members. You must determine led for the entire year, see No reference month, later.
how much APTC was paid for the coverage of a not law- Example 1. Andrew enrolls himself and his three de-
fully present family member. Complete Form 8962 using pendents, Terri, Phil, and Anne in a qualified health plan.
the following steps. Anne is not lawfully present in the United States. The
monthly enrollment premiums for the plan are $1,000. No
Step 1. Complete Part I according to the instructions. If one in Andrew’s family is eligible for MEC (other than Mar-
you are not eligible for the PTC, skip the rest of these ketplace coverage) and the applicable SLCSP premium
steps, complete Form 8962 through line 27, and then see that would apply to all four members of Andrew’s family is
How To Determine the Excess APTC That Must Be Re- $1,200. There are no changes involving the lawfully
paid, later. present members of the coverage family during the year.
Step 2. Determine your monthly enrollment premiums Anne is disenrolled from coverage as of April 1. The
and applicable SLCSP premium using the instructions un- monthly enrollment premiums for Andrew and his other
der How To Determine Your Monthly Enrollment Premiums two dependents are $800 and the applicable SLCSP pre-
and SLCSP Premium, later. mium that applies to Andrew’s coverage family of three is
$900. The Marketplace reports the following amounts on
Step 3. Complete line 9, including Parts IV and V if in- Form 1095-A, Part III.
structed to do so.
Months Column A Column B
Step 4. If Situation 1 (discussed later) applies to you, do
one of the following. January, February, March . . . . . . . $1,000 $1,200
April through December. . . . . . . . $800 $900
• If the enrolled lawfully present family members are en-
rolled for all 12 months of 2023, check the “Yes” box When completing Form 8962, Andrew enters $9,600
on line 10 and complete line 11, and lines 24 through ($800 x 12) as the enrollment premiums on line 11, col-
29, as appropriate. umn (a), and $10,800 ($900 x 12) as the premium for the
• If the enrolled lawfully present family members are en- applicable SLCSP on line 11, column (b).
rolled for less than 12 months, check the “No” box on
line 10, skip line 11, and complete lines 12 through 29, Situation 2—Changes in enrollment or coverage fam-
as appropriate. ily involving a lawfully present family member. Situa-
tion 2 applies if you have family members who are not law-
If Situation 2 (discussed later) applies to you, check the fully present that are enrolled for all or part of the year, and
“No” box on line 10, skip line 11, and complete lines 12 there are either changes in your coverage family during
through 25. Then, do one of the following. the year (counting only lawfully present family members)
• If line 24 is less than line 25, you have excess APTC. or enrollment changes involving your lawfully present fam-
See How To Determine the Excess APTC That Must ily members enrolled in the coverage during the year. If
Be Repaid, later. Situation 2 applies, use these rules to determine the en-
rollment premiums and the applicable SLCSP premium for
• If line 24 is equal to or greater than line 25, complete the months any not lawfully present family members are
line 26 as instructed. (Do not follow the instructions enrolled. First, use Worksheet A to determine if you have a
under How To Determine the Excess APTC, later.) reference month for enrollment premiums or for the appli-
cable SLCSP premium. You may have a reference month
How To Determine Your Monthly Enrollment for enrollment premiums (discussed next) or a reference
Premiums and Applicable SLCSP Premium month for the applicable SLCSP premium (discussed
later), or for both.
See Situation 1 or Situation 2 next for how to determine
your monthly enrollment premium and applicable SLCSP Reference month for enrollment premiums. A refer-
premium. ence month for enrollment premiums is a month in which
the not lawfully present family member is not enrolled in
Situation 1—Not lawfully present family members en- coverage and there are no other changes in the members
rolled and no other changes in enrollment or cover- of your family who are enrolled in the coverage. In other

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words, your enrolled family members are the same during enrollment premiums and the applicable SLCSP premium
the reference month as for a month the not lawfully for January through March (the months Anne was enrolled
present family member was enrolled, except that the not in coverage) because Andrew’s coverage family and en-
lawfully present family member is not enrolled. Enter on rolled family members for April through August (Andrew,
Form 8962, Part II, column (a), the enrollment premiums Phil, and Terri) are the same as for January through March
for the reference month as the enrollment premiums for except for Anne who is not lawfully present. (September
the months the not lawfully present family member was through December are also reference months for
enrolled. enrollment premiums.) The enrollment premiums and
SLCSP premium for April through August are the same
Reference month for SLCSP premium. A reference
amounts they would have been for January through March
month for the applicable SLCSP premium is a month in
without Anne. Therefore, for the months January through
which the not lawfully present family member is not enrol-
March, Andrew enters on Form 8962, lines 12 through 23,
led in coverage and there are no other changes in your
$800 (the enrollment premiums for April through August)
coverage family. In other words, your coverage family is
in column (a) and $900 (the SLCSP premium that applies
the same during the reference month as for a month the
to the coverage family for April through August) in column
not lawfully present family member was enrolled, except
(b).
the not lawfully present family member is not included in
your coverage family. Enter on Form 8962, Part II, column Example 3. The facts are the same as in Example 1,
(b), the applicable SLCSP premium for the reference earlier, except that Andrew becomes eligible for em-
month as the applicable SLCSP premium for the months ployer-sponsored coverage on April 1, notifies the Market-
the not lawfully present family member was enrolled. place, but remains enrolled in the qualified health plan.
The Marketplace reports the following amounts on Form
No reference month. If you do not have a reference
1095-A, Part III.
month for enrollment premiums, you may have to contact
your insurance company to find out what the amount of
the enrollment premiums would have been if the policy Months Column A Column B
had covered only lawfully present family members. If you January, February, March. . . . . . . $1,000 $1,200
do not have a reference month for the applicable SLCSP April through December . . . . . . . . $800 $400
premium, you must look up the SLCSP premium that ap-
plies to your coverage family (without any not lawfully Andrew does not have a reference month for the appli-
present family members). See Determining the Premium cable SLCSP premium for the months Anne was enrolled
for the Applicable Second Lowest Cost Silver Plan in the qualified health plan because there is another
(SLCSP), later. change in his coverage family for the months April through
You may use Worksheet A to determine whether December (Andrew is not in the coverage family because
TIP you have any reference months. he is eligible for employer-sponsored coverage). Thus,
there are no months when Andrew’s coverage family is the
same (except for Anne) before and after Anne is disenrol-
Example 2. The facts are the same as in Example 1, led from coverage. Andrew must look up the SLCSP pre-
earlier, except that Andrew becomes eligible for em- mium that applies to his coverage family without Anne. An-
ployer-sponsored coverage on September 1, notifies the drew determines that the correct applicable SLCSP
Marketplace, but remains enrolled in the qualified health premium to enter on Form 8962 for the months January
plan (although he cannot take the PTC for his coverage for through March for a coverage family consisting of Andrew,
the months after August). The applicable SLCSP premium Terri, and Phil is $900.
that applies to Terri and Phil is only $400. The Market- April through December are reference months for An-
place reports the following amounts on Form 1095-A, Part drew for enrollment premiums because the family mem-
III. bers who are enrolled for those months are the same fam-
ily members who were enrolled in January through March,
Months Column A Column B except for Anne.
Therefore, for the months January through March, An-
January, February, March . . . . . . . $1,000 $1,200
drew enters on Form 8962, lines 12 through 23, $800 (the
April through August. . . . . . . . . . $800 $900 enrollment premiums for April through December) in col-
September through December. . . $800 $400 umn (a) and $900 (the SLCSP premium that would apply
to the coverage family of Andrew, Terri, and Phil) in col-
Andrew must complete lines 12 through 23 of Form umn (b).
8962. April through August are reference months for both

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Worksheet A. Do You Have Any Reference Months? Keep for Your Records
Use this worksheet to determine whether you have any reference months.
Months in 2023 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jan. Feb. Mar. Apr. May Jun. Jul. Aug. Sep. Oct. Nov. Dec.
1. Check a box for each month in which any
family members not lawfully present were
enrolled in coverage . . . . . . . . . . . . . . . . . . . .
2. Check a box for each month in which:
• Only lawfully present family members
were enrolled in coverage; and
• There were no other changes in
members of your tax family* who are
enrolled in coverage, as compared to a
month for which you checked a box on
line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The months for which you checked boxes
on line 2 are your reference months for
enrollment premiums. Use the enrollment
premium reported on Form 1095-A, Part III,
column A, for the reference month as your
enrollment premium on Form 8962 for the
month(s) you checked on line 1.

Note. If you did not check any boxes on this
line, see No reference month, earlier.
3. Check a box for each month in which:
• Only lawfully present family members
were enrolled in coverage; and
• There were no other changes in your
coverage family,* as compared to a
month for which you checked a box on
line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The months for which you checked boxes
on line 3 are your reference months for the
applicable SLCSP premium. Use the
applicable SLCSP premium reported on
Form 1095-A, Part III, column B, for the
reference month as your applicable SLCSP
premium on Form 8962 for the month(s) you
checked on line 1.

Note. If you did not check any boxes on this
line, see No reference month, earlier.
* See Terms You May Need To Know, earlier, for the definitions of tax family and coverage family.

How To Determine the Excess APTC That members who are lawfully present for 1 or more
Must Be Repaid months of the year.
• You have excess APTC on line 27 of Form 8962.
The excess APTC (see the instructions for Form 8962,
line 28) applies only to excess APTC for coverage of law- • Your excess APTC on line 27 of Form 8962 is more
than your amount from Table 5 in the Form 8962 in-
fully present individuals. Excess APTC that relates to the
structions.
coverage of individuals who are not lawfully present must
be figured without limitation. Use Worksheet B to deter- If line 27 is not more than your amount from Table 5 in
mine the amount of excess APTC if all of the following ap- the Form 8962 instructions, do not complete Worksheet B.
ply. Leave line 28 of Form 8962 blank, enter the amount from
• You or a member of your family is not lawfully present line 27 on line 29, and follow the instructions for line 29. If
and is enrolled in a qualified health plan with family

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you must complete Worksheet B, see the illustrated exam- SLCSP premium ($900) for January through March
ple. because Andrew’s coverage family for these months (An-
drew, Phil, and Terri) is the same as for January through
March except for Anne. September through December are
Illustrated Example of Determining the not reference months for the applicable SLCSP premium
Excess APTC That Must Be Repaid (and Andrew doesn’t check these boxes) because, as ex-
plained above, there was another change in his coverage
Andrew enrolls himself and his three dependents, Terri, family beginning in September.
Phil, and Anne in a qualified health plan. Anne is not law-
fully present in the United States and is disenrolled from Step 3. Andrew checks the “No” box on line 9 because
the coverage as of April 1. Andrew becomes eligible for he is neither allocating policy amounts with another tax-
employer-sponsored coverage on September 1, notifies payer nor using the alternative calculation for year of mar-
the Marketplace, but remains enrolled in the qualified riage.
health plan. The Marketplace reports the following
amounts on Form 1095-A, Part III. Step 4. Because Situation 2 (discussed earlier) applies to
Andrew, he checks the “No” box on line 10, skips line 11,
and completes lines 12 through 25. On lines 12 through
Months Column A Column B Column C 14, column (a), he enters $800 as determined on Work-
January, February, sheet A, line 2. On lines 12 through 14, column (b), he en-
March . . . . . . . . . . . . $1,000 $1,200 $953 ters $900 as determined on Worksheet A, line 3.
April through Andrew’s PTC on line 24 ($4,656) is less than his APTC
August . . . . . . . . . . . . $800 $900 $653 on line 25 ($6,736), and his excess APTC on line 27
September through ($2,080 is greater than his Table 5 repayment limitation
December. . . . . . . . . $800 $400 $153 amount ($1,800) in the Form 8962 instructions. According
to the instructions under How To Determine the Excess
APTC That Must Be Repaid, earlier, Andrew must com-
Step 1. Andrew completes Part I of Form 8962 (not illus- plete Worksheet B to figure the amount of excess APTC.
trated). His household income for the year on his Form
8962, line 3, is $76,313, which is 275% of the federal pov- Andrew completes Worksheet B as follows.
erty line. The annual contribution amount Andrew enters Line 1. Andrew enters $953. This is the monthly APTC
on line 8a is $3,816 and the monthly contribution amount shown on Form 1095-A, Part III, column C, for January,
he enters on line 8b is $318. February, and March (the months that Anne was enrolled
Step 2. Andrew determines his monthly enrollment pre- in coverage).
miums and applicable SLCSP premium using the instruc- Line 2. Andrew enters $582. This is the amount from
tions under How To Determine Your Monthly Premium and Form 8962, Part II, column (e), for January through March
Applicable SLCSP Premium, earlier. Situation 2 in that dis- and represents the applicable monthly SLCSP premium
cussion applies to Andrew because he has a lawfully for April through August (reference months for the applica-
present family member enrolled in coverage and there are ble SLCSP premium) for Andrew, Terri, and Phil of $900
changes in his coverage family in 2023, counting only law- minus the monthly contribution amount of $318 from Form
fully present family members: beginning in September, 8962, line 8b.
only Phil and Terri are in the coverage family. Andrew is no
longer in the coverage family because he becomes eligi- Line 4. Andrew enters $1,000. This is the monthly pre-
ble for employer-sponsored coverage. mium for January through March shown on Form 1095-A,
Andrew completes Worksheet A as explained below to Part III, column A.
determine his reference months for the enrollment premi- Line 5. Andrew enters $1,200. This is the applicable
ums and the applicable SLCSP premium for the months SLCSP premium shown on Form 1095-A, Part III, column
Anne was enrolled. (Andrew’s Worksheet A is shown B.
later.)
Line 6. Andrew enters $318. This is the monthly contri-
Line 1. He checks the boxes for January, February, bution amount from Form 8962, line 8b.
and March because those are the months in which Anne
is enrolled in Marketplace coverage. Lines 7 through 14. Andrew completes these lines as
instructed on Worksheet B.
Line 2. He checks the boxes for April through Decem-
ber. Those months are reference months for enrollment Line 15. Line 14 is more than line 13. Accordingly, An-
premiums ($800) for January through March because his drew enters the amount from line 13 ($1,800) on Form
tax family for these months (Andrew, Phil, and Terri) is the 8962, lines 28 and 29.
same as for January through March except for Anne.
Line 3. He checks the boxes for April through August.
These months are reference months for the applicable

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Worksheet B. Excess APTC That Must Be Repaid                                                        Keep for Your Records
 Complete columns            only for the months a not lawfully present family member was enrolled in coverage. (If you comple-
ted Worksheet A, these are the months for which you checked a box on line 1 of the worksheet.)
Months in 2023 . . . . . .   Jan. Feb. Mar. Apr. May                             Jun.     Jul. Aug. Sep. Oct.                   Nov.                                                   Dec.
1.  Enter APTC from 
    Form 1095-A, Part 
    III, column 
    C . . . . . . . . . . .
2.  Enter the monthly 
    credit amount from 
    Form 8962, Part II, 
    column (e) . . . . .
3.  Subtract line 2 
    from line 1. If zero 
    or less, leave this 
    line blank and skip 
    lines 4 through 10 
    for the 
    month . . . . . . . .
4.  Enter the monthly 
    premium amount 
    from Form 1095-A, 
    Part III, column A . .
5.  Enter the SLCSP 
    premium from 
    Form 1095-A, Part 
    III, column B . . . . . .
6.  Enter the monthly 
    contribution 
    amount from Form 
    8962, line 8b . . . . .
7.  Subtract line 6 
    from line 5 . . . . .
8.  Enter the smaller 
    of line 4 or 
    line 7 . . . . . . . . .
9.  Subtract line 8 
    from line 1. If zero 
    or less, 
    enter -0-  . . . . . .
10. Subtract line 9 
    from line 3 . . . . .
11. Add the amounts on line 10. If all of your line 3 results were zero or less, stop here. None of your excess APTC was from 
    individuals who were not lawfully present. Enter the repayment limitation amount from Table 5 in the Form 8962 instructions on 
    Form 8962, line 28, and continue to line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           11.
12. Enter the repayment limitation amount from Table 5 in the Form 8962 instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                              12.
13. Add lines 11 and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.
14. Enter the amount from Form 8962, line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .            14.
15. Compare lines 13 and 14.
    • If line 14 is more than line 13, enter the amount from line 13 on Form 8962, lines 28 and 29, and follow the instructions for 
      line 29.
    • If line 14 is less than or equal to line 13, leave Form 8962, line 28, blank and enter the amount from line 27 on line 29.

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Andrew’s Worksheet A. Do You Have Any Reference Months?
Use this worksheet to determine whether you have any reference months.
Months in 2023
Check a box for each month in which any
family members not lawfully present were
enrolled in coverage
Check a box for each month in which:
• Only lawfully present family members
were enrolled in coverage; and
• There were no other changes in
members of your tax family* who are
enrolled in coverage, as compared to a
month for which you checked a box on
line 1
The months for which you checked boxes
on line 2 are your reference months for
enrollment premiums. Use the enrollment
premium reported on Form 1095-A, Part III,
column A, for the reference month as your
enrollment premium on Form 8962 for the
month(s) you checked on line 1.

Note. If you did not check any boxes on this
line, see No reference month, earlier.
Check a box for each month in which:
• Only lawfully present family members
were enrolled in coverage; and
• There were no other changes in your
coverage family,* as compared to a
month for which you checked a box on
line 1
The months for which you checked boxes
on line 3 are your reference months for the
applicable SLCSP premium. Use the
applicable SLCSP premium reported on
Form 1095-A, Part III, column B, for the
reference month as your applicable SLCSP
premium on Form 8962 for the month(s) you
checked on line 1.

Note. If you did not check any boxes on this
line, see No reference month, earlier.
*See Terms You May Need To Know, earlier, for the denitions of tax famliy and coverage family.

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Andrew's Worksheet B. Excess APTC That Must Be Repaid
Complete columns              only for the months a not lawfully present family member was enrolled in coverage. (If you comple-
ted Worksheet A, these are the months for which you checked a box on line 1 of the worksheet.)
Months in 2023 . . . . . .    Jan.   Feb.  Mar. Apr. May                         Jun.     Jul. Aug. Sep. Oct.                   Nov.                                                    Dec.
1.  Enter APTC from 
    Form 1095-A, Part 
    III, column 
    C . . . . . .             $953   $953  $953
2.  Enter the monthly 
    credit amount from 
    Form 8962, Part II, 
    column 
    (e) . . . . . . . . . . . 582    582   582
3.  Subtract line 2 
    from line 1. If zero 
    or less, leave this 
    line blank and skip 
    lines 4 through 10 
    for the 
    month . . . . . . . .     371    371   371
4.  Enter the monthly 
    premium amount 
    from Form 1095-A, 
    Part III, column A . .    1,000  1,000 1,000
5.  Enter the SLCSP 
    premium from 
    Form 1095-A, Part 
    III, column 
    B . . . . . .             1,200  1,200 1,200
6.  Enter the monthly 
    contribution 
    amount from Form 
    8962, line 8b . . . . .   318    318   318
7.  Subtract line 6 
    from line 5 . . . . .     882    882   882
8.  Enter the smaller 
    of line 4 or 
    line 7 . . . . .          882    882   882
9.  Subtract line 8 
    from line 1. If zero 
    or less, 
    enter -0- . . . . .           71 71    71
10. Subtract line 9 
    from line 3 . . . . .     300    300   300
11. Add the amounts on line 10. If all of your line 3 results were zero or less, stop here. None of your excess APTC was from 
    individuals who were not lawfully present. Enter the repayment limitation amount from Table 5 in the Form 8962 instructions on 
    Form 8962, line 28, and continue to line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           11. 900
12. Enter the repayment limitation amount from Table 5 in the Form 8962 instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                              12. 1,800
13. Add lines 11 and 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. 2,700
14. Enter the amount from Form 8962, line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .            14. 2,080
15. Compare lines 13 and 14.
    • If line 14 is more than line 13, enter the amount from line 13 on Form 8962, lines 28 and 29, and follow the instructions for 
      line 29.
    • If line 14 is less than or equal to line 13, leave Form 8962, line 28, blank and enter the amount from line 27 on line 29.

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Determining the Premium for Allocating Policy Amounts for

the Applicable Second Lowest Individuals With No One in

Cost Silver Plan (SLCSP) Their Tax Family

If you or a member of your family enrolls in a qualified If an individual you enrolled in coverage is not included in
health plan and APTC is paid for the coverage, the Mar- any tax family, you must reconcile the APTC paid for the
ketplace will generally identify the applicable SLCSP pre- individual’s coverage, even if you are claimed as a de-
mium and report it on Form 1095-A. The Marketplace de- pendent by another taxpayer. If you are enrolled in the
termines the applicable SLCSP premium based on your same policy as the individual not included in any tax fam-
address and the members of your coverage family. Provid- ily, you have to allocate policy amounts even though the
ing correct information on your application for financial as- conditions in the Form 8962 instructions for line 9 are not
sistance and notifying the Marketplace if you move or the met. Use the example below to complete Form 8962 if
members of your coverage family change are necessary your family size is zero but you have to allocate policy
for the Marketplace to report a correct applicable SLCSP amounts.
premium. If the Marketplace does not have accurate and
Example. Mark enrolls himself and his child, Donna, in
updated information, the applicable SLCSP premium the
a qualified health plan with coverage effective for all of
Marketplace reports on Form 1095-A may not be accurate
2023. The Form 1095-A he received from the Marketplace
for all months and you will need to determine the correct
shows that $6,000 of APTC was paid for their coverage
applicable SLCSP premium for those months. See Appli-
($500 is entered in Part III, column C, for each of lines 21
cable SLCSP premium tools below.
through 32). Mark files an income tax return for 2023 on
If you did not request financial assistance (APTC) and Form 1040 and does not include anyone in his tax family.
the Marketplace has an applicable SLCSP premium tool Mark’s parents, Steve and Sherry, include Mark in their tax
(discussed in the next paragraph), the Marketplace will not family. No one includes Donna in their tax family. Because
report an applicable SLCSP premium (Part III, column B, Mark enrolled Donna in coverage and no one includes
will report -0- or be blank). If you did not request financial Donna in their tax family, Mark must reconcile the APTC
assistance (APTC) and the Marketplace does not have an paid for Donna’s coverage. Steve and Sherry must recon-
applicable SLCSP premium tool, it may report an SLCSP cile the APTC paid for Mark’s coverage. Because Steve
premium that applies to everyone enrolled in your qualified and Sherry must reconcile the APTC paid for Mark’s cov-
health plan because it may not be able to identify the erage and Mark must reconcile the APTC paid for Donna’s
members of your coverage family from the information on coverage, Mark must complete Part IV of Form 8962 to al-
your application. If you take the PTC on your tax return, locate policy amounts with Steve and Sherry. Mark,
you will need to determine the SLCSP premium that ap- Sherry, and Steve do not agree on an allocation percent-
plies to your coverage family for each month of coverage. age. Mark completes Form 8962 as follows.
Applicable SLCSP premium tools. Only the Marketpla- Lines 1, 2a, 3, 4, and 5. Mark enters -0-.
ces are able to provide applicable SLCSP premiums. The Line 9. Mark reads Allocating policy amounts under
federally facilitated Marketplace and most state Market- Line 9 in the Form 8962 instructions. Although the first
places have provided applicable SLCSP premium tools condition in that discussion is not met, the allocation rules
that, as you prepare your tax return, you may use to look still apply because the APTC must be reported on two
up the SLCSP premium that applies to your coverage fam- separate returns (Mark's for Donna; Steve and Sherry's for
ily for each month. If you enrolled through the federally fa- Mark). He checks “Yes” on line 9. Then, he reads Table 3
cilitated Marketplace, you will find the tool at in the instructions. According to Step 3 in Table 3, he must
HealthCare.gov/Tax-Tool/. allocate in Part IV using the rules under Allocation Situa-
If you enrolled through a state-based Marketplace, you tion 4. Other situations where a policy is shared between
may find information about whether your state has an ap- two tax families in the Form 8962 instructions.
plicable SLCSP premium tool on the state-based Market-
place’s website. If the website does not have an applica- Line 30 (Part IV). Mark enters the Marketplace-as-
ble SLCSP premium tool, you will need to contact the signed policy number in column (a), Steve’s SSN in col-
state-based Marketplace directly for the correct SLCSP umn (b), “01” in column (c), and “12” in column (d). He
premium. leaves columns (e) and (f) blank because he is not an ap-
plicable taxpayer. He enters “0.50” in column (g). This is
the allocation percentage based on the rules under Allo-
cation Situation 4. Other situations where a policy is
shared between two tax families in the Form 8962 instruc-
tions.

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Lines 12 through 23, column (f).    Mark enters $250                 Allocation Among Two Taxpayers 
on each line (0.50 x the $500 APTC shown on his Form 
1095-A).                                                             Who Divorced or Legally Separated in 
                                                                     2023 and One or More Other 
Lines  25,  27,  and  29.   Mark  enters  $3,000  APTC, 
which  is  the  total  of  lines  12  through  23,  column  (f),  on Taxpayers
these lines and on his Schedule 2 (Form 1040), line 2.
                                                                     Use this section to allocate policy amounts from a quali-
                                                                     fied health plan if you meet either of the following condi-
                                                                     tions and no other allocations for the policy are necessary.
Allocation of Policy Amounts                                           You are allocating enrollment premiums, applicable 
                                                                     •
Among Three or More                                                    SLCSP premiums, and APTC with a former spouse as 
                                                                       a result of your divorce or legal separation in 2023 and 
Taxpayers                                                              are also allocating amounts with another taxpayer who 
                                                                       is including an individual in their tax family who, when 
This section covers allocations of policy amounts (enroll-             you were married to the former spouse, was enrolled 
ment premiums, applicable SLCSP premiums, and APTC)                    in a qualified health plan with members of your and 
among three or more taxpayers.                                         your former spouse’s tax families.
Before you read this section, first read Part IV—Alloca-             • You are the taxpayer who is including in your tax family 
tion  of  Policy  Amounts  in  the  Form  8962  instructions.          an individual enrolled in the plan with tax family mem-
Then, use the following instructions to complete Part IV of            bers of taxpayers who must also allocate policy 
Form 8962 if one qualified health plan covers individuals              amounts as a result of divorce or separation in 2023.
from three or more tax families in the same month. Specifi-           Example. Kara and David and their two children, Mer-
cally, these instructions apply to:                                  edith and Sam, enroll in a qualified health plan for 2023. 
•  Taxpayers who must allocate policy amounts because                Kara  and  David  were  married  at  the  beginning  of  2023 
   of a divorce or legal separation in 2023 and must also            and divorce in 2023. Meredith and Sam move in with their 
   allocate policy amounts with another taxpayer (for ex-            grandmother, Lydia, in May of 2023. Lydia claims Meredith 
   ample, a grandparent who includes in their tax family a           and Sam as dependents on her 2023 income tax return. 
   child enrolled with the former spouses);                          Kara, David, and Lydia use this section to allocate policy 
                                                                     amounts  to  compute  their  respective  PTC  and  reconcile 
•  Taxpayers who must allocate policy amounts because 
                                                                     the PTC with the APTC paid.
   they are legally married but are not filing a joint return 
                                                                      Kara and David use the allocation method under Rules 
   (for example, filing their returns as married filing sepa-
                                                                     for the Taxpayers Who Divorced or Legally Separated in 
   rately), and must also allocate policy amounts with an-
                                                                     2023 and Are Also Allocating With Another Taxpayer next.
   other taxpayer (for example, a grandparent who in-
                                                                      Lydia  uses  the  allocation  method  under Rules  for  the 
   cludes in their tax family a child enrolled with the 
                                                                     Taxpayer(s)  Allocating  With  Taxpayers  Who  Divorced  or 
   spouses); and
                                                                     Legally Separated in 2023, later.
•  Other taxpayers who are including an individual in 
   their tax family who is enrolled in a qualified health            Rules for the Taxpayers Who Divorced or 
   plan together with members of two or more other tax               Legally Separated in 2023 and Are Also 
   families.
                                                                     Allocating With Another Taxpayer
No APTC.    If you or a member of your tax family is en-
rolled  in  a  qualified  health  plan  with  members  of  two  or   Use this allocation method if you divorced or legally sepa-
more other tax families and no APTC is paid for coverage             rated  during  the  year  and  you  must  allocate  policy 
under the plan, use the instructions for Form 8962 under             amounts (enrollment premiums, applicable SLCSP premi-
Allocation Situation 3 No APTC . to allocate the enrollment          ums, and APTC) with your former spouse as well as with 
premiums  from  the  qualified  health  plan  among  the  tax        another taxpayer who is including in their tax family an in-
families. You allocate the enrollment premiums in propor-            dividual enrolled in a qualified health plan with members 
tion to the SLCSP premium that applies to each taxpayer              of your and your former spouse’s tax families.
who has a coverage family member enrolled in the plan. 
                                                                     Step 1. Determine an allocation percentage with your for-
For purposes of this enrollment premium allocation, only 
                                                                     mer spouse. You use this percentage to allocate the total 
coverage family members enrolled in the plan are consid-
                                                                     enrollment  premiums,  the  applicable  SLCSP  premiums, 
ered  in  determining  the  SLCSP  premium  that  applies  to 
                                                                     and APTC for coverage under the plan during the months 
each  taxpayer.  You  and  the  other  taxpayers  must  com-
                                                                     you  were  married.  You  will  find  these  amounts  on  your 
plete column (e) on the appropriate line in Part IV to allo-
                                                                     Form(s)  1095-A,  Part  III,  columns  A,  B,  and  C,  respec-
cate  the  enrollment  premiums  to  each  family.  Leave  col-
                                                                     tively.  You  and  your  former  spouse  can  allocate  these 
umns (f) and (g) blank. See Missing or incorrect SLCSP 
                                                                     amounts using any percentage you agree on from -0- to 
premium on Form 1095-A under     Line 10 in the Form 8962 
                                                                     100,  but  you  must  allocate  all  amounts  using  the  same 
instructions to determine your applicable SLCSP premium 
                                                                     percentage. If you do not agree on a percentage, you and 
to use for the allocation.

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your former spouse must allocate 50% of each of these Column (c). Enter the first month you are allocating
amounts to each of you. policy amounts. For example, if you are allocating a per-
centage from January through June, enter “01” in column
Step 2. Separately from the first allocation, determine an (c).
allocation percentage with the taxpayer(s) who included in
their tax family the individual(s) enrolled in the plan with a Column (d). Enter the last month you are allocating
member of your tax family or a member of your former policy amounts. For example, if you are allocating a per-
spouse’s tax family. You may agree on any allocation per- centage from January through June, enter “06” in column
centage from -0- to 100. You may use the percentage you (d).
agreed on for every month that this allocation rule applies, Column (e). Enter the decimal from Worksheet C,
or you may agree on different percentages for different line 5.
months. However, you must use the same allocation per-
centage for all policy amounts (enrollment premiums, ap- Column (f). Enter the decimal from Worksheet C,
plicable SLCSP premiums, and APTC) in a month. If you line 5.
cannot agree on an allocation percentage, the allocation Column (g). Enter the decimal from Worksheet C,
percentage is equal to the number of individuals the other line 5.
taxpayer includes in their tax family for the tax year who
were enrolled in the plan for which you are allocating pol-
Rules for the Taxpayer(s) Allocating With
icy amounts, divided by the total number of individuals en-
rolled in the qualified health plan. The allocation percent- Taxpayers Who Divorced or Legally
age is the percentage that applies to the amounts the Separated in 2023
other taxpayer must use to compute the PTC and recon-
Use this allocation method if you are including in your tax
cile it with APTC. You and your former spouse must com-
family one or more individuals who were enrolled in a
pute the PTC and reconcile APTC using the remaining
qualified health plan with members of the tax families of
amounts.
other taxpayers who must also allocate policy amounts as
Step 3. Complete Worksheet C below. a result of divorce or legal separation in 2023.

Worksheet C. Allocations for the Divorced or Step 1. Determine an allocation percentage with one of
Legally Separated Taxpayers the former spouses. You may agree on any allocation per-
1. Enter as a decimal your percentage from centage from -0- to 100. You may use the percentage you
Step 1 above . . . . . . . . . . . . . . . . . . . . . . . . 1. agreed on for every month during which this allocation rule
2. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. 1.0 applies, or you may agree on different percentages for dif-
ferent months. However, you must use the same allocation
3. Enter as a decimal the total of the percentage for all policy amounts (enrollment premiums,
percentage(s) from Step 2 above allocated applicable SLCSP premiums, and APTC) in a month. If
to the other taxpayer(s). you cannot agree on an allocation percentage, the alloca-
Note. See Example 2, later, for details on
tion percentage is equal to the number of individuals you
adding the percentages for multiple
taxpayers . . . . . . . . . . . . . . . . . . . . . . . . . . 3. include in your tax family for the tax year who were enrol-
led in the qualified health plan for which you are allocating
4. Subtract line 3 from line 2 . . . . . . . . . . . . . 4. policy amounts, divided by the total number of individuals
5. Multiply line 1 by line 4. Enter the result as enrolled in the plan. The allocation percentage is the per-
a decimal. This is your allocation centage that applies to the amounts you must use to com-
percentage. Go to Step 4 below . . . . . . . . 5. pute the PTC and reconcile it with APTC. The former
spouse must compute the PTC and reconcile APTC using
Step 4. If you use the same percentage in Step 2 above the remaining amounts.
for every month to which this allocation method applies,
use only one of lines 30 through 33 in Part IV to report the Step 2. Allocate the policy amounts with the second for-
allocation. If you use different percentages for different mer spouse using the same rules as Step 1 above. Enter
months under Step 2, use a separate line in Part IV for the percentage on line 4 of Worksheet D.
each allocation percentage. Complete the line as ex-
plained below. Step 3. Complete Worksheet D below.

Column (a). Enter the Marketplace-assigned policy
number from Form 1095-A, line 2. If the policy number on
the Form 1095-A is more than 15 characters, enter only
the last 15 characters.
Column (b). Enter the SSN of your former spouse.

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Worksheet D. Taxpayer Allocating With effective October 1. Lydia is enrolled in employer-spon-
Divorced or Separated Taxpayers sored coverage.
On their respective tax returns, Kara files as single and
1. Enter the decimal from line 1 of the includes only herself in her tax family; David files as single
Worksheet C completed by one of the and includes only himself in his tax family; and Lydia files
former spouses from Step 1 above . . . . . . . 1.
as head of household and includes Meredith and Sam in
2. Enter as a decimal the percentage from her tax family.
Step 1 above . . . . . . . . . . . . . . . . . . . . . . . . . 2. Under Step 1 of Rules for the Taxpayers Who Divorced
3. Multiply line 1 by line 2 . . . . . . . . . . . . . . . . 3. or Legally Separated in 2023 and Are Also Allocating With
4. Enter the decimal from line 1 of the Another Taxpayer, Kara and David agree to allocate the
Worksheet C completed by the other former policy amounts 30% to Kara and 70% to David. Under
spouse from Step 2 above . . . . . . . . . . . . . 4. Step 2 of that method (Kara, David) and under Rules for
5. Enter as a decimal the percentage from the Taxpayer(s) Allocating With Taxpayers Who Divorced
Step 2 above . . . . . . . . . . . . . . . . . . . . . . . . . 5. or Legally Separated in 2023 (Lydia), Kara and Lydia
6. Multiply line 4 by line 5 . . . . . . . . . . . . . . . . . 6. agree to allocate 80% of the policy amounts to Lydia, and
David and Lydia agree to allocate 50% of the policy
7. Add line 3 and line 6. This is the allocation amounts to Lydia. Each of them completes a worksheet as
percentage. Go to Step 4 below . . . . . . . . . 7.
shown below and uses it to complete Part IV.
Kara completes Worksheet C as follows.
Step 4. If you use the same percentages in Steps 1 and 2 Kara's Worksheet C. Allocations for Divorced
above for every month to which this allocation method ap-
or Legally Separated Taxpayers
plies, use only one of lines 30 through 33 in Part IV to re-
port the allocation. If you use different percentages for dif- 1. Enter as a decimal your percentage from
ferent months in Step 1 or Step 2, use a separate line in Step 1 above . . . . . . . . . . . . . . . . . . . . . . 1. 0.30
Part IV for each allocation percentage. Complete the line 2. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . . . 2. 1.0
as explained below. 3. Enter as a decimal the total of the
Column (a). Enter the Marketplace-assigned policy percentages from Step 2 above
number from Form 1095-A, line 2. If the policy number on allocated to the other taxpayer(s) . . . . . 3. 0.80
the Form 1095-A is more than 15 characters, enter only 4. Subtract line 3 from line 2 . . . . . . . . . . . 4. 0.20
the last 15 characters. 5. Multiply line 1 by line 4. Enter the result
Column (b). Enter the SSN of the former spouse as a decimal. This is the allocation
whose percentage you entered on Worksheet D, line 1. percentage. Go to Step 4 below . . . . . . 5. 0.06
After completing Worksheet C, Kara completes Form
Column (c). Enter the first month you are allocating
8962, Part IV, line 30, as follows.
policy amounts. For example, if you are allocating a per-
centage from January through June, enter “01” in column Column (a). Kara enters the Marketplace-assigned
(c). policy number from Form 1095-A, line 2.
Column (d). Enter the last month you are allocating Column (b). Kara enters David's SSN.
policy amounts. For example, if you are allocating a per-
Column (c). Kara enters “01.”
centage from January through June, enter “06” in column
(d). Column (d). Kara enters “09.”
Column (e). Enter the decimal from Worksheet D, Columns (e), (f), and (g). Kara enters “0.06.”
line 7.
After completing Part IV, Kara multiplies the amounts
Columns (f) and (g). Enter the decimal from Work- from Form 1095-A, Part III, by the corresponding percen-
sheet D, line 7. tages in Part IV, and enters these allocated amounts on
Example 1. Kara and David were married at the begin- Form 8962, lines 12 through 20, columns (a), (b), and (f).
ning of 2023 and have two children, Meredith and Sam. On each of those lines, she will enter $42 in column (a)
Kara enrolled herself, David, Meredith, and Sam in a (enrollment premiums of $700 x 0.06), $39 in column (b)
qualified health plan with coverage effective January 1. (applicable SLCSP premium of $650 x 0.06), and $26 in
For each month of coverage, the enrollment premiums column (f) (APTC of $425 x 0.06). She completes her
were $700, the applicable SLCSP premium for a coverage Form 8962, lines 21 through 23, columns (a), (b), and (f),
family of four was $650, and the APTC was $425. by entering the monthly amounts from her separate Form
Meredith and Sam moved in with their grandmother, Ly- 1095-A for her self-only coverage from October through
dia, in May. Kara and David divorced in September. Kara December. She does not allocate those amounts.
enrolled in a new qualified health plan for self-only cover-
David completes Worksheet C as follows.
age. David became eligible for and enrolled in em-
ployer-sponsored self-only coverage. Meredith and Sam
became eligible for and enrolled in government-spon-
sored coverage. All of the new plans have coverage

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David's Worksheet C. Allocations for                                 Lydia's Worksheet D. Taxpayer Allocating 
Divorced or Legally Separated Taxpayers                              With Divorced or Legally Separated 
1. Enter as a decimal your percentage                                Taxpayers 
   from Step 1 above . . . . . . . . . . . . . . . .         1. 0.70 1. Enter the decimal from line 1 of the 
2. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . . 2. 1.0     Worksheet C completed by one of the 
3. Enter as a decimal the total of the                                  former spouses from Step 1 
   percentages from Step 2 above                                        above  . . . . . . . . . . . . . . . . . . . . . . . . .  1. 0.30
   allocated to the other                                            2. Enter as a decimal the percentage 
   taxpayer(s)  . . . . . . . . . . . . . . . . . . . . . .  3. 0.50    from Step 1 above . . . . . . . . . . . . . . .           2. 0.80
4. Subtract line 3 from line 2  . . . . . . . . . .          4. 0.50 3. Multiply line 1 by line 2 . . . . . . . . . . . .         3. 0.24
5. Multiply line 1 by line 4. Enter the result                       4. Enter the decimal from line 1 of the 
   as a decimal. This is the allocation                                 Worksheet C completed by the other 
   percentage. Go to Step 4 below . . . . .                  5. 0.35    former spouse from Step 2 
                                                                        above . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0.70
After completing Worksheet C, David completes Form                   5. Enter as a decimal the percentage 
8962, Part IV, line 30, as follows.                                     from Step 2 above . . . . . . . . . . . . . . .           5. 0.50
                                                                     6. Multiply line 4 by line 5 . . . . . . . . . . . .         6. 0.35
Column  (a). David  enters  the  Marketplace-assigned 
policy number from Form 1095-A, line 2.                              7. Add line 3 and line 6. This is the 
                                                                        allocation percentage. Go to Step 4 
Column (b).  David enters Kara's SSN.                                   below . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 0.59
Column (c). David enters “01.”
                                                                     After  completing  Worksheet  D,  Lydia  completes  Form 
Column (d).  David enters “09.”                                      8962, Part IV, line 30, as follows.
Columns (e), (f), and (g). David enters “0.35.”                      Column  (a). Lydia  enters  the  Marketplace-assigned 
After completing Part IV, David multiplies the amounts               policy number from Form 1095-A, line 2.
from Form 1095-A, Part III, by the corresponding percen-             Column (b). Lydia enters Kara's SSN.
tages  in  Part  IV,  and  enters  these  allocated  amounts  on 
Form 8962, lines 12 through 20, columns (a), (b), and (f).           Column (c). Lydia enters “01.”
On each of those lines, he will enter $245 in column (a)             Column (d). Lydia enters “09.”
(enrollment premiums of $700 x 0.35), $228 in column (b) 
(applicable SLCSP premium of $650 x 0.35), and $149 in               Columns (e), (f), and (g).    Lydia enters “0.59.”
column  (f)  (APTC  of  $425  x  0.35).  David  leaves  Form 
8962, lines 21 through 23, blank because he was not en-              After  completing  Part  IV,  Lydia  multiplies  the  amounts 
rolled  in  a  qualified  health  plan  during  October  through     from Form 1095-A, Part III, by the corresponding percen-
December.                                                            tages  in  Part  IV,  and  enters  these  allocated  amounts  on 
                                                                     Form 8962, lines 12 through 20, columns (a), (b), and (f). 
Lydia completes Worksheet D as follows.                              On each of those lines, she will enter $413 in column (a) 
                                                                     (enrollment premiums of $700 x 0.59), $384 in column (b) 
                                                                     (applicable SLCSP premium of $650 x 0.59), and $251 in 
                                                                     column  (f)  (APTC  of  $425  x  0.59).  Lydia  leaves  Form 
                                                                     8962, lines 21 through 23, blank because she, Meredith, 
                                                                     and Sam were not enrolled in a qualified health plan dur-
                                                                     ing October through December.
                                                                     Example 2.  The facts are the same as in                        Example 1, 
                                                                     except  that  in  May,  Meredith  moved  in  with  her  grand-
                                                                     mother, Lydia, and Sam moved in with his aunt, Kimberly.
                                                                     On their respective tax returns, Kara files as single and 
                                                                     includes only herself in her tax family; David files as single 
                                                                     and includes only himself in his tax family; Lydia files as 
                                                                     head of household and includes Meredith in her tax family; 
                                                                     and  Kimberly  files  as  head  of  household  and  includes 
                                                                     Sam  in  her  tax  family.  Kimberly  is  enrolled  in  em-
                                                                     ployer-sponsored coverage.
                                                                     Under Step 1 of  Rules for the Taxpayers Who Divorced 
                                                                     or Legally Separated in 2023 and Are Also Allocating With 
                                                                     Another  Taxpayer,  Kara  and  David  agree  to  allocate  the 
                                                                     policy  amounts  40%  to  Kara  and  60%  to  David.  Under 
                                                                     Step 2 of that method (Kara, David) and under                   Rules for 

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the Taxpayer(s) Allocating With Taxpayers Who Divorced                  After completing Worksheet C, David completes Form 
or Legally Separated in 2023 (Lydia, Kimberly), Kara and                8962, Part IV, line 30, as follows.
Lydia agree to allocate 50% of the policy amounts to Ly-
                                                                        Column  (a). David  enters  the  Marketplace-assigned 
dia, and Kara and Kimberly agree to allocate 25% of the 
                                                                        policy number from Form 1095-A, line 2.
policy amounts to Kimberly. David and Lydia agree to allo-
cate 20% of the policy amounts to Lydia, and David and                  Column (b).  David enters Kara's SSN.
Kimberly agree to allocate 25% of the policy amounts to 
                                                                        Column (c). David enters “01.”
Kimberly. Each of them completes a worksheet as shown 
below and uses it to complete Part IV.                                  Column (d).  David enters “09.”
Kara completes Worksheet C as follows.
                                                                        Columns (e), (f), and (g).    David enters “0.33.”
Kara's Worksheet C. Allocations for Divorced 
or Legally Separated Taxpayers                                          After  completing  Part  IV,  David  completes  his  Form 
1. Enter as a decimal your percentage                                   8962 in the same manner described in Example 1, earlier, 
   from Step 1 above . . . . . . . . . . . . . . . . .         1. 0.40  but applies the different allocation percentage.

2. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . . . 2. 1.0   Lydia completes Worksheet D as follows.
3. Enter as a decimal the total of the                                  Lydia's Worksheet D. Taxpayer Allocating 
   percentages from Step 2 above                                        With Divorced or Legally Separated 
   allocated to the other 
   taxpayer(s)  . . . . . . . . . . . . . . . . . . . . . . .  3. 0.75* Taxpayers
4. Subtract line 3 from line 2  . . . . . . . . . . .          4. 0.25  1. Enter the decimal from line 1 of the 
                                                                           Worksheet C completed by one of the 
5. Multiply line 1 by line 4. Enter the result 
                                                                           former spouses from Step 1 
   as a decimal. This is the allocation                                                                                                 0.40
   percentage. Go to Step 4 below . . . . . .                  5. 0.10     above  . . . . . . . . . . . . . . . . . . . . . . . . .  1.
                                                                        2. Enter as a decimal the percentage 
* This is the total of Kara's agreed percentages with Lydia and            from Step 1 above . . . . . . . . . . . . . . .           2. 0.50
Kimberly (0.50 + 0.25).                                                 3. Multiply line 1 by line 2 . . . . . . . . . . . .         3. 0.20
After  completing  Worksheet  C,  Kara  completes  Form                 4. Enter the decimal from line 1 of the 
8962, Part IV, line 30, as follows.                                        Worksheet C completed by the other 
Column  (a). Kara  enters  the  Marketplace-assigned                       former spouse from Step 2 
policy number from Form 1095-A, line 2.                                    above . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0.60
                                                                        5. Enter as a decimal the percentage 
Column (b). Kara enters David's SSN.                                       from Step 2 above . . . . . . . . . . . . . . .           5. 0.20
Column (c). Kara enters “01.”                                           6. Multiply line 4 by line 5 . . . . . . . . . . . .         6. 0.12
Column (d). Kara enters “09.”                                           7. Add line 3 and line 6. This is the 
                                                                           allocation percentage. Go to Step 4 
Columns (e), (f), and (g).  Kara enters “0.10.”                            below . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 0.32

After  completing  Part  IV,  Kara  completes  her  Form                After  completing  Worksheet  D,  Lydia  completes  Form 
8962 in the same manner described in Example 1, earlier,                8962, Part IV, line 30, as follows.
but applies the different allocation percentage.
                                                                        Column  (a). Lydia  enters  the  Marketplace-assigned 
David completes Worksheet C as follows.                                 policy number from Form 1095-A, line 2.
David's Worksheet C. Allocations for                                    Column (b).  Lydia enters Kara's SSN.
Divorced or Legally Separated Taxpayers                                 Column (c). Lydia enters “01.”
1. Enter as a decimal your percentage                                   Column (d).  Lydia enters “09.”
   from Step 1 above . . . . . . . . . . . . . . . .           1. 0.60
2. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . .   2. 1.0   Columns (e), (f), and (g).    Lydia enters “0.32.”

3. Enter as a decimal the total of the                                  After  completing  Part  IV,  Lydia  completes  her  Form 
   percentages from Step 2 above                                        8962 in the same manner as in Example 1, earlier, but ap-
   allocated to the other                                               plies the different allocation percentage.
   taxpayer(s)  . . . . . . . . . . . . . . . . . . . . . .    3. 0.45*
4. Subtract line 3 from line 2  . . . . . . . . . .            4. 0.55  Kimberly completes Worksheet D as follows.
5. Multiply line 1 by line 4. Enter the result 
   as a decimal. This is the allocation 
   percentage. Go to Step 4 below . . . . .                    5. 0.33
* This is the total of David's agreed percentages with Lydia 
and Kimberly (0.20 + 0.25). 

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Kimberly's Worksheet D. Taxpayer Allocating Example. Pat and Jamie were married for all of 2023
With Divorced or Legally Separated and have three children, Jason, Alicia, and Dawn. All five
Taxpayers individuals enrolled in a qualified health plan and were
covered for all of 2023. At enrollment, Pat and Jamie ex-
1. Enter the decimal from line 1 of the pected to file a joint return and include the children in their
Worksheet C completed by one of the tax family for the year of coverage. However, Pat and Ja-
former spouses from Step 1 mie change their minds and file as married filing sepa-
above . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0.40 rately and each includes only themselves in their respec-
2. Enter as a decimal the percentage tive tax family. Neither checks the box in the top right-hand
from Step 1 above . . . . . . . . . . . . . . . 2. 0.25 corner of Form 8962. Jason, Alicia, and Dawn moved in
3. Multiply line 1 by line 2 . . . . . . . . . . . . 3. 0.10 with their uncle, Andy, in April. Andy files as head of
4. Enter the decimal from line 1 of the household and includes Jason, Alicia, and Dawn in his tax
Worksheet C completed by the other family.
former spouse from Step 2 Pat and Jamie use the allocation method under Rules
above . . . . . . . . . . . . . . . . . . . . . . . . . 4. 0.60 for the Married Taxpayers Not Filing a Joint Return and
5. Enter as a decimal the percentage Also Allocating With Another Taxpayer next.
from Step 2 above . . . . . . . . . . . . . . . 5. 0.25 Andy uses the allocation method under Rules for the
Taxpayer(s) Allocating With Married Taxpayers Not Filing
6. Multiply line 4 by line 5 . . . . . . . . . . . . 6. 0.15
a Joint Return, later.
7. Add line 3 and line 6. This is the
allocation percentage. Go to Step 4
below . . . . . . . . . . . . . . . . . . . . . . . . . . 7. 0.25 Rules for the Married Taxpayers Not Filing a
Joint Return and Also Allocating With
After completing Worksheet D, Kimberly completes Another Taxpayer

Form 8962, Part IV, line 30, as follows. Use this allocation method if you are married but not filing
Column (a). Kimberly enters the Marketplace-as- a joint return and you must allocate policy amounts with
signed policy number from Form 1095-A, line 2. your spouse and with a taxpayer who is including in their
tax family an individual enrolled in a qualified health plan
Column (b). Kimberly enters Kara's SSN. with members of your and your spouse’s tax families. Un-
Column (c). Kimberly enters “01.” der this method, you must first allocate 50% each of en-
rollment premiums and APTC to yourself and your spouse.
Column (d). Kimberly enters “09.” Line 4 of Worksheet E accomplishes this 50% allocation.
Columns (e), (f), and (g). Kimberly enters “0.25.” Complete the steps below to determine the amounts to
enter on your Form 8962, Part IV.
After completing Part IV, Kimberly completes her Form
8962 in the same manner described for Lydia in Exam- Step 1. Determine the applicable SLCSP for your cover-
ple 1, earlier, but applies the different allocation percent- age family. See Determining the Premium for the Applica-
age. ble Second Lowest Cost Silver Plan (SLCSP), earlier. For
this purpose, your coverage family or your spouse’s cover-
age family (but not both) should include the individuals the
Allocation Among Taxpayers Who Are other taxpayer is including in their tax family and who was
Married But Not Filing a Joint Return enrolled in a qualified health plan with your and your spou-
and One or More Other Taxpayers se’s tax family members. Enter the applicable SLCSP pre-
mium you determined on line 5 of Worksheet E.
Use this section if you meet either of the following condi-
tions and no other allocations for the policy are necessary. Step 2. Separately from the first allocation (the 50%
spousal allocation), determine an allocation percentage
• You are allocating enrollment premiums and APTC with the taxpayer(s) including in their tax family the individ-
with a spouse to whom you are legally married but not ual(s) enrolled in the plan. You may agree on any alloca-
filing a joint return in 2023 and you are also allocating tion percentage from -0- to 100. You may use the percent-
enrollment premiums, applicable SLCSP premiums, age you agreed on for every month in which this allocation
and APTC with another taxpayer who is including in rule applies, or you may agree on different percentages for
their tax family an individual who was enrolled in a different months. However, you must use the same alloca-
qualified health plan with members of your and your tion percentage for all policy amounts (enrollment premi-
spouse’s tax families. ums, applicable SLCSP premiums, and APTC) in a month.
• You are the taxpayer who is including in your tax family If you cannot agree on an allocation percentage, the allo-
an individual who was enrolled in the plan with tax cation percentage is equal to the number of individuals the
family members of taxpayers who must also allocate other taxpayer includes in their tax family for the tax year
policy amounts because the taxpayers are legally who were enrolled in the qualified health plan for which
married but not filing a joint return in 2023. you are allocating amounts, divided by the total number of
individuals enrolled in the plan. The allocation percentage

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is the percentage that applies to the amounts the other enter the decimal from line 4 of Worksheet E in column
taxpayer must use to compute the PTC and reconcile it (e).
with APTC. You must compute the PTC and reconcile
Column (f). If your filing status is married filing sepa-
APTC using the remaining amounts.
rately and you did not check the box in the top right-hand
corner of Form 8962, leave column (f) blank. If you
Step 3. Complete Worksheet E below. checked the box, or Exception 1—Certain married per-
Worksheet E. Allocations for Married sons living apart under Married taxpayers (discussed ear-
lier under Terms You May Need To Know) applies to you,
Taxpayers Not Filing a Joint Return
enter the decimal from line 3 of Worksheet E in column (f)
1. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . 1. 1.0 and include the amount from line 6 of Worksheet E in the
2. Enter as a decimal the total of the totals on the appropriate lines of Form 8962, column (b),
percentage(s) from Step 2 above for the months allocated.
allocated to the other Column (g). Enter the decimal from line 4 of Work-
taxpayer(s) . . . . . . . . . . . . . . . . . . . . . 2.
sheet E.
3. Subtract line 2 from line 1 . . . . . . . . . 3.
4. Divide line 3 by 2.0. Enter the result as Rules for the Taxpayer(s) Allocating With
a decimal . . . . . . . . . . . . . . . . . . . . . . 4. Married Taxpayers Not Filing a Joint Return
5. Enter the applicable SLCSP premium
as determined in Step 1 above. Then, Use this allocation method if you are including in your tax
go to line 6 if you checked the box in family an individual who was enrolled in a qualified health
the top right-hand corner of Form plan with tax family members of taxpayers who must also
8962, or Exception 1—Certain married allocate policy amounts because the taxpayers are legally
persons living apart under Married married but not filing a joint return in 2023.
taxpayers (discussed earlier under
Terms You May Need To Know) Step 1. Determine an allocation percentage with one of
applies to you. Otherwise, stop the spouses. You may agree on any allocation percentage
here . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. from -0- to 100. You may use the percentage you agreed
6. Multiply line 5 by line 3. Complete on for every month in which this allocation rule applies, or
Form 8962, Part IV, as instructed in you may agree on different percentages for different
Step 4 below . . . . . . . . . . . . . . . . . . . . 6. months. However, you must use the same allocation per-
centage for all policy amounts (enrollment premiums, ap-
Step 4. If you use the same percentage for every month plicable SLCSP premiums, and APTC) in a month. If you
during which this allocation method applies, use only one cannot agree on an allocation percentage, the allocation
of lines 30 through 33 in Part IV to report the allocation. If percentage is equal to the number of individuals you will
you use different percentages for different months under include in your tax family for the tax year who were enrol-
Step 2, use a separate line in Part IV for each allocation led in the qualified health plan for which you are allocating
percentage. Complete the line as explained below. policy amounts, divided by the total number of individuals
enrolled in the plan. The allocation percentage is the per-
Column (a). Enter the Marketplace-assigned policy centage that applies to the amounts you must use to com-
number from Form 1095-A, line 2. If the policy number on pute the PTC and reconcile it with APTC. The spouses
the Form 1095-A is more than 15 characters, enter only must compute the PTC and reconcile APTC using the re-
the last 15 characters. maining amounts. Enter the percentage as a decimal on
Column (b). Enter the SSN of your spouse. line 1 of Worksheet F.

Column (c). Enter the first month you are allocating Step 2. Allocate the policy amounts with the second
policy amounts. For example, if you are allocating a per- spouse using the same rules as Step 1 above. Enter the
centage from January through June, enter “01” in column percentage as a decimal on line 3 of Worksheet F.
(c).
Step 3. Complete Worksheet F below.
Column (d). Enter the last month you are allocating
policy amounts. For example, if you are allocating a per-
centage from January through June, enter “06” in column
(d).
Column (e). If your filing status is married filing sepa-
rately and you did not check the box in the top right-hand
corner of Form 8962, leave column (e) blank. If you
checked the box, or Exception 1—Certain married per-
sons living apart under Married taxpayers (discussed ear-
lier under Terms You May Need To Know) applies to you,

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Worksheet F. Taxpayer Allocating With Column (d). Enter the last month you are allocating
Married Taxpayers Not Filing a Joint Return policy amounts. For example, if you are allocating a per-
centage from January through June, enter “06” in column
Part I: Allocation Percentage for Enrollment Premiums (d).
and APTC Paid
Column (e). Enter the decimal from Worksheet F,
1. Enter as a decimal the percentage line 5.
from Step 1 above . . . . . . . . . . . . . . . . 1.
2. Divide line 1 by 2.0. Enter the result as Column (f). Leave column (f) blank.
a decimal . . . . . . . . . . . . . . . . . . . . . . . . 2.
Column (g). Enter the decimal from Worksheet F,
3. Enter as a decimal the percentage line 5.
from Step 2 above . . . . . . . . . . . . . . . . 3.
4. Divide line 3 by 2.0. Enter the result as Example. Pat and Jamie were married for all of 2023
a decimal . . . . . . . . . . . . . . . . . . . . . . . . 4. and have three children, Jason, Alicia, and Dawn. All five
individuals enrolled in a qualified health plan and were
5. Add lines 2 and 4. Enter the result as a
covered for all of 2023. For each month of coverage, the
decimal. This is your allocation
percentage for enrollment premiums enrollment premiums were $1,000, the premium for the
and APTC paid . . . . . . . . . . . . . . . . . . . 5. applicable SLCSP for a coverage family of five was $800,
and the APTC was $200. At enrollment, Pat and Jamie ex-
Part II: Allocation of the Applicable SLCSP Premium pected to file a joint return and include the children in their
6. Enter the amount of the applicable tax family.
SLCSP premium from line 5 of Jason, Alicia, and Dawn moved in with their uncle,
Worksheet E completed by the spouse Andy, in April. On their respective tax returns, Pat and Ja-
in Step 1 above . . . . . . . . . . . . . . . . . . . 6. mie file as married filing separately and each includes only
7. Enter the decimal from line 1 of this themselves in their respective tax family. Neither checks
worksheet . . . . . . . . . . . . . . . . . . . . . . . 7. the box in the top right-hand corner of Form 8962. Andy
8. Multiply line 6 by line 7 . . . . . . . . . . . . . 8. files as head of household and includes Jason, Alicia, and
Dawn in his tax family.
9. Enter the amount of the applicable Pat and Jamie allocate the enrollment premiums and
SLCSP premium from line 5 of the APTC 50% to Pat and 50% to Jamie. Under Step 1 of
Worksheet E completed by the spouse Rules for the Married Taxpayers Not Filing a Joint Return
in Step 2 above . . . . . . . . . . . . . . . . . . . 9.
and Also Allocating With Another Taxpayer, earlier, Pat
10. Enter the decimal from line 3 of this and Jamie determine that Pat’s coverage family will in-
worksheet . . . . . . . . . . . . . . . . . . . . . . . 10.
clude Pat, Jason, and Alicia and that Jamie’s coverage
11. Multiply line 9 by line 10 . . . . . . . . . . . . 11. family will include Jamie and Dawn. Pat and Jamie each
12. Add lines 8 and 11. This is the look up their applicable SLCSP premiums. The applicable
applicable SLCSP premium allocated SLCSP premium for Pat’s coverage family of three is $450
to you that you must include on lines 12 and the applicable SLCSP premium for Jamie’s coverage
through 23, column (b), for the months family of two is $400.
in which this allocation applies . . . . . . 12. Under Step 2 of Rules for the Married Taxpayers Not
Filing a Joint Return and Also Allocating With Another Tax-
Step 4. If you use the same percentage for every month payer (Pat, Jamie) and under Rules for the Taxpayer(s) Al-
during which this allocation method applies, use only one locating With Married Taxpayers Not Filing a Joint Return
of lines 30 through 33 in Part IV to report the allocation. If (Andy), earlier, Pat and Andy agree to allocate 67% of the
you use different percentages for different months, use a policy amounts to Andy, and Jamie and Andy agree to al-
separate line in Part IV for each allocation percentage. locate 50% of the policy amounts to Andy. Pat, Jamie, and
Complete the line as explained below. Andy each complete a worksheet as shown below and
use it to complete Part IV.
Column (a). Enter the Marketplace-assigned policy
Pat completes Worksheet E as follows.
number from Form 1095-A, line 2. If the policy number on
the Form 1095-A is more than 15 characters, enter only
the last 15 characters.
Column (b). Enter the SSN of the spouse whose per-
centage you entered on Worksheet F, line 1.
Column (c). Enter the first month you are allocating
policy amounts. For example, if you are allocating a per-
centage from January through June, enter “01” in column
(c).

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Pat's Worksheet E. Allocations for Married                           Jamie's Worksheet E. Allocations for Married 
Taxpayers Not Filing a Joint Return                                  Taxpayers Not Filing a Joint Return
1. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . . . 1. 1.0  1. Enter 1.0 . . . . . . . . . . . . . . . . . . . . . . .    1. 1.0
2. Enter as a decimal the total of the                               2. Enter as a decimal the total of the 
   percentage(s) from Step 2 above                                      percentage(s) from Step 2 above 
   allocated to the other                                               allocated to the other 
   taxpayer(s)  . . . . . . . . . . . . . . . . . . . . . .  2. 0.67    taxpayer(s)  . . . . . . . . . . . . . . . . . . . . .     2. 0.50
3. Subtract line 2 from line 1 . . . . . . . . . .           3. 0.33 3. Subtract line 2 from line 1 . . . . . . . . .              3. 0.50
4. Divide line 3 by 2.0. Enter the result as                         4. Divide line 3 by 2.0. Enter the result as 
   a decimal  . . . . . . . . . . . . . . . . . . . . . . .  4. 0.17    a decimal  . . . . . . . . . . . . . . . . . . . . . .     4. 0.25
5. Enter the applicable SLCSP premium                                5. Enter the applicable SLCSP premium 
   as determined in Step 1 above. Then,                                 as determined in Step 1 above. Then, 
   go to line 6 if you checked the box in                               go to line 6 if you checked the box in 
   the top right-hand corner of Form                                    the top right-hand corner of Form 
   8962, or Exception 1—Certain married                                 8962, or Exception 1—Certain married 
   persons living apart under Married                                   persons living apart under Married 
   taxpayers (discussed earlier under                                   taxpayers (discussed earlier under 
   Terms You May Need To Know) applies                                  Terms You May Need To Know) 
   to you. Otherwise, stop here . . . . . . . .              5. 450     applies to you. Otherwise, stop 
6. Multiply line 5 by line 3. Complete                                  here . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. 400
   Form 8962, Part IV, as instructed in                              6. Multiply line 5 by line 3. Complete 
   Step 4 below . . . . . . . . . . . . . . . . . . . . .    6.         Form 8962, Part IV, as instructed in 
After  completing  Worksheet  E,  Pat  completes  Form                  Step 4 below . . . . . . . . . . . . . . . . . . . .       6.  
8962, Part IV, line 30, as follows.
                                                                     After completing Worksheet E, Jamie completes Form 
Column (a). Pat enters the Marketplace-assigned pol-                 8962, Part IV, line 30, as follows.
icy number from Form 1095-A, line 2.
                                                                     Column  (a). Jamie  enters  the  Marketplace-assigned 
Column (b). Pat enters Jamie’s SSN.                                  policy number from Form 1095-A, line 2.
Column (c). Pat enters “01.”                                         Column (b).  Jamie enters Pat’s SSN.
Column (d). Pat enters “12.”                                         Column (c). Jamie enters “01.”
Column (e). Pat leaves this column blank.                            Column (d).  Jamie enters “12.”
Column (f). Pat leaves this column blank.                            Column (e).  Jamie leaves this column blank.
Column (g). Pat enters “0.17.”                                       Column (f). Jamie leaves this column blank.
After completing Part IV, Pat multiplies the APTC from               Column (g).  Jamie enters “0.25.”
Form 1095-A, Part III, column C, by the percentage in Part 
IV, column (g), and enters $34 (APTC of $200 x 0.17) on              After  completing  Part  IV,  Jamie  multiplies  the  APTC 
Form  8962,  lines  12  through  23,  column  (f).  Pat  leaves      from Form 1095-A, Part III, column C, by the percentage in 
lines  12  through  23,  columns  (a)  through  (e),  blank  be-     Part IV, column (g), and enters $50 (APTC of $200 x 0.25) 
cause he is not eligible to take the PTC.                            on  Form  8962,  lines  12  through  23,  column  (f).  Jamie 
                                                                     leaves lines 12 through 23, columns (a) through (e), blank 
Jamie completes Worksheet E as follows.                              because she is not eligible to take the PTC.

                                                                     Andy completes Worksheet F as follows.

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Andy's Worksheet F. Taxpayer Allocating With (b) (applicable SLCSP premium allocated to him on Work-
Married Taxpayers Not Filing a Joint Return sheet F, line 12), and $118 in column (f) (APTC of $200 x
0.59).
Part I: Allocation Percentage for Enrollment Premiums
and APTC Paid
Other Taxpayers Allocating Policy
1. Enter as a decimal the percentage
from Step 1 above . . . . . . . . . . . . . . . . 1. 0.67 Amounts With Two or More Other
2. Divide line 1 by 2.0. Enter the result as Taxpayers
a decimal . . . . . . . . . . . . . . . . . . . . . . . . 2. 0.34
If you or another person in your tax family was enrolled in
3. Enter as a decimal the percentage a qualified health plan with individuals in at least two other
from Step 2 above . . . . . . . . . . . . . . . . 3. 0.50
tax families, APTC was paid for coverage under the policy,
4. Divide line 3 by 2.0. Enter the result as and you don't meet the rules for divorce or for married indi-
a decimal . . . . . . . . . . . . . . . . . . . . . . . . 4. 0.25
viduals filing separate returns, you and the taxpayers who
5. Add lines 2 and 4. Enter the result as a are including in their tax family the individuals not in your
decimal. This is your allocation tax family should use the instructions for Form 8962 under
percentage for enrollment premiums Allocation Situation 4. Other situations where a policy is
and APTC paid . . . . . . . . . . . . . . . . . . . 5. 0.59
shared between two tax families to allocate amounts from
Part II: Allocation of the Applicable SLCSP Premium the qualified health plan. There must be an allocation per-
centage for each taxpayer who is including in their tax
6. Enter the amount of the applicable
family an individual who is enrolled in a qualified health
SLCSP premium from line 5 of
Worksheet E completed by the spouse plan with a member of your tax family. If you cannot agree
in Step 1 above . . . . . . . . . . . . . . . . . . . 6. 450 on an allocation percentage with all taxpayers who are in-
cluding enrolled individuals in a tax family, the allocation
7. Enter the decimal from line 1 of this
worksheet . . . . . . . . . . . . . . . . . . . . . . . 7. 0.67 percentage for a particular taxpayer is equal to the num-
ber of individuals the taxpayer will include in their tax fam-
8. Multiply line 6 by line 7 . . . . . . . . . . . . . 8. 302 ily for the tax year who were enrolled in the qualified health
9. Enter the amount of the applicable plan for which you are allocating policy amounts, divided
SLCSP premium from line 5 of by the total number of individuals enrolled in the plan.
Worksheet E completed by the spouse
in Step 2 above . . . . . . . . . . . . . . . . . . . 9. 400 Example 1. Erik enrolled himself and his sons, Bill and
10. Enter the decimal from line 3 of this Arvind, in a qualified health plan with coverage effective
worksheet . . . . . . . . . . . . . . . . . . . . . . . 10. 0.50 for all of 2023. For the year, the enrollment premiums were
$8,000; the premium for the applicable SLCSP for a cover-
11. Multiply line 9 by line 10 . . . . . . . . . . . . 11. 200
age family consisting of Erik, Bill, and Arvind was $9,000;
12. Add lines 8 and 11. This is the and the APTC paid for their coverage was $4,500. In
applicable SLCSP premium allocated March, Bill dropped out of school to work full-time and
to you that you must include on lines moved permanently into his own apartment. In May, Ar-
12 through 23, column (b), for the vind moved in with his mother Sharon, where he lived until
months in which this allocation the end of 2023. On their respective tax returns, Erik files
applies . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 502
as single and includes only himself in his tax family, Bill
files as single and includes only himself in his tax family,
After completing Worksheet F, Andy completes Form and Sharon files as head of household and includes her-
8962, Part IV, line 30, as follows. self and Arvind in her tax family.
Column (a). Andy enters the Marketplace-assigned Erik and Bill agree to allocate 25% of the policy
policy number from Form 1095-A, line 2. amounts to Bill. Erik and Sharon agree to allocate 40% of
the policy amounts to Sharon. Erik allocates the remaining
Column (b). Andy enters Pat’s SSN. 35% of the policy amounts to himself.
Column (c). Andy enters “01.” Bill completes Form 8962, Part IV, line 30, as follows.
Column (d). Andy enters “12.” Column (a). Bill enters the Marketplace-assigned pol-
icy number from Form 1095-A, line 2.
Column (e). Andy enters “0.59.”
Column (b). Bill enters Erik's SSN.
Column (f). Andy leaves this column blank.
Column (c). Bill enters “01.”
Column (g). Andy enters “0.59.”
Column (d). Bill enters “12.”
After completing Part IV, Andy multiplies the amounts Columns (e), (f), and (g). Bill enters an allocation
from Form 1095-A, Part III, by the corresponding percen- percentage of “0.25” in columns (e), (f), and (g).
tages in Part IV, and enters these allocated amounts on
Form 8962, lines 12 through 23, columns (a), (b), and (f). After completing Part IV, Bill multiplies the amounts
On each of those lines, he will enter $590 in column (a) from Form 1095-A, Part III, by the corresponding percen-
(enrollment premiums of $1,000 x 0.59), $502 in column tages in Part IV, and enters these allocated amounts on

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his Form 8962, lines 12 through 23, columns (a), (b), and
(f). The sum of his monthly entries will be $2,000 in col-
umn (a) (enrollment premiums of $8,000 x 0.25), $2,250 in Alternative Calculation for Year
column (b) (applicable SLCSP premium of $9,000 x 0.25),
of Marriage
and $1,125 in column (f) (APTC of $4,500 x 0.25).
Sharon completes Form 8962, Part IV, line 30, as fol- If you got married during 2023 and APTC was paid for an
lows. individual in your tax family, you may want to use the alter-
native calculation for year of marriage, an optional calcula-
Column (a). Sharon enters the Marketplace-assigned tion that may reduce the amount of excess APTC you
policy number from Form 1095-A, line 2. would have to repay under the general rules. Before you
Column (b). Sharon enters Erik’s SSN. read this section, first read the instructions for line 9 in the
Instructions for Form 8962. Complete Table 4 and, if re-
Column (c). Sharon enters “01.” quired, Worksheet 3 in those instructions.
Column (d). Sharon enters “12.” If you do not meet either of the above conditions,
you are not eligible to elect the alternative calcu-
Columns (e), (f), and (g). Sharon enters an allocation CAUTION!
lation. Leave Form 8962, Part V, blank.
percentage of “0.40” in columns (e), (f), and (g).
After completing Part IV, Sharon multiplies the amounts If you are eligible, electing the alternative calculation
from Form 1095-A, Part III, by the corresponding percen- may reduce the amount of excess APTC you have to re-
tages in Part IV, and enters these allocated amounts on pay. Electing the alternative calculation is optional. Work-
Form 8962, lines 12 through 23, columns (a), (b), and (f). sheet V will tell you whether the alternative calculation will
The sum of her monthly entries will be $3,200 in column benefit you.
(a) (enrollment premiums of $8,000 x 0.40), $3,600 in col- Before you begin the steps, determine your alterna-
umn (b) (applicable SLCSP premium of $9,000 x 0.40), tive family size and your spouse’s alternative family size
and $1,800 in column (f) (APTC of $4,500 x 0.40). using the instructions under Alternative Family Size next.
Then, read Table A to determine which steps to complete.
Erik completes Form 8962, Part IV, line 30, as follows.

Column (a). Erik enters the Marketplace-assigned Alternative Family Size
policy number from Form 1095-A, line 2.
Column (b). Erik enters either Bill’s SSN or Sharon’s Alternative family size is used to determine an alternative
SSN. monthly contribution amount (see Monthly contribution
amount under Terms You May Need To Know, earlier) on
Column (c). Erik enters “01.” Worksheets I and III, which may reduce the amount of ex-
cess APTC for the pre-marriage months that you must re-
Column (d). Erik enters “12.”
pay.
Columns (e), (f), and (g). Erik enters an allocation
When determining your alternative family size, include
percentage of “0.35” in columns (e), (f), and (g), which is
yourself and any individual in the tax family who qualifies
the percentage of policy amounts not allocated to Bill or
as your dependent for the year under the rules explained
Sharon.
in the Instructions for Form 1040 or the Instructions for
After completing Part IV, Erik multiplies the amounts Form 1040-NR. Do not include any individual who does
from Form 1095-A, Part III, by the corresponding percen- not qualify as your dependent under those rules or who is
tages in Part IV, and enters these allocated amounts on included in your spouse’s alternative family size.
his Form 8962, lines 12 through 23, columns (a), (b), and When determining your spouse’s alternative family size,
(f). The sum of his monthly entries will be $2,800 in col- include your spouse and any individual in the tax family
umn (a) (enrollment premiums of $8,000 x 0.35), $3,150 in who qualifies as your spouse’s dependent for the year un-
column (b) (applicable SLCSP of $9,000 x 0.35), and der the rules explained in the Instructions for Form 1040 or
$1,575 in column (f) (APTC of $4,500 x 0.35). the Instructions for Form 1040-NR. Do not include any in-
Example 2. The facts are the same as in Example 1, dividual who does not qualify as your spouse’s dependent
except Erik and Bill cannot agree on an allocation percent- under those rules or who is included in your alternative
age. Because Erik did not agree on an allocation percent- family size.
age with all taxpayers who are including individuals in a
Note. You may include an individual who qualifies as
tax family, Bill and Sharon determine their allocation per-
the dependent of both you and your spouse in either alter-
centages of 33% by dividing the number of enrolled indi-
native family size.
viduals each will include in their tax family (1 each for Bill
and Sharon) by the number of individuals enrolled in the Example 1. Ron, Suzy, and their son Max have lived
plan (3, Erik, Bill, and Arvind). Erik’s allocation percentage together since July 2022. Ron and Suzy got married in Au-
is 34%, which is the percentage of policy amounts not al- gust 2023. Each of them had coverage under a qualified
located to Bill and Sharon. Each taxpayer completes Part health plan for the months before September. Max
IV as explained in Example 1 using these percentages. qualifies as Ron’s dependent under the rules explained in

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the Instructions for Form 1040. Max also qualifies as Su- Worksheet for Line 4 of Worksheet I
zy’s dependent under those rules. Ron and Suzy can in-
clude Max in either alternative family size. Use this worksheet to figure the amount to enter on line 4
of Worksheet I.
Example 2. Rob and his son Liam lived together from
1. Enter the amount from line 2 of Worksheet I . . . . . . .
January through May 2023. On June 10, 2023, Rob mar- 1.
ried Tara. She moved in with Rob and Liam on June 11. 2. Enter the amount from line 3 of
Worksheet I . . . . . . . . . . . . . . . . . . . 2.
Each of them had coverage under a qualified health plan
3. Multiply the amount on line 2 by 4.0 . . . . . . . . . . . . .
for the months before July. Liam qualifies as Rob’s de- 3.
pendent under the rules explained in the Instructions for 4. Is the amount on line 1 more than the amount on
Form 1040. Liam also qualifies as Tara’s dependent under line 3?
those rules. (Liam is Tara’s stepchild and lived with Tara Yes. Enter 401 here and on line 4 of Worksheet I.
No. Divide the amount on line 1 by the amount on
for more than half of 2023.) Rob and Tara can include line 2. If the result is not a whole percentage, do not
Liam in either alternative family size. round; instead, multiply this number by 100 (to
Example 3. Stacey and her daughter Leia lived to- express it as a percentage) and then drop any
numbers after the decimal point. Enter the result here
gether from January through July 2023. Stacey married and on line 4 of Worksheet I. For example, for 0.9984,
Vince in August 2023, and Vince moved in with Stacey enter the result as 99; for 1.8565, enter the result as
and Leia. Each of them had coverage under a qualified 185; and for 3.997, enter the result as 399 . . . . . . . . . 4.
health plan for the months before September. Leia quali-
fies as Stacey’s dependent under the rules explained in
the Instructions for Form 1040. Leia does not qualify as Step 2

Vince’s dependent under those rules because Leia did not Complete Worksheet II to determine your alternative
live with Vince for more than half of 2023. Stacey must in- monthly credit amounts to include on Form 8962, lines 12
clude Leia in her alternative family size. Vince cannot in- through 23, column (e), for your pre-marriage months. En-
clude Leia in his alternative family size. ter in columns A and B on Worksheet II the amounts from
Table A. Which Steps To Complete columns A and B in Part III of the Form(s) 1095-A that re-
ports coverage for all individuals in your tax family enrolled
Answer the following questions to determine which in a qualified health plan for 1 or more pre-marriage
steps to complete. months, including yourself, who are (a) included in Part II
of a Form 1095-A sent to you for the pre-marriage months;
1. Have you determined your and your spouse's alternative family or (b) not included in Part II of the Form 1095-A sent to
size as explained earlier under Alternative Family Size?
you or to your spouse, but who are included in your alter-
Yes. Go to question 2.
native family size.
No. Read Alternative Family Size. Then, go to question 2.
2. Is there an individual in your alternative family size (including Missing or incorrect SLCSP premium. For your
yourself) who was enrolled in a qualified health plan for 1 or more pre-marriage months, if there were changes in your cover-
of your pre-marriage months?* age family that you did not report to the Marketplace or
Yes. Complete Steps 1, 2, and 5. Go to question 3. APTC was not paid for the coverage, or there is an individ-
No. Go to question 3. ual in your coverage family not included in Part II of the
3. Is there an individual in your spouse’s alternative family size Form 1095-A sent to you who is included in your alterna-
(including your spouse) who was enrolled in a qualified health plan tive family size, you may have to determine a new pre-
for 1 or more of your pre-marriage months?* mium for your applicable SLCSP for those months. See
Yes. Complete Steps 3, 4, and 5. Go to question 4. Determining the Premium for the Applicable Second Low-
No. Go to question 4. est Cost Silver Plan (SLCSP), earlier.
4. The instructions for Step 5 will prompt you to complete Worksheet
V. If you check the “Yes” box on Worksheet V, line 14, complete Step 3
Steps 6, 7, and 8.
Complete Worksheet III if there is an individual included in
* Your pre-marriage months include the month you got married.
your spouse’s alternative family size who was enrolled in a
If you completed Part IV of Form 8962, do not in- qualified health plan for 1 or more of your pre-marriage
TIP clude any amounts from Form(s) 1095-A that months.
were allocated to another taxpayer when complet- Worksheet for Line 4 of Worksheet III
ing the steps for your and your spouse's alternative calcu- Use this worksheet to figure the amount to enter on line 4
lation. of Worksheet III.

Step 1

Complete Worksheet I if there is an individual included in
your alternative family size who was enrolled in a qualified
health plan for 1 or more of your pre-marriage months.

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1. Enter the amount from line 2 of Worksheet III . . . . . . 1. your spouse may have to determine a new premium for
the applicable SLCSP for those months. See Determining
2. Enter the amount from line 3 of
Worksheet III . . . . . . . . . . . . . . . . . . . 2. the Premium for the Applicable Second Lowest Cost Silver
3. Multiply the amount on line 2 by 4.0 . . . . . . . . . . . . 3. Plan (SLCSP), earlier.
4. Is the amount on line 1 more than the amount on
line 3? Step 5
Yes. Enter 401 here and on line 4 of Worksheet III.
No. Divide the amount on line 1 by the amount on After you have completed Steps 1 and 2 and/or Steps 3
line 2. If the result is not a whole percentage, do not and 4, complete Worksheet V to determine what entries
round; instead, multiply this number by 100 (to you must make on Form 8962, lines 12 through 23, for
express it as a percentage) and then drop any your pre-marriage months.
numbers after the decimal point. Enter the result here
and on line 4 of Worksheet III. For example, for
0.9984, enter the result as 99; for 1.8565, enter the Step 6
result as 185; and for 3.997, enter the result
as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Complete Form 8962, lines 35 and 36, using the following
instructions. Follow these instructions only if you checked
the “Yes” box on Worksheet V, line 14.
Step 4
Line 35.
Complete Worksheet IV to determine your spouse's alter-
native monthly credit amounts to include on Form 8962, • Column (a): Enter the family size from Worksheet I,
lines 12 through 23, column (e), for your pre-marriage line 1.
months. Enter in columns A and B on Worksheet IV the • Column (b): Enter the amount from Worksheet I,
amounts from columns A and B in Part III of the Form(s) line 7.
1095-A that reports coverage for all individuals in your tax
family enrolled in a qualified health plan for 1 or more • Column (c): Enter the month from Worksheet I, line 8.
pre-marriage months, including your spouse, who are (a) • Column (d): Enter the month from Worksheet I, line 9.
included in Part II of a Form 1095-A sent to your spouse
for the pre-marriage months; or (b) not included in Part II Line 36.
of the Form 1095-A sent to you or to your spouse, but who Column (a): Enter the family size from Worksheet III,
•
are included in your spouse's alternative family size. line 1.
Missing or incorrect SLCSP premium. For your • Column (b): Enter the amount from Worksheet III,
pre-marriage months, if there were changes in your spou- line 7.
se’s coverage family that your spouse did not report to the
Marketplace or APTC was not paid for the coverage, or • Column (c): Enter the month from Worksheet III,
line 8.
there is an individual in your spouse’s coverage family not
included in Part II of the Form 1095-A sent to your spouse • Column (d): Enter the month from Worksheet III,
who is included in your spouse’s alternative family size, line 9.

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Step 7                                                       Column  (d). Subtract  column  (c)  from  column  (b)  and 
                                                             enter the result. If zero or less, enter -0-.
Complete  Form  8962,  lines  12  through  23,  columns  (a) 
through (f), using the following instructions. Follow these  Column  (e). For  your  pre-marriage  months,  enter  the 
instructions only if you checked the “Yes” box on Work-      amounts from lines 1 through 12, column A, of Worksheet 
sheet V, line 14.                                            V in the boxes for the corresponding months in column (e).
                                                              For the months you were married for the entire month, 
Column (a). Enter the amounts from column (a) of Work-       enter the smaller of column (a) or (d).
sheet 3 in the Form 8962 instructions.
                                                             Column (f). Enter the amounts from column (f) of Work-
Column (b). Enter the amounts from column (b) of Work-       sheet 3 in the Form 8962 instructions.
sheet 3 in the Form 8962 instructions.
                                                             Step 8
Column (c). For pre-marriage months, enter the totals of 
Worksheet II, column C, and Worksheet IV, column C. For      Continue to Form 8962, line 24, and complete the rest of 
example, if you entered $200 on Worksheet II, column C,      the form.
lines 1 through 5, and you entered $250 on Worksheet IV, 
column C, lines 3 through 5, enter $200 on lines 12 and      Line 26. Enter -0-.
13, and $450 on lines 14 through 16 of Form 8962, col-
umn (c).                                                     Lines 27 through 29. If line 24 is less than line 25, com-
For the months you were married for the entire month,        plete these lines. Otherwise, leave these lines blank.
enter the amount from Form 8962, line 8b.

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Worksheet I. Your Alternative Monthly Contribution Amount                                         Keep for Your Records
1. Alternative family size: Enter the total number of individuals in your alternative family size 
   (discussed earlier) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          1.  
2. One-half of household income: Divide Form 8962, line 3, by 2.0. Round to the nearest whole 
   dollar amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        2.  
3. Alternative federal poverty line: Enter the federal poverty line amount as determined by your 
   alternative family size on line 1 above and the federal poverty table you used on Form 8962, 
   line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.  
4. Alternative household income as a percentage of federal poverty line: Enter the amount from the 
   worksheet under Step 1.
   Continue to Step 3 if you checked the “Yes” box for question 3 in Table A. Otherwise, if you did not 
   complete Part IV of Form 8962, check the “No” box on line 9 of Form 8962 and continue to line 10. If 
   you completed Part IV of Form 8962, check the “No” box on line 10, and see Lines 12 Through 
   23—Monthly Calculation in the Instructions for Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                     4.  
5. Alternative applicable figure: Using your line 4 percentage, locate your applicable figure in Table 2 in 
   the Instructions for Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 5.  
6. Multiply line 2 by line 5 and enter the result rounded to the nearest whole dollar amount . . . . . . . . .                                                      6.  
7. Alternative monthly contribution amount: Divide line 6 by 12.0 and enter the result rounded to the 
   nearest whole dollar amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  7.  
8. Alternative start month: Enter the first full month you or any individual included in your alternative 
   family size on line 1 had coverage under a qualified health plan. For example, enter “02” if you were 
   enrolled in a qualified health plan with coverage effective on February 1 . . . . . . . . . . . . . . . . . . . . . .                                            8.  
9. Alternative stop month: Enter the last month you or any individual included in your alternative family 
   size on line 1 had coverage under a qualified health plan or the month in which you got married, 
   whichever is earlier. For example, enter “09” if you had coverage under a qualified health plan for all 
   of 2023 and you got married on September 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                               9.  

Worksheet II. Your Alternative Monthly Credit Amounts for 
Pre-Marriage Months                                                                               Keep for Your Records
  Complete this worksheet only for months beginning with the month on line 8 of Worksheet I and ending with the month 
on line 9 of Worksheet I. For example, if you entered “02” on Worksheet I, line 8, and “10” on Worksheet I, line 9, com-
plete only lines 2 through 10 of this worksheet.
   Monthly      A. Form(s) 1095-A,  B. Form(s) 1095-A,         C. Worksheet I,   D. Subtract C from                                                                     E. Smaller of 
   Calculation       lines 21–32,         lines 21–32,                    line 7 B (If zero or less,                                                                    column A or 
                       column A*             column B*                                            enter -0-.)                                                           column D
  1 January
  2 February
  3 March
  4 April
  5 May
  6 June
  7 July
  8 August
  9 September
10 October
11 November
12 December
* See Step 2, earlier, for instructions on the Form 1095-A amounts to report on this worksheet.

After completing this worksheet: Continue to Step 3 if you checked the “Yes” box for question 3 in Table A. Otherwise, go to Step 
5.

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Worksheet III. Your Spouse's Alternative Monthly 
Contribution Amount                                                                              Keep for Your Records
1. Alternative family size: Enter the total number of individuals in your spouse's alternative family size 
   (discussed earlier) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      1.  
2. One-half of household income: Divide Form 8962, line 3, by 2.0. Round to the nearest whole 
   dollar amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    2.  
3. Alternative federal poverty line: Enter the federal poverty line amount as determined by your 
   spouse's alternative family size on line 1 above and the federal poverty table you used on Form 
   8962, line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.  
4. Alternative household income as a percentage of federal poverty line: Enter the amount from the 
   worksheet under Step 3. If you completed Step 2, continue to Step 5. If you did not complete Step 2 
   and you did not complete Part IV of Form 8962, check the “No” box on line 9 of Form 8962 and 
   continue to line 10. If you did not complete Step 2 and you completed Part IV of Form 8962, check 
   the “No” box on line 10, and see Lines 12 Through 23—Monthly Calculation in the Instructions for 
   Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  4.  
5. Alternative applicable figure: Using your line 4 percentage, locate your applicable figure in Table 2 in 
   the Instructions for Form 8962 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             5.  
6. Multiply line 2 by line 5 and enter the result rounded to the nearest whole dollar amount . . . . . . . . . .                                                  6.  
7. Alternative monthly contribution amount: Divide line 6 by 12.0 and enter the result rounded to the 
   nearest whole dollar amount . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              7.  
8. Alternative start month: Enter the first full month your spouse or any individual included in your 
   spouse's alternative family size on line 1 had coverage under a qualified health plan. For example, 
   enter “05” if your spouse was enrolled in a qualified health plan with coverage effective on May 1 . . .                                                       8.  
9. Alternative stop month: Enter the last month your spouse or any individual included in your spouse's 
   alternative family size on line 1 had coverage under a qualified health plan or the month in which you 
   got married, whichever is earlier. For example, enter “07” if your spouse's coverage under a 
   qualified health plan (and the coverage of all individuals included in your spouse's alternative family 
   size) terminated July 31 and you got married on September 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                    9.  

Worksheet IV. Your Spouse's Alternative Monthly Credit 
Amounts for Pre-Marriage Months                                                                  Keep for Your Records
Complete this worksheet only for months beginning with the month on line 8 of Worksheet III and ending with the 
month on line 9 of Worksheet III. For example, if you entered “05” on Worksheet III, line 8, and “10” on Worksheet III, 
line 9, complete only lines 5 through 10 of this worksheet.
   Monthly     A. Form(s) 1095-A,  B. Form(s) 1095-A,       C. Worksheet III,      D. Subtract C from                                                                 E. Smaller of 
   Calculation lines 21–32,         lines 21–32,                line 7             B (If zero or less,                                                                column A or 
               column A*            column B*                                      enter -0-.)                                                                        column D
1 January
2 February
3 March
4 April
5 May
6 June
7 July
8 August
9 September
10 October
11 November
12 December
* See Step 4, earlier, for instructions on the Form 1095-A amounts to report on this worksheet.

After completing this worksheet: Continue to Step 5.

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Worksheet V. Alternative Calculation for Year of Marriage 
Totals Worksheet                                                                                                      Keep for Your Records
Column A. Complete column A below only for the months you have entries in column E of                                                    Worksheet II and/or Work-
sheet IV. Leave column A blank for all other months. Add the amounts in column E of Worksheets II and IV separately for 
each month and enter the total in column A below on the line for the same month.
Column B. Complete column B below for any month you have an entry in column A. For each month, enter the corre-
sponding amount from lines 1 through 12, column (e), of Worksheet 3 under Line 9 in the Instructions for Form 8962.
                                                                                                                    A. Total alternative B. Premium assistance 
                    Monthly Calculation                                                                             premium assistance     amounts (regular 
                                                                                                                      amounts              calculation)
1     January . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     1
2     February . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      2
3     March . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     3
4     April . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
5     May . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   5
6     June . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  6
7     July . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  7
8     August . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    8
9     September . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         9
10    October . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     10
11    November . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        11
12    December . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        12
13 Totals: Enter the total of column A, lines 1 through 12, and the 
      total of column B, lines 1 through 12 . . . . . . . . . . . . . . . . . . . . . . . . .                     13
14    Is line 13, column A, more than line 13, column B?
        Yes. Your alternative calculation reduces your excess APTC. If you did not complete Part IV of Form 8962, check the “Yes” 
      box on line 9. Also check the “No” box on line 10. Continue to Steps 6, 7, and 8, earlier.
       
        No. The alternative calculation does not reduce your excess APTC. Leave Form 8962, Part V, blank.
       • If you did not complete Part IV of Form 8962, check the “No” box on line 9 and continue to Form 8962, line 10. If you are 
         required to use lines 12 through 23 of Form 8962, enter the amounts from lines 1 through 12 of Worksheet 3 in the Form 
         8962 instructions on the lines for the corresponding months and columns on Form 8962.
       • If you completed Part IV of Form 8962, check the “No” box on line 10. Enter the amounts from lines 1 through 12 of 
         Worksheet 3 in the Form 8962 instructions on the lines for the corresponding months and columns on Form 8962, lines 12 
         through 23.

Example of the Alternative                                          January  1  through  July  31.  The  Marketplace  sent  him  a 
                                                                    Form 1095-A (not illustrated) showing his enrollment infor-
Calculation for Year of Marriage                                    mation for this 7-month period.
The  following  example  describes  the  alternative  calcula-                                                    From August 1 through December 31, 2023, Paulette, 
tion for year of marriage for Paulette Oak and Quentin Ce-          Quentin, and Quentin’s two dependent children were en-
dar.                                                                rolled  together  in  a  different  qualified  health  plan.  The 
                                                                    Marketplace  sent  them  a  Form  1095-A  (not  illustrated) 
In  2023,  Paulette  and  Quentin  were  single  and  main-
                                                                    showing their enrollment information for this 5-month pe-
tained separate residences until they got married on July 
                                                                    riod.
18.
Paulette  has  no  dependents.  She  was  enrolled  in  a                                                         Paulette and Quentin first complete lines 1 through 8 of 
qualified health plan from January 1 through July 31. The           Form 8962. Then, they read the instructions for line 9 and 
Marketplace  sent  her  a  Form  1095-A  (not  illustrated)         complete Table 4 (not illustrated) and Worksheet 3 (not il-
showing  her  enrollment  information  for  this  7-month  pe-      lustrated) in the Form 8962 instructions and Worksheets I 
riod.                                                               through V (not illustrated) in this publication. Using the in-
                                                                    formation in the worksheets and on Forms 1095-A (not il-
Quentin  has  two  dependent  children.  He  and  his  two          lustrated), they complete lines 9 through 29, 35, and 36 of 
children  were  enrolled  in  a  qualified  health  plan  from      Form 8962.

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Paulette and Quentin's Form 8962, Lines 1 Line 10. As explained under Step 5 (Worksheet V), later,
Through 11 they check “No” on line 10.

Paulette and Quentin fill out Form 8962 (not illustrated), Line 11. Because Paulette and Quentin checked “No” on
lines 1 through 11, as follows. line 10, they skip line 11 and complete lines 12 through 23
to figure their monthly PTC.
Line 1. They enter “4” because this is the number of indi-
viduals they included in their tax family. Step 1 (Paulette's Worksheet I)

Line 2a. They enter $108,000, which they figured using Line 1. They enter “1” as Paulette’s alternative family size
Worksheet 1-1 (not illustrated) in the Form 8962 instruc- because she can include only herself. She can’t include
tions. either of Quentin’s children in her alternative family size
because neither of them lived with her for more than half
Line 2b. They leave line 2b blank because neither of of 2023 and she could not claim them as dependents.
Quentin’s dependent children is required to file a federal
income tax return. Lines 2 through 9. They complete these lines according
to the instructions on the worksheet.
Line 3. They enter $108,000, the sum of lines 2a and 2b.
Line 4. They enter $27,750 from Table 1-1 in the Form Step 2 (Paulette's Worksheet II)
8962 instructions. This is the federal poverty line for a fam-
ily size of 4. They also check box c on line 4. They complete Worksheet II only for January through July
(the month Paulette and Quentin got married). They com-
Line 5. Using Worksheet 2 in the Form 8962 instructions, plete columns A and B using the amounts shown on Pau-
they divide line 3 ($108,000) by line 4 ($27,750) to get lette’s Form 1095-A. They complete columns C and D ac-
389%. cording to the instructions shown on the worksheet.

Line 7. They enter their applicable figure of 0.0823 from Step 3 (Quentin's Worksheet III)
Table 2 in the Instructions for Form 8962. According to the
fourth column of Table 2, 0.0823 is the applicable figure if Line 1. They enter “3” as Quentin's alternative family size
the amount on line 5 is 389%. consisting of Quentin and his two dependent children.

Line 8a. They multiply line 3 ($108,000) by line 7 Lines 2 through 9. They complete these lines according
(0.0823) and enter the result, $8,888. to the instructions on the worksheet.
Line 8b. They divide line 8a ($8,888) by 12.0 and enter
the result, $741. Step 4 (Quentin's Worksheet IV)

Line 9. Paulette and Quentin read the instructions for They complete Worksheet IV only for January through July
line 9, which explain that because they got married in (the month Paulette and Quentin got married). They com-
2023, they may be eligible to complete Part V (not illustra- plete columns A and B using the amounts shown on
ted) to elect the alternative calculation for year of mar- Quentin’s Form 1095-A. They complete columns C and D
riage. This calculation may reduce the amount of excess according to the instructions shown on the worksheet.
APTC they would otherwise have to repay.
The preliminary steps in determining whether they may Step 5 (Worksheet V)
be eligible are to complete Table 4 and Worksheet 3 in the
Form 8962 instructions. (Both the table and worksheet for Quentin and Paulette complete Worksheet V only for the
Paulette and Quentin are not illustrated.) Worksheet 3 months they have entries in column E of Worksheets II
would show that if Paulette and Quentin do not elect the and IV (January through July). They qualify for the alterna-
alternative calculation, their total PTC will be $5,805 tive calculation for year of marriage because line 13, col-
(line 13, column (e)). The excess APTC they will have to umn A ($5,152), is more than line 13, column B ($3,675).
pay with their tax return is $2,618, which is the difference Accordingly, they check “Yes” on line 14. They also check
between $8,423 (APTC for the year on line 13, column (f)) “Yes” on Form 8962, line 9; check “No” on line 10; and
and $5,805. continue to Steps 6, 7, and 8 in this publication.
Because Paulette and Quentin checked the “Yes” box
on line 14 of Worksheet 3, they complete Worksheets I Step 6
through V (not illustrated) to determine if the alternative
calculation for year of marriage will benefit them. They Paulette and Quentin complete lines 35 and 36 as ex-
complete Worksheets I through V before they check any plained below.
of the boxes on line 9. As explained under Step 5 (Work-
sheet V), later, they qualify for the alternative calculation Line 35.
for year of marriage and check “Yes” on line 9.
• Column (a): They enter “1,” Paulette's alternative fam-
ily size from Worksheet I, line 1.

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• Column (b): They enter $379, Paulette's alternative Column (d). They enter the difference between columns
monthly contribution amount from Worksheet I, line 7. (c) and (b).

• Column (c): They enter “01,” the alternative start Column (e). On lines 12 through 18, they enter $736, the
month from Worksheet I, line 8. monthly amounts from column A of Worksheet V. On lines
• Column (d): They enter “07,” the alternative stop 19 through 23, they enter $426, the smaller of column (a)
month from Worksheet I, line 9. or (d).

Line 36. Column (f). On lines 12 through 18, they enter $794 and
$573 on lines 19 through 23, the monthly amounts from
• Column (a): They enter “3,” Quentin's alternative fam-
column (f) of Worksheet 3.
ily size from Worksheet III, line 1.
• Column (b): They enter $151, Quentin's alternative Step 8
monthly contribution amount from Worksheet III,
line 7. Paulette and Quentin complete lines 24 through 29 as ex-
plained below.
• Column (c): They enter “01,” the alternative start
month from Worksheet III, line 8. Line 24. They add the amounts on lines 12 through 23,
• Column (d): They enter “07,” the alternative stop column (e), and enter the total, $7,282. (As explained ear-
month from Worksheet III, line 9. lier under Line 9, their total PTC would be only $5,805 if
they did not elect the alternative calculation.)
Step 7
Line 25. They add the amounts on lines 12 through 23,
column (f), and enter the total, $8,423.
Paulette and Quentin complete lines 12 through 23 as
explained below. Line 26. According to Step 8, they enter -0- because they
elected the alternative calculation for year of marriage.
Column (a). On lines 12 through 18, they enter $1,500
and $1,350 on lines 19 through 23, the monthly amounts Line 27. They subtract line 24 from line 25 and enter the
from column (a) of Worksheet 3 (not illustrated). difference, $1,141.

Column (b). On lines 12 through 18, they enter $1,266 Line 28. They enter the repayment limitation of $3,000
and $1,167 on lines 19 through 23, the monthly amounts from Table 5 in the Form 8962 instructions.
from column (b) of Worksheet 3.
Line 29. They enter $1,141. This is the smaller of line 27
Column (c). On lines 12 through 18, they enter $530, the or line 28. They also enter $1,141 on Schedule 2 (Form
monthly totals from Worksheet II, column C, and Work- 1040), line 2 (non illustrated). (As explained earlier under
sheet IV, column C. On lines 19 through 23, they enter Line 9 , the excess APTC they would have to pay would be
$741, the amount from Form 8962, line 8b. $2,618 if they did not elect the alternative calculation.)

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If you meet the requirements described above, do the
following.
Self-Employed Health
• If you are filing Schedule 1 (Form 1040), complete
Insurance Deduction and PTC lines 18 (Penalty on early withdrawal of savings) and
19a (Alimony paid). Also, figure any write-in adjust-
This part provides special instructions for figuring the ments you will enter on the dotted line next to line 26.
self-employed health insurance deduction and PTC if you
• Complete line 20 of Schedule 1 (Form 1040) if you
or your spouse was self-employed, you or a member of
made contributions to a traditional individual retire-
your tax family was enrolled in a qualified health plan in
ment arrangement (IRA) and you (and your spouse if
2023, and you may be eligible for the PTC. Because the
filing a joint return) were not covered by a retirement
amount of the self-employed health insurance deduction
plan at work or through self-employment.
may affect the amount of the PTC, and the amount of the
PTC may affect the amount of the deduction, a taxpayer • If you elect to report your child’s interest and dividends
who may be eligible for both may have difficulty determin- on your tax return, complete Form 8814, Parents’
ing the amounts of those items. A taxpayer who may be el- Election To Report Child’s Interest and Dividends.
igible for both may follow the instructions in this part to de- Using this information, do the following.
termine amounts of the self-employed health insurance
deduction and PTC that are allowable under the law. 1. If you have health insurance premiums for which you
cannot claim the PTC (see Nonspecified premiums,
Using the special instructions in this part is op-
later), first complete Worksheet P or, if required, Form
! tional. If you are eligible for both a self-employed 7206 but only with respect to those premiums. Skip
CAUTION health insurance deduction and the PTC for the
Worksheets W and X if either of the following applies.
same premiums, you may use any computation method
that results in reporting amounts that satisfy the rules for a. You completed Worksheet P and line 2 is less than
both the deduction and PTC, as long as the sum of the de- or equal to line 1.
duction claimed for the premiums and the PTC computed,
b. You completed Form 7206 and line 13 is equal to
taking the deduction into account, is less than or equal to
or less than line 3.
the enrollment premiums.
2. Then, complete Worksheet W and Worksheet X. You
Before you complete any of the worksheets in this part, have to complete Worksheet X only if APTC was paid
you should first do the following. to your insurer on your behalf for the months you were
• Read the instructions for line 17 of Schedule 1 (Form self-employed. If APTC was not paid to your insurer
1040) to find out if you meet the requirements for on your behalf for the months you were self-em-
claiming the self-employed health insurance deduc- ployed, skip Worksheet X.
tion.
3. After completing Worksheets W and X, you may
• Read the Instructions for Form 8962 to find out if you choose to use either the Simplified Calculation
meet the requirements for claiming the PTC except for Method or the Iterative Calculation Method to com-
the requirement that your household income be at pute your self-employed health insurance deduction
least 100% of the federal poverty line for your family and PTC. The Simplified Calculation Method is
size for 2023. You will determine whether you meet the shorter, but in some cases will not produce a result as
100% requirement in the process of completing these favorable as the Iterative Calculation Method.
instructions.

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Worksheet P. Self-Employed Health Insurance Deduction for
Nonspecified Premiums Keep for Your Records

Before you begin: Read Exceptions, later, to see if you can use this worksheet instead of Form 7206 to figure your deduction
for nonspecified premiums. Also read the definitions of specified premiums and nonspecified premiums.
1. Enter the total amount of nonspecified premiums paid in 2023 for health insurance coverage
established under your business (or the S corporation in which you were a more-than-2%
shareholder) for 2023 for you, your spouse, and your dependents. Your insurance can also
cover your child who was under age 27 at the end of 2023, even if the child was not your
dependent. But do not include amounts for any month you were eligible to participate in an
employer-sponsored health plan or amounts paid from retirement plan distributions that were
nontaxable because you are a retired public safety officer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.
2. Enter your net profit* and any other earned income** from the business under which the
insurance plan is established, minus any deductions on lines 15 and 16 of Schedule 1 (Form
1040). Do not include Conservation Reserve Program payments exempt from
self-employment tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.
3. Self-employed health insurance deduction for nonspecified premiums. Enter the
smaller of line 1 or line 2. Do not include this amount in figuring any medical expense
deduction on Schedule A (Form 1040) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
• If line 2 is equal to or less than line 1, stop here. Do not read the rest of these special
instructions. Enter this amount on line 17 of Schedule 1 (Form 1040). Use Form 8962 to
figure the PTC for specified premiums.
• If line 2 is more than line 1, complete Worksheet W. Also complete Worksheet X if APTC
was paid to your insurer on your behalf for the months you were self-employed. If APTC
was not paid to your insurer on your behalf for the months you were self-employed, skip
Worksheet X.

* If you used either optional method to figure your net earnings from self-employment, do not enter your net profit. Instead, enter the
amount from Schedule SE, line 4b.

** Earned income includes net earnings and gains from the sale, transfer, or licensing of property you created. However, it does not
include capital gain income. If you were a more-than-2% shareholder in the S corporation under which the insurance plan is
established, earned income is your Medicare wages (box 5 of Form W-2) from that corporation.

self-employed. If APTC was not paid to your insurer on
Instructions for Worksheet P your behalf for the months you were self-employed,
skip Worksheet X.
Use Worksheet P to figure the amount you can deduct for
nonspecified premiums. Nonspecified Premiums

Exceptions. Use Form 7206 instead of Worksheet P to A nonspecified premium is either of the following.
figure your deduction for nonspecified premiums if any of
• A premium for health insurance coverage established
the following apply. (Only include nonspecified premiums
under your business (or the S corporation in which you
on line 1 or 2 of Form 7206.)
were a more-than-2% shareholder) but paid for cover-
• You had more than one source of income subject to age in a plan that is not a qualified health plan.
self-employment tax.
• The portion of the premium for coverage in a plan that
• You file Form 2555. is a qualified health plan established under your busi-
• You are using amounts paid for qualified long-term ness (or the S corporation in which you were a
care insurance to figure the deduction. more-than-2% shareholder) but that is attributable to
individuals not in your coverage family.
After you complete Form 7206, follow the instructions
below. Calculate how much of these nonspecified premiums
• If line 13 is equal to or less than line 3, stop here. Do are fully deductible by entering this amount on line 1 of
not read the rest of these special instructions. Enter Worksheet P or, if required, on line 1 or 2 of Form 7206.
the amount from line 14 of Form 7206 on line 17 of Complete the remainder of the appropriate worksheet.

Schedule 1 (Form 1040). Use Form 8962 to figure the The following are examples of nonspecified premiums.
PTC for specified premiums.
• Premiums paid for a qualified health plan other than
• If line 13 is more than line 3, complete Worksheet W. during a coverage month.
Also complete Worksheet X if APTC was paid to your
insurer on your behalf for the months you were

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• Premiums paid to cover an individual other than you, family, use only the portion of the premiums for the speci-
your spouse, or your dependents. fied qualified health plan that is allocable to your coverage
family. You determine the specified premiums that are allo-
• Premiums for qualified long-term care insurance.
cable to your coverage family by multiplying the enrollment
• Dental insurance premiums. premiums for the months you were self-employed and the
• Medicare premiums you voluntarily paid to obtain in- plan covered non-coverage family members by a fraction.
surance in your name that is similar to qualifying The numerator of the fraction is the premium for the appli-
health insurance. cable SLCSP for your coverage family. The denominator
of the fraction is the total of (a) the premium for the appli-
Example. In 2023, you were self-employed and were cable SLCSP for your coverage family, and (b) the pre-
enrolled in a qualified health plan through the Market- mium for the applicable SLCSP for the individuals who are
place. You enrolled your dependent, 22-year-old daughter not in your coverage family.
in individual market coverage not offered through the Mar-
Example. Gary was self-employed in 2023 and enrol-
ketplace. This coverage has an annual premium of
led in a qualified health plan. APTC was paid to his insurer
$3,000. This $3,000 premium is a nonspecified premium
on his behalf. The policy covers Gary, Gary's wife Sue,
because it is for coverage under a plan that is not a quali-
and Gary’s two dependent daughters. Sue is not in the
fied health plan. Include this $3,000 premium on Work-
coverage family because she is eligible to enroll in her em-
sheet P, line 1, or, if required, on line 1 of Form 7206.
ployer’s health insurance. The enrollment premium is
$15,000. The premium for the applicable SLCSP covering
Specified Premiums Gary and his two daughters is $12,000 and the premium
for the applicable SLCSP covering Sue is $6,000. Gary
Specified premiums are the premiums for a specified figures the amount of specified premiums by multiplying
qualified health plan or plans for which you may otherwise the $15,000 enrollment premium by a fraction. The numer-
claim as a self-employed health insurance deduction on ator of the fraction is the premium for his applicable
line 17 of Schedule 1 (Form 1040). Generally, these are SLCSP ($12,000). The denominator of the fraction is the
the premiums paid for the months you were self-em- total of the premiums for the applicable SLCSP of both
ployed. If you were self-employed for part of a month, the Gary and Sue ($18,000). The result is $10,000 ($15,000
entire premium for that month is a specified premium. A enrollment premium x ($12,000/$18,000)) of specified
specified qualified health plan is a qualified health plan premiums, which Gary enters on Worksheet W, line 1, and
that covers one or more members of your coverage family Worksheet X, line 27. The remaining $5,000 of enrollment
for a month for which your enrollment premium(s) has premium ($15,000 enrollment premium – $10,000 speci-
been paid by the due date prescribed under Enrollment fied premiums) is attributable to Sue's coverage and is a
premiums, earlier. Qualified health plan, coverage family, nonspecified premium that Gary enters on Worksheet P,
and enrollment premiums are defined earlier under Terms line 1.
You May Need To Know.

Example. You were enrolled in a qualified health plan
through the Marketplace for all of 2023 and you were
self-employed from September 15 through December 31.
Only the premiums for the last 4 months are specified pre-
miums and only those premiums are entered on Work-
sheet W, line 1, and Worksheet X, line 27, if you are re-
quired to complete those worksheets. You are not allowed
a self-employed health insurance deduction for the Janu-
ary through August premiums because you were not
self-employed during those months. Those premiums are
neither specified premiums nor nonspecified premiums.
However, you may be allowed a PTC for your coverage for
January through August.

Plan covering individuals in another tax family. If the
plan covers at least one individual in your tax family and
one individual in another tax family, you may have to allo-
cate policy amounts between your tax family and the other
tax family. See Line 9 in the Form 8962 instructions for in-
structions on how to allocate policy amounts. Do this allo-
cation before you determine the portion of the specified
premiums allocable to your coverage family discussed
next.

Plan covering individuals not in your coverage family.
If the plan covers individuals who are not in your coverage

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Worksheet W. Figuring the Limit on the Self-Employed 
Health Insurance Deduction for Specified Premiums                                           Keep for Your Records
Caution. If you have more than one trade or business under which a qualified health plan is established, complete lines 4 
through 13 separately for each trade or business. Add the amounts on line 13 for all the trades or businesses. Then, 
complete lines 14 through 17 once for all trades or businesses.
1.  Enter your specified premiums. See Specified Premiums under Instructions for Worksheet 
    P, earlier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1.   
2.  Enter the APTC from Form 1095-A, Part III, column C, that is attributable to the premiums on 
    line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.   
3.  Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              3.   
4.  Enter your net profit* and any other earned income** from the business under which the qualified 
    health plan is established. Do not include Conservation Reserve Program payments exempt from 
    self-employment tax. If the business is an S corporation, skip to line 11 . . . . . . . . . . . . . . . . . . . . . .                                          4.   
5.  Enter the total of all net profits* from Schedule C (Form 1040), line 31; Schedule F (Form 1040), 
    line 34; or box 14, code A, of Schedule K-1 (Form 1065), plus any other income allocable to the 
    profitable businesses. Do not include Conservation Reserve Program payments exempt from 
    self-employment tax. See the Instructions for Schedule SE (Form 1040). Do not include any net 
    losses shown on these schedules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        5.   
6.  Divide line 4 by line 5  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           6.   
7.  Multiply line 15 of Schedule 1 (Form 1040) by line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                               7.   
8.  Subtract line 7 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              8.   
9.  Enter the amount, if any, from line 16 of Schedule 1 (Form 1040) attributable to the same business 
    for which the qualified health plan is established . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                           9.   
10. Subtract line 9 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              10.  
11. Enter your Medicare wages (box 5 of Form W-2) from an S corporation in which you are a 
    more-than-2% shareholder and in which the qualified health plan is established . . . . . . . . . . . . . . .                                                   11.  
12. Enter any amount from Form 2555, line 45, attributable to the amount entered on line 4 or line 11 
    above  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   12.  
    Note. If you are not filing Form 2555, enter -0-.
13. Subtract line 12 from line 10 or 11, whichever applies  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                13.  
14. Enter your self-employed health insurance deduction for nonspecified premiums from Worksheet 
    P, line 3, or Form 7206, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 14.  
15. Subtract line 14 from line 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                15.  
16. Enter the smaller of line 3 or line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   16.  
17. Add lines 14 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .            17.  
18. Is line 2 blank or -0-? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          18.  
      Yes. Skip line 19 and Worksheet X. Use one of the methods that follow Worksheet X to figure 
    the PTC and self-employed health insurance deduction for specified premiums.
      No. Go to line 19.
19. Subtract line 16 from line 15. Then, go to Worksheet X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                   19.  
* If you used either optional method to figure your net earnings from self-employment from any business, do not enter your net profit from the 
business. Instead, enter the amount attributable to that business from Schedule SE, line 4b.
 
 ** Earned income includes net earnings and gains from the sale, transfer, or licensing of property you created. However, it does not include 
capital gain income.

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Worksheet X. Figuring Household Income and the 
Repayment Limitation                                                                         Keep for Your Records
Complete this worksheet only if APTC was paid to your insurer on your behalf for the months you were self-employed.
Part I: Taxpayer's Modified AGI

1.   Combine the amounts from:
     •  Form 1040, 1040-SR, or 1040-NR, lines 2a, 9, and the excess, if any, of line 6a over 
        line 6b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      1.   
     Note. See the instructions if you are filing Form 8582, 8814, or 8815.
2.   Enter any amounts from Form 2555, lines 45 and 50 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                   2.   
3.   Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         3.   
4.   Enter the total of the amounts from:
     •  Schedule 1 (Form 1040), lines 11 through 16, 18, and 19a, plus any write-in adjustments 
        you entered on the dotted line next to Schedule 1 (Form 1040), line 26 . . . . . . . . . . . . . . . . . .                                               4.   
     Note. See the instructions if you made contributions to a traditional IRA.                                                                                       
5.   Enter the amount from Worksheet W, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                            5.   
6.   Enter the amount from Worksheet W, line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                            6.   
7.   Add lines 4, 5, and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         7.   
8.   Subtract line 7 from line 3. Then, go to Part II if you are claiming dependents on your tax return. If 
     you are not claiming any dependents on your tax return, skip Part II and go to Part III . . . . . . . . . .                                                 8.   
Part II: Dependents’ Modified AGI

Note. Use Part II to figure the combined modified AGI for the dependents you included in your tax family. Only include the modified 
AGI of those dependents who are required to file a return. Do not include the modified AGI of dependents who are filing a tax return 
only to claim a refund of tax withheld or estimated tax.

9.   Enter the combined AGI for your dependents from Form 1040, 1040-SR, or 1040-NR, 
     line 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.   
10.  Enter any tax-exempt interest for your dependents from Form 1040, 1040-SR, or 1040-NR, 
     line 2a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.  
11.  Enter any amounts for your dependents from Form 2555, lines 45 and 50 . . . . . . . . . . . . . . . . . . .                                                 11.  
12.  Enter for each of your dependents the excess, if any, of Form 1040 or 1040-SR, line 6a, over 
     line 6b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.  
13.  Add lines 9 through 12. Then, go to Part III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        13.  

                                                                                                                                                                 Continued on next page

Instructions for Worksheet X                                  If you are filing Form 8815, Exclusion of Interest From 
                                                              Series EE and I U.S. Savings Bonds Issued After 1989, do 
Line 1. If you are filing Form 8582, Passive Activity Loss    not  complete  the  form  until  you  are  instructed  to  do  so 
Limitations, and both lines 1d and 3 of that form are los-    later. Include on line 1 the amount from Schedule B (Form 
ses:                                                          1040), line 2.

•  Do not complete Part II or III of that form until you are  Line 4.           Include your IRA deduction on line 4 only if you 
   instructed to do so later, and                             (and your spouse if filing a joint return) were                                                         not covered 
•  Do not include any losses from rental real estate activ-   by a retirement plan at work or through self-employment.
   ities on line 1.
                                                              Line  25.         Also  enter  this  amount  on  line  28  of  the  Form 
If  you  are  filing  Form  8814,  and  the  amount  on  Form 8962  you  attach  to  your  tax  return  if  you  are  required  to 
8814, line 4, is more than $1,250, you must also include      complete that line and you do not complete                                                              Worksheet Y. 
the following amounts on line 1.                              Do not enter an amount from Table 5 in the Form 8962 in-
•  The tax-exempt interest from Form 8814, line 1b.           structions.
•  The lesser of Form 8814, line 4 or line 5.
•  Any nontaxable social security benefits your child re-
   ceived.

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Worksheet X. Figuring Household Income and the 
Repayment Limitation (continued)                                                                                   Keep for Your Records
Part III: Repayment Limitation
14.  Household income. Add lines 8 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                       14.   
15.  Enter the smaller of Worksheet W, line 19, or $700 ($350 if your filing status is single) . . . . . . . . .                                              15.   
16.  Subtract line 15 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        16.   
17a. Enter the number of qualifying individuals in your tax family 
     (including yourself) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   17a.  
17b. Enter the federal poverty line amount as determined by the family size on line 17a and federal 
     poverty Table 1-1, 1-2, or 1-3 for your state of residence during 2023 in the Form 8962 
     instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17b.  
18.  Divide line 16 by line 17b. If the result is not a whole percentage, do not round; instead, multiply 
     this number by 100 (to express it as a percentage) and then drop any numbers after the decimal 
     point. For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 
     3.997, enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             18.   %
     •  If the result is less than 200, enter $700 ($350 if your filing status is single) on line 25. Skip 
        lines 19 through 24.
     •  If the result is 200 or more, go to line 19.
19.  Enter the smaller of Worksheet W, line 19, or $1,800 ($900 if your filing status is single) . . . . . . .                                                19.   
20.  Subtract line 19 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        20.   
21.  Divide line 20 by line 17b. If the result is not a whole percentage, do not round; instead, multiply 
     this number by 100 (to express it as a percentage) and then drop any numbers after the decimal 
     point. For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 
     3.997, enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             21.   %
     •  If the result is less than 300, enter $1,800 ($900 if your filing status is single) on line 25. Skip 
        lines 22 through 24.
     •  If the result is 300 or more, go to line 22.
22.  Enter the smaller of Worksheet W, line 19, or $3,000 ($1,500 if your filing status is single) . . . . . .                                                22.   
23.  Subtract line 22 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        23.   
24.  Divide line 23 by line 17b. If the result is not a whole percentage, do not round; instead, multiply 
     this number by 100 (to express it as a percentage) and then drop any numbers after the decimal 
     point. For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 
     3.997, enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             24.   %
     •  If the result is less than 400, enter $3,000 ($1,500 if your filing status is single) on line 25.
     •  If the result is 400 or more, enter the amount from Worksheet W, line 2, on line 25. 
25.  Enter the amount you were instructed to enter here by line 18, 21, or 24. See instructions . . . . . .                                                   25.   
Part IV: Maximum Self-Employed Health Insurance Deduction 
26.  Add lines 6 and 25  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      26.   
27.  Enter the amount from Worksheet W, line 1  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         27.   
28.  Enter the smaller of line 26 or line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                28.   
29.  Enter the amount from Worksheet W, line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         29.   
30.  Enter the smaller of line 28 or line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                30.   
31.  Add lines 5 and 30. Then, use one of the methods that follow to figure the PTC and the 
     self-employed health insurance deduction for specified premiums . . . . . . . . . . . . . . . . . . . . . . . . .                                        31.   

Iterative Calculation Method                                       Step 1

Follow the steps below to figure your self-employed health         Figure your AGI, modified AGI, and household income us-
insurance deduction and PTC under the Iterative Calcula-           ing                                  Worksheet X, line 31, as your self-employed health in-
tion Method. You do not have to use this method. You can           surance deduction. If you did not fill out Worksheet X, use 
use the Simplified Calculation Method (discussed later) or         the amount from                                 Worksheet W, line 17. Use Worksheets 
any computation method that satisfies each set of rules as         1-1 and 1-2 in the Form 8962 instructions to figure modi-
long as the sum of the deduction claimed for the premi-            fied AGI and household income.
ums and the PTC computed, taking the deduction into ac-                                                   If you are claiming any of the following deductions 
count, is less than or equal to the premiums.                                                           ! or  exclusions,  see                                Special  Instructions  for 
        Do  not  round  to  whole  dollars  when  performing       CAUTION                                Self-Employed Individuals Who Claim Certain De-
                                                                   ductions/Exclusions, later, before you complete Step 1.
!       the computations under this method. Instead, use 
CAUTION dollars  and  cents.  This  is  necessary  so  you  can 
                                                                   1. Passive activity losses from rental real estate activities 
complete Step 6.                                                                                        and lines 1d and 3 of Form 8582 are losses.
                                                                   2. IRA deduction and you (or your spouse if filing a joint 
                                                                                                        return) were covered by a retirement plan at work or 
                                                                                                        through self-employment. 

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3. Exclusion of interest from series EE and I U.S. savings 1. Enter the amount from Worksheet
bonds issued after 1989. W, line 1. . . . . . . . . . . . . . . . . . . . . . . 1. .
Caution. If the amounts on lines 12 through
4. Student loan interest deduction. 23, column (e), of your Step 2 Form 8962 are
not the same for each month and you had
specified premiums for less than 12 months,
Step 2 skip lines 2 through 5 below and enter on
line 6 the total of those column (e) amounts
Figure the total PTC on Form 8962 using the AGI, modi- for the months you paid specified premiums.
fied AGI, and household income you determined in Step 2. Enter the total PTC (Form 8962, line 24) you
1. Enter the modified AGI and household income from figured in Step 2, earlier. . . . . . . . . . . . . 2. .
Step 1 on the Form 8962. When figuring the PTC, use all 3. Enter the number of months in 2023 for
which specified premiums were paid. . . . . 3.
enrollment premiums for qualified health plans in which
Note. Self-employment for part of a month
you or an individual in your tax family enrolled. Complete counts as a full month of self-employment.
this Form 8962 only through line 24. Do not attach this 4. Enter the number of months someone in your
Form 8962 to your tax return. coverage family was enrolled in the qualified
health plan. . . . . . . . . . . . . . . . . . . . . . 4.
Cannot take the PTC. If you are not eligible to take the
5. Divide line 3 by line 4. . . . . . . . . . . . . . . 5.
PTC, stop here. Do not use this method. Instead, figure
your self-employed health insurance deduction using the 6. Multiply line 5 by line 2. . . . . . . . . . . . . . 6. .
Self-Employed Health Insurance Deduction Worksheet in 7. Subtract line 6 from line 1 . . . . . . . . . . . . 7. .
the Instructions for Form 1040 or the Instructions for Form 8. Enter the amount from Worksheet X, line 30.
1040-NR; or, if required, Form 7206. If you are following If you did not complete Worksheet X, enter
the amount from Worksheet W, line 16 . . . . 8. .
the instructions under Special Instructions for Self-Em-
9. Enter the smaller of line 7 or line 8. Then, go
ployed Individuals Who Claim Certain Deductions/Exclu- to Step 4 next. . . . . . . . . . . . . . . . . . . . 9. .
sions, later, make this determination when you complete
the final iteration of Step 2. Refigure the deductions/exclu-
More than one trade or business. If you have more
sions if you are not eligible for the PTC.
than one trade or business under which you established a
qualified health plan, you must complete lines 1 through 7
Step 3 separately for each trade or business. Use the following
Figure your self-employed health insurance deduction for instructions to complete the Step 3 Worksheet.
specified premiums by completing the following work- Line 1. Enter the amounts for the separate trade or
sheet. business.
If you have more than one trade or business un- If the Caution under line 1 applies to you, skip lines 2
through 5. Enter on line 6 the total of the column (e)
! der which you established a qualified health plan, amounts for the months you paid specified premiums that
CAUTION see More than one trade or business below be-
fore you complete the Step 3 Worksheet. are allocable to the specified premiums you entered on
line 1 for the separate trade or business. You can allocate
Step 3 Worksheet the column (e) amounts using any reasonable method.
One reasonable method is based on enrollment premiums
Enter amounts in dollars and cents. Do not round to whole for each plan. Under this method, multiply the total of the
dollars. column (e) amounts for the months you paid specified pre-
miums by a fraction. The numerator of the fraction is the
amount of specified premiums you entered on line 1 for
the separate trade or business. The denominator of the
fraction is the total of the column (a) amounts for the
months you paid specified premiums.
Line 2. Enter the Step 2 PTC that is allocable to the
specified premiums you entered on line 1 for the separate
trade or business. You can allocate the Step 2 PTC using
any reasonable method. One reasonable method is based
on enrollment premiums for each plan. Under this method,
multiply the Step 2 PTC by a fraction. The numerator of
the fraction is the amount of specified premiums you en-
tered on line 1 for the separate trade or business. The de-
nominator of the fraction is the amount on line 11, column
(a), or the total of lines 12 through 23, column (a), of the
Step 2 Form 8962.
Lines 3 through 6. Complete these lines for the plan
established under the separate trade or business.

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Line 7. After you complete this line for each trade or Line 1. Enter the amount from the Step 3 Worksheet
business, add the amounts on line 7 for all the trades or for the same separate trade or business for which you are
businesses. Use the total of the line 7 amounts to com- completing the Step 5 Worksheet.
plete lines 8 and 9. If the Caution under line 1 applies to you, skip lines 2
and 3. Enter on line 4 the total of the column (e) amounts
Lines 8 and 9. Complete these lines once for all
for the months you paid specified premiums that are allo-
trades or businesses.
cable to the specified premiums you entered on line 1 for
the separate trade or business. Allocate the column (e)
Step 4 amounts using the same method you used on the Step 3
Worksheet.
Refigure the total PTC on another Form 8962. Complete
this Form 8962 through line 29. When refiguring the total Line 2. Enter the Step 4 PTC that is allocable to the
PTC, use all enrollment premiums for qualified health premiums you entered on line 1 for the separate trade or
plans in which you or any individual in your tax family en- business. Use the same allocation method you used on
rolled. Determine AGI, modified AGI, and household in- the Step 3 Worksheet.
come using the total of the Step 3 Worksheet, line 9, and
Line 3. Enter the amount from the Step 3 Worksheet
Worksheet W, line 14, as your self-employed health insur-
for the same separate trade or business for which you are
ance deduction. Use Worksheets 1-1 and 1-2 in the Form
completing the Step 5 Worksheet.
8962 instructions to figure modified AGI and household in-
come. Line 5. After you complete this line for each trade or
business, add the amounts on line 5 for all the trades or
Step 5 businesses. Use the total of the line 5 amounts to com-
plete lines 6 and 7.
Refigure your self-employed health insurance deduction
for specified premiums by completing the Step 5 Work- Lines 6 and 7. Complete these lines once for all
sheet. trades or businesses.

If you have more than one trade or business un- Step 6
! der which you established a qualified health plan,
CAUTION see More than one trade or business, later, before
Answer the following three questions.
you complete the Step 5 Worksheet.
1. Is the change in the self-employed health insurance
Step 5 Worksheet deduction from Step 3 to Step 5 less than $1.00?
Yes No
Enter amounts in dollars and cents. Do not round to whole
dollars. 2. Is the change in the total PTC from Step 2 to Step 4
less than $1.00?
1. Enter the amount from line 1 of the Step Yes No
3 Worksheet. . . . . . . . . . . . . . . . . . . . . 1. .
Caution. If you skipped lines 2 through 5 of 3. Did you answer “Yes” to both questions 1 and 2?
the Step 3 Worksheet, skip lines 2 and 3 Yes. You can claim a PTC for the amount you fig-
below and enter on line 4 the total of the ured in Step 4. Attach the Form 8962 you used in Step
column (e) amounts from your Step 4 Form 4 to your tax return. You can claim a self-employed
8962 for the months you paid specified
premiums. health insurance deduction for the specified premi-
2. Enter the total PTC (Form 8962, line 24) you ums equal to the amount on line 7 of the Step 5 Work-
figured in Step 4, earlier. . . . . . . . . . . . . 2. . sheet.
3. Enter the amount from line 5 of the Step
3 Worksheet. . . . . . . . . . . . . . . . . . . . . 3. Note. Your self-employed health insurance deduction
4. Multiply line 3 by line 2. . . . . . . . . . . . . . 4. . is the total of the Step 5 Worksheet, line 7, and Work-
5. Subtract line 4 from line 1. . . . . . . . . . . . . 5. . sheet W, line 14. Enter this total on line 17 of Sched-
6. Enter the amount from Worksheet X, line 30. ule 1 (Form 1040).
If you did not complete Worksheet X, enter
the amount from Worksheet W, line 16. . . . 6. . No. Repeat Step 4 and Step 5 (using amounts de-
7. Enter the smaller of line 5 or line 6. Then, go termined in the immediately preceding step) until
to Step 6 next. . . . . . . . . . . . . . . . . . . . 7. . changes in both the self-employed health insurance
deduction and the total PTC between steps are less
More than one trade or business. If you have more than $1.00.
than one trade or business under which you established a If you are unable to complete Step 6 because
qualified health plan, you must complete lines 1 through 5 ! changes between steps are always $1.00 or
separately for each trade or business. Use the following CAUTION more, do not use the Iterative Calculation
instructions to complete the Step 5 Worksheet. Method. Instead, use the Simplified Calculation Method or
any computation method that satisfies the rules for the
self-employed health insurance deduction and PTC as

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long as the sum of the deduction claimed for the premi- the final iteration of Step 2. Refigure the deductions/exclu-
ums and the PTC computed, taking the deduction into ac- sions if you are not eligible for the PTC.
count, is less than or equal to the premiums.
Step 3

Simplified Calculation Method Figure your self-employed health insurance deduction by
completing the following worksheet.
Follow the steps below to figure your self-employed health
If you have more than one trade or business un-
insurance deduction and PTC under the Simplified Calcu-
der which you established a qualified health plan,
lation Method. You do not have to use this method. You CAUTION!
see More than one trade or business below be-
can use the Iterative Calculation Method (discussed ear-
fore you complete the Step 3 Worksheet.
lier) if you can complete Step 6 of that method or you can
use any computation method that satisfies each set of Step 3 Worksheet
rules as long as the sum of the deduction claimed for the
premiums and the PTC computed, taking the deduction 1. Enter the amount from Worksheet
W, line 1 . . . . . . . . . . . . . . . . . . . . . . . . . 1.
into account, is less than or equal to the premiums.
Caution. If the amounts on lines 12 through
23, column (e), of your Step 2 Form 8962
Step 1 are not the same for each month and you
had specified premiums for less than 12
Figure your AGI, modified AGI, and household income us- months, skip lines 2 through 5 below and
ing Worksheet X, line 31, as your self-employed health in- enter on line 6 the total of those column (e)
surance deduction. If you did not fill out Worksheet X, use amounts for the months you paid specified
premiums.
the amount from Worksheet W, line 17. Use Worksheets
2. Enter the total PTC (Form 8962, line 24) you
1-1 and 1-2 in the Form 8962 instructions to figure modi- figured in Step 2, earlier . . . . . . . . . . . . . . 2.
fied AGI and household income.
3. Enter the number of months in 2023 for
If you are claiming any of the following deductions which specified premiums were
paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
CAUTION Self-Employed Individuals Who Claim Certain De-
! or exclusions, see Special Instructions for Note. Self-employment for part of a month
ductions/Exclusions, later, before you complete Step 1. counts as a full month of self-employment.
4. Enter the number of months someone in
1. Passive activity losses from rental real estate activities your coverage family was enrolled in the
and lines 1d and 3 of Form 8582 are losses. qualified health plan . . . . . . . . . . . . . . . . . 4.
2. IRA deduction and you (or your spouse if filing a joint 5. Divide line 3 by line 4 . . . . . . . . . . . . . . . . 5.
return) were covered by a retirement plan at work or 6. Multiply line 5 by line 2 . . . . . . . . . . . . . . . 6.
through self-employment. 7. Subtract line 6 from line 1 . . . . . . . . . . . . . 7.
3. Exclusion of interest from series EE and I U.S. savings 8. Enter the amount from Worksheet X,
bonds issued after 1989. line 30. If you did not complete Worksheet
X, enter the amount from Worksheet
4. Student loan interest deduction. W, line 16 . . . . . . . . . . . . . . . . . . . . . . . . 8.
9. Enter the smaller of line 7 or line 8 . . . . . . 9.
10. Enter the amount from Worksheet
Step 2 W, line 14 . . . . . . . . . . . . . . . . . . . . . . . . 10.
11. Add lines 9 and 10. Use this amount as your
Figure the total PTC on Form 8962 using the AGI, modi- self-employed health insurance deduction
fied AGI, and household income you determined in Step in Step 4 next. Also enter this amount on
line 17 of Schedule 1 (Form 1040) . . . . . . 11.
1. Enter the modified AGI and household income from
Step 1 on the Form 8962. When figuring the PTC, use all
enrollment premiums for qualified health plans in which More than one trade or business. If you have more
you or any individual in your tax family enrolled. Complete than one trade or business under which you established a
this Form 8962 only through line 24. Do not attach this qualified health plan, you must complete lines 1 through 7
Form 8962 to your tax return. separately for each trade or business. Use the following
instructions to complete the Step 3 Worksheet.
Cannot take the PTC. If you are not eligible to take the Line 1. Enter the amounts for the separate trade or
PTC, stop here. Do not use this method. Instead, figure business.
your self-employed health insurance deduction using the If the Caution under line 1 applies to you, skip lines 2
Self-Employed Health Insurance Deduction Worksheet in through 5. Enter on line 6 the total of the column (e)
the Instructions for Form 1040 or the Instructions for Form amounts for the months you paid specified premiums that
1040-NR; or, if required, Form 7206. If you are following are allocable to the specified premiums you entered on
the instructions under Special Instructions for Self-Em- line 1 for the separate trade or business. You can allocate
ployed Individuals Who Claim Certain Deductions/Exclu- the column (e) amounts using any reasonable method.
sions, later, make this determination when you complete

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One reasonable method is based on enrollment premiums Read the following instructions if you are claiming one
for each plan. Under this method, multiply the total of the or more of the deductions/exclusions listed above. Read
column (e) amounts for the months you paid specified pre- these instructions before you complete the Iterative Cal-
miums by a fraction. The numerator of the fraction is the culation Method or Simplified Calculation Method.
amount of specified premiums you entered on line 1 for
1. The first time you complete the Iterative Calculation
the separate trade or business. The denominator of the
Method or Simplified Calculation Method, you do so
fraction is the total of the column (a) amounts for the
without including any of the deductions/exclusions
months you paid specified premiums.
listed above in AGI, modified AGI, or household in-
Line 2. Enter the Step 2 PTC that is allocable to the come. If you use the Simplified Calculation Method,
specified premiums you entered on line 1 for the separate complete it only through Step 3. Enter “400” on the in-
trade or business. You can allocate the Step 2 PTC using terim Form 8962, line 5, if you answer “Yes” on Work-
any reasonable method. One reasonable method is based sheet 2, line 4, in the Form 8962 instructions.
on enrollment premiums for each plan. Under this method,
2. After you complete (1), figure the deduction/exclusion
multiply the Step 2 PTC by a fraction. The numerator of
using the appropriate form or worksheet in your tax re-
the fraction is the amount of specified premiums you en-
turn instructions. When figuring modified AGI on the
tered on line 1 for the separate trade or business. The de-
form or worksheet (or AGI on Form 8903), use as your
nominator of the fraction is the amount on line 11, column
self-employed health insurance deduction the amount
(a), or the total of lines 12 through 23, column (a), of the
from Step 6 of the Iterative Calculation Method or
Step 2 Form 8962.
Step 3 of the Simplified Calculation Method.
Lines 3 through 6. Complete these lines for the plan
established under the separate trade or business. If you are claiming more than one deduction/exclusion
on the list, you must figure the deductions/exclusions
Line 7. After you complete this line for each trade or
in the order shown in the list. For example, if you are
business, add the amounts on line 7 for all the trades or
claiming the student loan interest deduction and the
businesses. Use the total of the line 7 amounts to com-
exclusion of interest from series EE and I U.S. savings
plete lines 8 through 11.
bonds, you must figure the exclusion of interest from
Lines 8 through 11. Complete these lines once for all series EE and I U.S. savings bonds first and complete
trades or businesses. (3) and (4) or (5) using that exclusion. Then, you fig-
ure the student loan interest deduction, as explained
Step 4 in (5) or at the end of Worksheets Y and Z.
3. Enter the deduction/exclusion you figured in (2) on
Refigure the final PTC on another Form 8962. Complete
your tax return.
this Form 8962 through line 29. Attach this Form 8962 to
your tax return. When refiguring the PTC, use all enroll- 4. If you completed Worksheet X, complete Worksheet Y
ment premiums for qualified health plans in which you or and follow the instructions under line 22 of that work-
any individual in your tax family enrolled. Determine AGI, sheet. Skip (5).
modified AGI, and household income using the amount
5. If you did not complete Worksheet X, do the following.
from line 11 of the Step 3 Worksheet as your self-em-
ployed health insurance deduction. Use Worksheets 1-1 a. Repeat the Iterative Calculation Method or Simpli-
and 1-2 in the Form 8962 instructions to figure modified fied Calculation Method. Use the deduction/exclu-
AGI and household income. sion from (2) in any step that requires you to figure
AGI, modified AGI, and household income.
Special Instructions for b. If the amount from (2) is the only deduction/exclu-
Self-Employed Individuals Who Claim sion on the list you are claiming, complete either
Certain Deductions/Exclusions method through the last step and follow the step
instructions for claiming the PTC and self-em-
The instructions in this section apply to you if you claim ployed health insurance deduction on your return.
any of the following deductions or exclusions. Skip (5c).
1. Passive activity losses from rental real estate activities c. If the amount from (2) is not the only deduction/
and lines 1d and 3 of Form 8582 are losses. exclusion on the list you are claiming, repeat the
Iterative Calculation Method through Step 6 or the
2. IRA deduction and you (or your spouse if filing a joint Simplified Calculation Method through Step 3. En-
return) were covered by a retirement plan at work or ter “400” on the interim Form 8962, line 5, if you
through self-employment. answered “Yes” on Worksheet 2, line 4, in the
3. Exclusion of interest from series EE and I U.S. savings Form 8962 instructions. Then, figure the additional
bonds issued after 1989. deduction/exclusion using the appropriate form or
worksheet in your tax return instructions. When
4. Student loan interest deduction. figuring modified AGI on the form or worksheet (or
AGI on Form 8903), use as your self-employed

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health insurance deduction the amount from Step    (3) and (5) for each additional deduction/exclu-
6 of the Iterative Calculation Method or Step 3 of sion. Follow (5b) for your final deduction/exclusion.
the Simplified Calculation Method. Then, repeat 

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Worksheet Y. Refiguring Household Income and the 
Repayment Limitation When Claiming Certain Deductions 
or Exclusions                                                                              Keep for Your Records
1.  Enter the amount from Worksheet X, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         1.   
2.  Enter the deduction or exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               2.   
3.  Revised household income. Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                              3.   
4.  Enter the smaller of Worksheet W, line 19, or $700 ($350 if your filing status is single) . . . . . . . . . .                                              4.   
5.  Subtract line 4 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                      5.   
6.  Enter the amount from Worksheet X, line 17b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          6.   
7.  Divide line 5 by line 6. If the result is not a whole percentage, do not round; instead, multiply this 
    number by 100 (to express it as a percentage) and then drop any numbers after the decimal point. 
    For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 3.997, 
    enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        7.          %
     • If the result is less than 200, enter $700 ($350 if your filing status is single) on line 14. Skip 
       lines 8 through 13.
     • If the result is 200 or more, go to line 8.
8.  Enter the smaller of Worksheet W, line 19, or $1,800 ($900 if your filing status is single) . . . . . . . .                                                8.   
9.  Subtract line 8 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                      9.   
10. Divide line 9 by line 6. If the result is not a whole percentage, do not round; instead, multiply this 
    number by 100 (to express it as a percentage) and then drop any numbers after the decimal point. 
    For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 3.997, 
    enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        10.         %
     • If the result is less than 300, enter $1,800 ($900 if your filing status is single) on line 14. Skip 
       lines 11 through 13.
     • If the result is 300 or more, go to line 11.
11. Enter the smaller of Worksheet W, line 19, or $3,000 ($1,500 if your filing status is single)  . . . . . .                                                 11.  
12. Subtract line 11 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                       12.  
13. Divide line 12 by line 6. If the result is not a whole percentage, do not round; instead, multiply this 
    number by 100 (to express it as a percentage) and then drop any numbers after the decimal point. 
    For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 3.997, 
    enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        13.         %
     • If the result is less than 400, enter $3,000 ($1,500 if your filing status is single) on line 14.
     • If the result is 400 or more, enter the amount from Worksheet W, line 2, on line 14.
14. Enter the amount you were instructed to enter here by line 7, 10, or 13. Also, enter this amount on 
    line 28 of the Form 8962 you attach to your tax return if you are required to complete that line and 
    you do not complete Worksheet Z. Do not enter an amount from Table 5 in the Form 8962 
    instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.  
15. Enter the amount from Worksheet X, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        15.  
16. Add lines 14 and 15  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       16.  
17. Enter the amount from Worksheet X, line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         17.  
18. Enter the smaller of line 16 or line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                18.  
19. Enter the amount from Worksheet X, line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         19.  
20. Enter the smaller of line 18 or line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                20.  
21. Enter the amount from Worksheet X, line 5  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                       21.  
22. Add lines 20 and 21. Then, see Next below for further instructions . . . . . . . . . . . . . . . . . . . . . . . . . .                                     22.  
Next. Repeat the Iterative Calculation Method or Simplified Calculation Method, whichever applies. In Step 1 of either method, use 
the amount on line 22 above as your self-employed health insurance deduction. Also, use the amount on line 2 above in any step 
that requires you to figure AGI, modified AGI, and household income. If the amount on line 2 above is the only deduction/exclusion 
on the list that you are claiming, complete either method through the last step. If you are claiming another deduction/exclusion on 
the list, do the following.
•   When you repeat either method as explained above, complete the Iterative Calculation Method through                                                           Step 6 or complete the 
    Simplified Calculation Method through Step 3. Enter “400” on the interim Form 8962, line 5, if you answer “Yes” on Worksheet 2, 
    line 3, in the Form 8962 instructions.
•   Figure the other deduction/exclusion using the appropriate form or the worksheet provided in your tax return instructions. Use 
    the self-employed health insurance deduction you figured in either Step 6 of the Iterative Calculation Method or Step 3 of the 
    Simplified Calculation Method to figure modified AGI for the other deduction/exclusion.
•   Then, complete Worksheet Z for the other deduction/exclusion.

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Worksheet Z. Refiguring Household Income and the 
Repayment Limitation When Claiming Certain Deductions 
or Exclusions                                                                              Keep for Your Records
Before you begin:
•   Complete Worksheet Y before you complete Worksheet Z.
1.  Enter the amount from Worksheet Y, line 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  1.   
2.  Enter the deduction or exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2.   
3.  Revised household income. Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        3.   
4.  Enter the smaller of Worksheet W, line 19, or $700 ($350 if your filing status is single) . . . . . . . . . .                                        4.   
5.  Subtract line 4 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                5.   
6.  Enter the amount from Worksheet X, line 17b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    6.   
7.  Divide line 5 by line 6. If the result is not a whole percentage, do not round; instead, multiply this 
    number by 100 (to express it as a percentage) and then drop any numbers after the decimal point. 
    For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 3.997, 
    enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  7.   %
     • If the result is less than 200, enter $700 ($350 if your filing status is single) on line 14. Skip 
       lines 8 through 13.
     • If the result is 200 or more, go to line 8.
8.  Enter the smaller of Worksheet W, line 19, or $1,800 ($900 if your filing status is single) . . . . . . . .                                          8.   
9.  Subtract line 8 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                9.   
10. Divide line 9 by line 6. If the result is not a whole percentage, do not round; instead, multiply this 
    number by 100 (to express it as a percentage) and then drop any numbers after the decimal point. 
    For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 3.997, 
    enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  10.  %
     • If the result is less than 300, enter $1,800 ($900 if your filing status is single) on line 14. Skip 
       lines 11 through 13.
     • If the result is 300 or more, go to line 11.
11. Enter the smaller of Worksheet W, line 19, or $3,000 ($1,500 if your filing status is single) . . . . . . .                                          11.  
12. Subtract line 11 from line 3. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 12.  
13. Divide line 12 by line 6. If the result is not a whole percentage, do not round; instead, multiply this 
    number by 100 (to express it as a percentage) and then drop any numbers after the decimal point. 
    For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 3.997, 
    enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  13.  %
     • If the result is less than 400, enter $3,000 ($1,500 if your filing status is single) on line 14.
     • If the result is 400 or more, enter the amount from Worksheet W, line 2, on line 14.
14. Enter the amount you were instructed to enter here by line 7, 10, or 13. Also enter this amount on 
    line 28 of the Form 8962 you attach to your tax return if you are required to complete that line. Do 
    not enter an amount from Table 5 in the Form 8962 instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . .                               14.  
15. Enter the amount from Worksheet X, line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  15.  
16. Add lines 14 and 15  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.  
17. Enter the amount from Worksheet X, line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   17.  
18. Enter the smaller of line 16 or line 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          18.  
19. Enter the amount from Worksheet X, line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   19.  
20. Enter the smaller of line 18 or line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          20.  
21. Enter the amount from Worksheet X, line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                  21.  
22. Add lines 20 and 21. Then, see Next below for further instructions . . . . . . . . . . . . . . . . . . . . . . . . . .                               22.  
Next. Repeat the Iterative Calculation Method or Simplified Calculation Method, whichever applies. In Step 1 of either method, use the amount on 
line 22 above as your self-employed health insurance deduction. Also use the amounts on line 2 of Worksheets Y and Z in any step that requires 
you to figure AGI, modified AGI, and household income. If you are not claiming any more deductions/exclusions on the list, complete either method 
through the last step and follow the step instructions for claiming the PTC and self-employed health insurance deduction on your tax return. If you 
are claiming another deduction/exclusion on the list, do the following.
•   When you repeat either method as explained above, complete the Iterative Calculation Method through Step 6 or complete the Simplified 
    Calculation Method through Step 3. Enter “400” on the interim Form 8962, line 5, if you answer “Yes” on Worksheet 2, line 3, in the Form 8962 
    instructions.
•   Figure the other deduction/exclusion using the appropriate form or the worksheet provided in your tax return instructions. Use the 
    self-employed health insurance deduction you figured in either Step 6 of the Iterative Calculation Method or Step 3 of the Simplified 
    Calculation Method to figure modified AGI for the other deduction/exclusion.
•   Then, complete another Worksheet Z for the other deduction/exclusion.

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Illustrated Example of the Simplified Carla’s Worksheet W

Calculation Method Carla begins by completing Worksheet W to determine the
limit on the self-employed health insurance deduction for
The following example illustrates the Simplified Calcula-
specified premiums.
tion Method.
In 2023, Carla Birch, her husband Jim, and their two
Carla's Worksheet X
dependent children enrolled in the applicable SLCSP
through the Marketplace. The annual premium was Because Carla had APTC during the months of self-em-
$13,000, and $4,200 in APTC was paid for Carla, her hus- ployment, she completes Worksheet X, Parts I and III. She
band, and two dependent children. All of the premiums skips Part II because neither one of her children is re-
are specified premiums. Carla operated a business as a quired to file a federal income tax return for 2023.
sole proprietorship during the entire year. Carla and Jim
are filing a joint Form 1040 (not illustrated). The income Line 1. Carla enters $114,094, which is the total income
and deductions on their Form 1040 and Schedule 1 (Form shown on line 9 of her Form 1040. Total income is the sum
1040), excluding Schedule 1 (Form 1040), line 17, consist of Jim’s salary, taxable interest, and Carla’s net profit.
of the following.
Line 4. Carla enters $4,619. This is the total of the de-
ductible part of her self-employment tax and her qualified
Jim's salary (Form 1040, line 1). . . . . . . . . . . $83,675
retirement plan deduction.
Taxable interest (Form 1040, line 2b) . . . . . . . 419
Carla’s net profit from her business on Line 17b. Carla enters $27,750. This is the federal pov-
Schedule 1 (Form 1040), line 3. . . . . . . . . . . 30,000 erty line shown in Table 1-1 in the Form 8962 instructions
Total income (Form 1040, line 9). . . . . . . . . . 114,094 for a family size of four.
Deductible part of Carla’s self-employment tax
(Schedule 1 (Form 1040), line 15) . . . . . . . . . 2,119
Carla’s qualified retirement plan deduction
(Schedule 1 (Form 1040), line 16) . . . . . . . . . 2,500

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Carla's Worksheet W. Figuring the Limit on the Self-Employed Health Insurance Deduction 
for Specified Premiums

 Caution.       If you have more than one trade or business under which a qualified health plan is established, complete 
lines 4 through 13 separately for each trade or business. Add the amounts on line 13 for all the trades or businesses. 
Then, complete lines 14 through 17 once for all trades or businesses.
1.  Enter your specified premiums. See Specified Premiums under Instructions for Worksheet 
    P, earlier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1.  13,000
2.  Enter the APTC from Form 1095-A, Part III, column C, that is attributable to the premiums on 
    line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.  4,200
3.  Subtract line 2 from line 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              3.  8,800
4.  Enter your net profit* and any other earned income** from the business under which the qualified 
    health plan is established. Do not include Conservation Reserve Program payments exempt from 
    self-employment tax. If the business is an S corporation, skip to line 11 . . . . . . . . . . . . . . . . . . . . . .                                          4.  30,000
5.  Enter the total of all net profits* from Schedule C (Form 1040), line 31; Schedule F (Form 1040), 
    line 34; or box 14, code A, of Schedule K-1 (Form 1065), plus any other income allocable to the 
    profitable business. Do not include Conservation Reserve Program payments exempt from 
    self-employment tax. See the Instructions for Schedule SE (Form 1040). Do not include any net 
    losses shown on these schedules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        5.  30,000
6.  Divide line 4 by line 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          6.  1.0
7.  Multiply line 15 of Schedule 1 (Form 1040) by line 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                               7.  2,119
8.  Subtract line 7 from line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              8.  27,881
9.  Enter the amount, if any, from line 16 of Schedule 1 (Form 1040), attributable to the same 
    business for which the qualified health plan is established . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                  9.  2,500
10. Subtract line 9 from line 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              10. 25,381
11. Enter your Medicare wages (box 5 of Form W-2) from an S corporation in which you are a 
    more-than-2% shareholder and in which the qualified health plan is established . . . . . . . . . . . . . . .                                                   11.  
12. Enter any amount from Form 2555, line 45, attributable to the amount entered on line 4 or line 11 
    above . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  12. -0-
    Note. If you are not filing Form 2555, enter -0-.
13. Subtract line 12 from line 10 or line 11, whichever applies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                  13. 25,381
14. Enter your self-employed health insurance deduction for nonspecified premiums from Worksheet 
    P, line 3, or Form 7206, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 14.  
15. Subtract line 14 from line 13  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               15. 25,381
16. Enter the smaller of line 3 or line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   16. 8,800
17. Add lines 14 and 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .            17. 8,800
18. Is line 2 blank or -0-? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          18.  
       Yes. Skip line 19 and Worksheet X. Use one of the methods that follow Worksheet X to figure 
    the PTC and self-employed health insurance deduction for specified premiums.
    x No. Go to line 19.
19. Subtract line 16 from line 15. Then, go to Worksheet X          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          19. 16,581
* If you used either optional method to figure your net earnings from self-employment from any business, do not enter your net profit from the 
business. Instead, enter the amount attributable to that business from Schedule SE, line 4b.
 
** Earned income includes net earnings and gains from the sale, transfer, or licensing of property you created. However, it does not include 
capital gain income.
The Simplified Calculation Method for Carla                                  the Form 8962 instructions to figure her modified AGI and 
                                                                             household  income.  Her  modified  AGI  and  household  in-
Step 1.   Carla figures her AGI, modified AGI, and house-                    come are each $97,625, the same as her AGI figured in 
hold  income  using  $11,800  as  the  self-employed  health                 this Step 1.
insurance  deduction.  (She  does                   not  enter  $11,800  on 
Schedule 1 (Form 1040), line 17.) Her AGI is $97,625, fig-                   Step 2. Carla figures the total PTC on Form 8962 (not il-
ured as follows.                                                             lustrated) using the modified AGI and household income 
                                                                             figured in Step 1. She completes Form 8962 only through 
                                                                             line 24. She uses the total PTC shown on line 24 ($5,873) 
Total income from Form 1040, line 9                 . . . . . . . . $114,094
                                                                             to figure the self-employed health insurance deduction in 
Minus: deductible part of self-employment 
                                                                             Step 3, later. She does not attach the Form 8962 to her 
tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2,119)
                                                                             tax return.
Minus: qualified retirement plan deduction                    . . . (2,500)
Minus: self-employed health insurance                                        Step 3. Carla completes the following worksheet to figure 
deduction from Worksheet X, line 31                 . . . . . . .   (11,800) the self-employed health insurance deduction she will en-
Equals: AGI     . . . . . . . . . . . . . . . . . . . . . . . . . . 97,625   ter on Schedule 1 (Form 1040), line 17.

 Carla uses this AGI amount on Worksheet 1-1. Taxpay-
er’s Modified AGI Worksheet—Line 2a (not illustrated) in 

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Carla's Worksheet X. Figuring Household Income and the Repayment Limitation
Complete this worksheet only if APTC was paid to your insurer on your behalf for the months you were self-employed.
Part I: Taxpayer's Modified AGI
1.  Combine the amounts from:
     • Form 1040, 1040-SR, or 1040-NR, lines 2a and 9, and the excess, if any, of line 6a over 
       line 6b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    1.   114,094
    Note. See the instructions if you are filing Form 8582, 8814, or 8815.
2.  Enter any amounts from Form 2555, lines 45 and 50 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                 2.    
3.  Add lines 1 and 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       3.   114,094
4.  Enter the total of the amounts from:
     • Schedule 1 (Form 1040), lines 11 through 16, 18, and 19a, plus any write-in adjustments you 
       entered on the dotted line next to Schedule 1 (Form 1040), line 26 . . . . . . . . . . . . . . . . . . . . . .                                         4.   4,619
    Note. See the instructions if you made contributions to a traditional IRA. 
5.  Enter the amount from Worksheet W, line 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          5.    
6.  Enter the amount from Worksheet W, line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          6.   8,800
7.  Add lines 4, 5, and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       7.   13,419
8.  Subtract line 7 from line 3. Then, go to Part II if you are claiming dependents on your tax return. If 
    you are not claiming any dependents on your tax return, skip Part II and go to Part III . . . . . . . . . .                                               8.   100,675
Part II: Dependents’ Modified AGI
 Note. Lines 9–13 of this part are omitted because Carla's dependent children are not required to file federal income tax returns.
Part III: Repayment Limitation
 
14. Household income. Add lines 8 and 13 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        14.  100,675
15. Enter the smaller of Worksheet W, line 19, or $700 ($350 if your filing status is single) . . . . . . . . .                                               15.  700
16. Subtract line 15 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         16.  99,975
17a. Enter the number of qualifying individuals in your tax family 
    (including yourself) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17a.                                                  4
17b. Enter the federal poverty line amount as determined by the family size on line 17a and federal 
    poverty Table 1-1, 1-2, or 1-3 for your state of residence during 2023 in the Form 8962 
    instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  17b. 27,750
18. Divide line 16 by line 17b. If the result is not a whole percentage, do not round; instead, multiply 
    this number by 100 (to express it as a percentage) and then drop any numbers after the decimal 
    point. For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 
    3.997, enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              18.  360%
     • If the result is less than 200, enter $700 ($350 if your filing status is single) on line 25. Skip 
       lines 19 through 24.
     • If the result is 200 or more, go to line 19.
19. Enter the smaller of Worksheet W, line 19, or $1,800 ($900 if your filing status is single) . . . . . . .                                                 19.  1,800
20. Subtract line 19 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         20.  98,875
21. Divide line 20 by line 17b. If the result is not a whole percentage, do not round; instead, multiply 
    this number by 100 (to express it as a percentage) and then drop any numbers after the decimal 
    point. For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 
    3.997, enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              21.  356%
     • If the result is less than 300, enter $1,800 ($900 if your filing status is single) on line 25. Skip 
       lines 22 through 24.
     • If the result is 300 or more, go to line 22.
22. Enter the smaller of Worksheet W, line 19, or $3,000 ($1,500 if your filing status is single) . . . . . .                                                 22.  3,000
23. Subtract line 22 from line 14. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         23.  97,625
24. Divide line 23 by line 17b. If the result is not a whole percentage, do not round; instead, multiply 
    this number by 100 (to express it as a percentage) and then drop any numbers after the decimal 
    point. For example, for 0.9984, enter the result as 99; for 1.8565, enter the result as 185; and for 
    3.997, enter the result as 399 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              24.  352%
     • If the result is less than 400, enter $3,000 ($1,500 if your filing status is single) on line 25.
     • If the result is 400 or more, enter the amount from Worksheet W, line 2, on line 25. 
25. Enter the amount you were instructed to enter here by line 18, 21, or 24. See instructions . . . . . .                                                    25.  3,000
Part IV: Maximum Self-Employed Health Insurance Deduction
26. Add lines 6 and 25 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        26.  11,800
27. Enter the amount from Worksheet W, line 1  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          27.  13,000
28. Enter the smaller of line 26 or line 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 28.  11,800
29. Enter the amount from Worksheet W, line 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          29.  25,381
30. Enter the smaller of line 28 or line 29 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 30.  11,800
31. Add lines 5 and 30. Then, use one of the methods that follow to figure the PTC and the 
    self-employed health insurance deduction for specified premiums . . . . . . . . . . . . . . . . . . . . . . . . .                                         31.  11,800

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Carla’s Step 3 Worksheet
1.  Enter the amount from Worksheet                                                   How To Get Tax Help
    W, line 1 . . . . . . . . . . . . . . . . . . . . . . . . .   1.         13,000
    Caution. If the amounts on lines 12 through                                       If you have questions about a tax issue; need help prepar-
    23, column (e), of your Step 2 Form 8962                                          ing your tax return; or want to download free publications, 
    are not the same for each month and you                                           forms, or instructions, go to IRS.gov to find resources that 
    had specified premiums for less than 12                                           can help you right away.
    months, skip lines 2 through 5 below and 
    enter on line 6 the total of those column (e) 
    amounts for the months you paid specified                                         Preparing and filing your tax return.  After receiving all 
    premiums.                                                                         your wage and earnings statements (Forms W-2, W-2G, 
2.  Enter the total PTC (Form 8962, line 24) you                                      1099-R,  1099-MISC,  1099-NEC,  etc.);  unemployment 
    figured in Step 2, earlier . . . . . . . . . . . . . .        2.         5,873    compensation statements (by mail or in a digital format) or 
3.  Enter the number of months in 2023 for                                            other  government  payment  statements  (Form  1099-G); 
    which specified premiums were                                                     and  interest,  dividend,  and  retirement  statements  from 
    paid . . . . . . . . . . . . . . . . . . . . . . . . . . . .  3.         12       banks and investment firms (Forms 1099), you have sev-
    Note. Self-employment for part of a month                                         eral options to choose from to prepare and file your tax re-
    counts as a full month of self-employment.                                        turn.  You  can  prepare  the  tax  return  yourself,  see  if  you 
4.  Enter the number of months someone in                                             qualify for free tax preparation, or hire a tax professional to 
    your coverage family was enrolled in the                                          prepare your return.
    qualified health plan . . . . . . . . . . . . . . . . .       4.         12
5.  Divide line 3 by line 4 . . . . . . . . . . . . . . . .       5.         1.0      Free options for tax preparation.    Your options for pre-
6.  Multiply line 5 by line 2 . . . . . . . . . . . . . . .       6.         5,873    paring  and  filing  your  return  online  or  in  your  local  com-
                                                                                      munity, if you qualify, include the following.
7.  Subtract line 6 from line 1 . . . . . . . . . . . . .         7.         7,127
8.  Enter the amount from Worksheet X,                                                • Free File. This program lets you prepare and file your 
    line 30. If you did not complete Worksheet                                          federal individual income tax return for free using soft-
    X, enter the amount from Worksheet W,                                               ware or Free File Fillable Forms. However, state tax 
    line 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.         11,800     preparation may not be available through Free File. Go 
9.  Enter the smaller of line 7 or line 8 . . . . . .             9.         7,127      to IRS.gov/FreeFile to see if you qualify for free online 
10. Enter the amount from Worksheet                                                     federal tax preparation, e-filing, and direct deposit or 
    W, line 14 . . . . . . . . . . . . . . . . . . . . . . . .    10.        -0-        payment options.
11. Add lines 9 and 10. Use this amount as your                                       • VITA. The Volunteer Income Tax Assistance (VITA) 
    self-employed health insurance deduction                                            program offers free tax help to people with 
    in Step 4 next. Also enter this amount on 
    line 17 of Schedule 1 (Form 1040)  . . . . . .                11.        7,127      low-to-moderate incomes, persons with disabilities, 
                                                                                        and limited-English-speaking taxpayers who need 
                                                                                        help preparing their own tax returns. Go to IRS.gov/
Step  4. Carla  refigures  the  final  PTC  on  another  Form 
                                                                                        VITA, download the free IRS2Go app, or call 
8962 (not illustrated). Carla figures AGI, modified AGI, and 
                                                                                        800-906-9887 for information on free tax return prepa-
household  income  using  the  amount  from  line  11  of  the 
                                                                                        ration.
Step 3 Worksheet as her self-employed health insurance 
deduction. Her AGI is $101,804, figured as follows.                                   • TCE. The Tax Counseling for the Elderly (TCE) pro-
Carla’s Step 4 Worksheet                                                                gram offers free tax help for all taxpayers, particularly 
                                                                                        those who are 60 years of age and older. TCE volun-
Total income from Form 1040, line 9 . . . . . . . .                          $114,094   teers specialize in answering questions about pen-
Minus: deductible part of self-employment                                               sions and retirement-related issues unique to seniors. 
tax  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (2,119)    Go to IRS.gov/TCE or download the free IRS2Go app 
Minus: qualified retirement plan                                                        for information on free tax return preparation.
deduction  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       (2,500)  • MilTax. Members of the U.S. Armed Forces and quali-
Minus: self-employed health insurance                                                   fied veterans may use MilTax, a free tax service of-
deduction from line 11 of the Step 3                                                    fered by the Department of Defense through Military 
Worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        (7,127)    OneSource. For more information, go to 
Equals: AGI . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        106,967    MilitaryOneSource MilitaryOneSource.mil/MilTax ( ).
                                                                                           Also, the IRS offers Free Fillable Forms, which can 
Carla uses this AGI amount on Worksheet 1-1. Taxpay-
                                                                                        be completed online and then e-filed regardless of in-
er’s Modified AGI Worksheet—Line 2a (not illustrated) in 
                                                                                        come.
the  Form  8962  instructions  to  refigure  her  modified  AGI 
and household income. Her modified AGI and household                                  Using online tools to help prepare your return.  Go to 
income are each $106,967, the same as her AGI figured                                 IRS.gov/Tools for the following.
earlier.
Carla  completes  Form  8962  (not  illustrated)  through                             • The Earned Income Tax Credit Assistant IRS.gov/ (
line  26.  She  enters  the  amount  from  line  26  ($104)  on                         EITCAssistant) determines if you’re eligible for the 
Schedule 3 (Form 1040), line 9, and attaches Form 8962.                                 earned income credit (EIC).

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• The Online EIN Application IRS.gov/EIN ( ) helps you Statement, and Form W-2c, Corrected Wage and Tax
get an employer identification number (EIN) at no Statement.
cost.
IRS social media. Go to IRS.gov/SocialMedia to see the
• The Tax Withholding Estimator IRS.gov/W4App ( ) various social media tools the IRS uses to share the latest
makes it easier for you to estimate the federal income information on tax changes, scam alerts, initiatives, prod-
tax you want your employer to withhold from your pay- ucts, and services. At the IRS, privacy and security are our
check. This is tax withholding. See how your withhold- highest priority. We use these tools to share public infor-
ing affects your refund, take-home pay, or tax due. mation with you. Don’t post your social security number
• The First-Time Homebuyer Credit Account Look-up (SSN) or other confidential information on social media
(IRS.gov/HomeBuyer) tool provides information on sites. Always protect your identity when using any social
your repayments and account balance. networking site.
The following IRS YouTube channels provide short, in-
• The Sales Tax Deduction Calculator IRS.gov/ (
formative videos on various tax-related topics in English,
SalesTax) figures the amount you can claim if you
Spanish, and ASL.
itemize deductions on Schedule A (Form 1040).
• Youtube.com/irsvideos.
Getting answers to your tax questions. On
IRS.gov, you can get up-to-date information on • Youtube.com/irsvideosmultilingua.
current events and changes in tax law. • Youtube.com/irsvideosASL.
• IRS.gov/Help: A variety of tools to help you get an-
swers to some of the most common tax questions. Watching IRS videos. The IRS Video portal
(IRSVideos.gov) contains video and audio presentations
• IRS.gov/ITA: The Interactive Tax Assistant, a tool that for individuals, small businesses, and tax professionals.
will ask you questions and, based on your input, pro-
vide answers on a number of tax topics. Online tax information in other languages. You can
• IRS.gov/Forms: Find forms, instructions, and publica- find information on IRS.gov/MyLanguage if English isn’t
tions. You will find details on the most recent tax your native language.

changes and interactive links to help you find answers Free Over-the-Phone Interpreter (OPI) Service. The
to your questions. IRS is committed to serving taxpayers with limited-English
• You may also be able to access tax information in your proficiency (LEP) by offering OPI services. The OPI Serv-
e-filing software. ice is a federally funded program and is available at Tax-
payer Assistance Centers (TACs), most IRS offices, and
every VITA/TCE tax return site. The OPI Service is acces-
Need someone to prepare your tax return? There are sible in more than 350 languages.
various types of tax return preparers, including enrolled
agents, certified public accountants (CPAs), accountants, Accessibility Helpline available for taxpayers with
and many others who don’t have professional credentials. disabilities. Taxpayers who need information about ac-
If you choose to have someone prepare your tax return, cessibility services can call 833-690-0598. The Accessi-
choose that preparer wisely. A paid tax preparer is: bility Helpline can answer questions related to current and
• Primarily responsible for the overall substantive accu- future accessibility products and services available in al-
racy of your return, ternative media formats (for example, braille, large print,
audio, etc.). The Accessibility Helpline does not have ac-
• Required to sign the return, and cess to your IRS account. For help with tax law, refunds, or
• Required to include their preparer tax identification account-related issues, go to IRS.gov/LetUsHelp.
number (PTIN).
Note. Form 9000, Alternative Media Preference, or
Although the tax preparer always signs the return, Form 9000(SP) allows you to elect to receive certain types
! you're ultimately responsible for providing all the of written correspondence in the following formats.
CAUTION information required for the preparer to accurately
prepare your return and for the accuracy of every item re- • Standard Print.
ported on the return. Anyone paid to prepare tax returns • Large Print.
for others should have a thorough understanding of tax
matters. For more information on how to choose a tax pre- • Braille.
parer, go to Tips for Choosing a Tax Preparer on IRS.gov. • Audio (MP3).
• Plain Text File (TXT).
Employers can register to use Business Services On- • Braille Ready File (BRF).
line. The Social Security Administration (SSA) offers on-
line service at SSA.gov/employer for fast, free, and secure Disasters. Go to IRS.gov/DisasterRelief to review the
W-2 filing options to CPAs, accountants, enrolled agents, available disaster tax relief.
and individuals who process Form W-2, Wage and Tax

64 Publication 974 (2023)

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Getting tax forms and publications. Go to IRS.gov/ Your taxes can be affected if your SSN is used to file a
Forms to view, download, or print all the forms, instruc- fraudulent return or to claim a refund or credit.
tions, and publications you may need. Or, you can go to
• The IRS doesn’t initiate contact with taxpayers by
IRS.gov/OrderForms to place an order.
email, text messages (including shortened links), tele-
Getting tax publications and instructions in eBook phone calls, or social media channels to request or
format. Download and view most tax publications and in- verify personal or financial information. This includes
structions (including the Instructions for Form 1040) on requests for personal identification numbers (PINs),
mobile devices as eBooks at IRS.gov/eBooks. passwords, or similar information for credit cards,
IRS eBooks have been tested using Apple's iBooks for banks, or other financial accounts.
iPad. Our eBooks haven’t been tested on other dedicated • Go to IRS.gov/IdentityTheft, the IRS Identity Theft
eBook readers, and eBook functionality may not operate Central webpage, for information on identity theft and
as intended. data security protection for taxpayers, tax professio-
nals, and businesses. If your SSN has been lost or
Access your online account (individual taxpayers stolen or you suspect you’re a victim of tax-related
only). Go to IRS.gov/Account to securely access infor- identity theft, you can learn what steps you should
mation about your federal tax account. take.
• View the amount you owe and a breakdown by tax • Get an Identity Protection PIN (IP PIN). IP PINs are
year. six-digit numbers assigned to taxpayers to help pre-
• See payment plan details or apply for a new payment vent the misuse of their SSNs on fraudulent federal in-
plan. come tax returns. When you have an IP PIN, it pre-
vents someone else from filing a tax return with your
• Make a payment or view 5 years of payment history
SSN. To learn more, go to IRS.gov/IPPIN.
and any pending or scheduled payments.
• Access your tax records, including key data from your Ways to check on the status of your refund.
most recent tax return, and transcripts. • Go to IRS.gov/Refunds.
• View digital copies of select notices from the IRS. • Download the official IRS2Go app to your mobile de-
• Approve or reject authorization requests from tax pro- vice to check your refund status.
fessionals. • Call the automated refund hotline at 800-829-1954.
• View your address on file or manage your communica- The IRS can’t issue refunds before mid-February
tion preferences. ! for returns that claimed the EIC or the additional
CAUTION child tax credit (ACTC). This applies to the entire
Get a transcript of your return. With an online account,
refund, not just the portion associated with these credits.
you can access a variety of information to help you during
the filing season. You can get a transcript, review your
most recently filed tax return, and get your adjusted gross Making a tax payment. Payments of U.S. tax must be
income. Create or access your online account at IRS.gov/ remitted to the IRS in U.S. dollars. Digital assets are not
Account. accepted. Go to IRS.gov/Payments for information on how
to make a payment using any of the following options.
Tax Pro Account. This tool lets your tax professional • IRS Direct Pay: Pay your individual tax bill or estimated
submit an authorization request to access your individual tax payment directly from your checking or savings ac-
taxpayer IRS online account. For more information, go to count at no cost to you.
IRS.gov/TaxProAccount.
• Debit Card, Credit Card, or Digital Wallet: Choose an
Using direct deposit. The safest and easiest way to re- approved payment processor to pay online or by
ceive a tax refund is to e-file and choose direct deposit, phone.
which securely and electronically transfers your refund di- Electronic Funds Withdrawal: Schedule a payment
•
rectly into your financial account. Direct deposit also when filing your federal taxes using tax return prepara-
avoids the possibility that your check could be lost, stolen, tion software or through a tax professional.
destroyed, or returned undeliverable to the IRS. Eight in
10 taxpayers use direct deposit to receive their refunds. If • Electronic Federal Tax Payment System: Best option
you don’t have a bank account, go to IRS.gov/ for businesses. Enrollment is required.
DirectDeposit for more information on where to find a bank • Check or Money Order: Mail your payment to the ad-
or credit union that can open an account online. dress listed on the notice or instructions.
Reporting and resolving your tax-related identity • Cash: You may be able to pay your taxes with cash at
theft issues. a participating retail store.
• Tax-related identity theft happens when someone • Same-Day Wire: You may be able to do same-day
steals your personal information to commit tax fraud. wire from your financial institution. Contact your finan-
cial institution for availability, cost, and time frames.

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Note. The IRS uses the latest encryption technology to under the Stay Connected tab, choose the Contact Us op-
ensure that the electronic payments you make online, by tion and click on “Local Offices.”
phone, or from a mobile device using the IRS2Go app are
safe and secure. Paying electronically is quick, easy, and The Taxpayer Advocate Service (TAS)
faster than mailing in a check or money order.
Is Here To Help You
What if I can’t pay now? Go to IRS.gov/Payments for
What Is TAS?
more information about your options.
• Apply for an online payment agreement IRS.gov/ ( TAS is an independent organization within the IRS that
OPA) to meet your tax obligation in monthly install- helps taxpayers and protects taxpayer rights. TAS strives
ments if you can’t pay your taxes in full today. Once to ensure that every taxpayer is treated fairly and that you
you complete the online process, you will receive im- know and understand your rights under the Taxpayer Bill
mediate notification of whether your agreement has of Rights.
been approved.
• Use the Offer in Compromise Pre-Qualifier to see if How Can You Learn About Your Taxpayer
you can settle your tax debt for less than the full Rights?
amount you owe. For more information on the Offer in
The Taxpayer Bill of Rights describes 10 basic rights that
Compromise program, go to IRS.gov/OIC.
all taxpayers have when dealing with the IRS. Go to
Filing an amended return. Go to IRS.gov/Form1040X TaxpayerAdvocate.IRS.gov to help you understand what
for information and updates. these rights mean to you and how they apply. These are
your rights. Know them. Use them.
Checking the status of your amended return. Go to
IRS.gov/WMAR to track the status of Form 1040-X amen- What Can TAS Do for You?
ded returns.
TAS can help you resolve problems that you can’t resolve
It can take up to 3 weeks from the date you filed
with the IRS. And their service is free. If you qualify for
! your amended return for it to show up in our sys- their assistance, you will be assigned to one advocate
CAUTION tem, and processing it can take up to 16 weeks.
who will work with you throughout the process and will do
everything possible to resolve your issue. TAS can help
Understanding an IRS notice or letter you’ve re- you if:
ceived. Go to IRS.gov/Notices to find additional informa-
tion about responding to an IRS notice or letter. • Your problem is causing financial difficulty for you,
your family, or your business;
Responding to an IRS notice or letter. You can now • You face (or your business is facing) an immediate
upload responses to all notices and letters using the threat of adverse action; or
Document Upload Tool. For notices that require additional
action, taxpayers will be redirected appropriately on • You’ve tried repeatedly to contact the IRS but no one
IRS.gov to take further action. To learn more about the has responded, or the IRS hasn’t responded by the
tool, go to IRS.gov/Upload. date promised.

Note. You can use Schedule LEP (Form 1040), Re- How Can You Reach TAS?
quest for Change in Language Preference, to state a pref-
erence to receive notices, letters, or other written commu- TAS has offices in every state, the District of Columbia,
nications from the IRS in an alternative language. You may and Puerto Rico. To find your advocate’s number:
not immediately receive written communications in the re- Go to TaxpayerAdvocate.IRS.gov/Contact-Us;
•
quested language. The IRS’s commitment to LEP taxpay-
ers is part of a multi-year timeline that began providing • Download Pub. 1546, The Taxpayer Advocate Service
translations in 2023. You will continue to receive communi- Is Your Voice at the IRS, available at IRS.gov/pub/irs-
cations, including notices and letters, in English until they pdf/p1546.pdf;
are translated to your preferred language. • Call the IRS toll free at 800-TAX-FORM
(800-829-3676) to order a copy of Pub. 1546;
Contacting your local TAC. Keep in mind, many ques-
tions can be answered on IRS.gov without visiting a TAC. • Check your local directory; or
Go to IRS.gov/LetUsHelp for the topics people ask about Call TAS toll free at 877-777-4778.
•
most. If you still need help, TACs provide tax help when a
tax issue can’t be handled online or by phone. All TACs
How Else Does TAS Help Taxpayers?
now provide service by appointment, so you’ll know in ad-
vance that you can get the service you need without long TAS works to resolve large-scale problems that affect
wait times. Before you visit, go to IRS.gov/TACLocator to many taxpayers. If you know of one of these broad issues,
find the nearest TAC and to check hours, available serv- report it to TAS at IRS.gov/SAMS. Be sure to not include
ices, and appointment options. Or, on the IRS2Go app, any personal taxpayer information.

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Low Income Taxpayer Clinics (LITCs)                              responsibilities  in  different  languages  for  individuals  who 
                                                                 speak English as a second language. Services are offered 
LITCs are independent from the IRS and TAS. LITCs rep-           for free or a small fee. For more information or to find an 
resent individuals whose income is below a certain level         LITC near you, go to               the   LITC           page at 
and who need to resolve tax problems with the IRS. LITCs         TaxpayerAdvocate.IRS.gov/LITC  or  see  IRS  Pub.  4134, 
can represent taxpayers in audits, appeals, and tax collec-      Low  Income  Taxpayer  Clinic  List,  at IRS.gov/pub/irs-pdf/
tion  disputes  before  the  IRS  and  in  court.  In  addition, p4134.pdf.
LITCs can provide information about taxpayer rights and 

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                   To help us develop a more useful index, please let us know if you have ideas for index entries.
Index              See “Comments and Suggestions” in the “Introduction” for the ways you can reach us.
 
A                                   H                                    Q
Abandonment  7                      Household income  6                  Qualified health plan 7
Advance payment of the premium 
 tax credit (APTC) 3                I                                    S
Allocation of policy amounts    28  Individual market plans 9            Second Lowest Cost Silver Plan 
 Divorced or legally separated  28  Individuals lawfully present   20     (SLCSP)   27
 Married but not filing a joint     Individuals not lawfully present  19 Self-employed health insurance 
   return 33                        Individuals who are incarcerated  7   deduction  47
 Two or more taxpayers  37          Iterative Calculation Method   52    Simplified calculation method                   55, 
Alternative calculation for year of                                       58
 marriage   38 44,                  M                                    SLCSP:
Alternative family size 38                                                Premium tools 27
                                    Married filing separately 8
Applicable taxpayer 7                                                    Specified premiums 49
                                    Married taxpayers 7
Assistance (See Tax help)                                                Spousal abandonment          8
                                    Minimum essential coverage     8
C                                   Modified AGI  6                      T
                                    Monthly credit amount 6
Coverage family 6                                                        Tax family 4
                                    N                                    Tax help 63
D
                                    Nonspecified premiums   48
Domestic abuse  7
                                    O
E
                                    Other coverage  19
Employer-sponsored plans        10
Expatriate health plans 8           P
G                                   Premium tax credit (PTC)  3 4, 
                                    Publications (See Tax help)
Government-sponsored 
 programs   9

68                                                                                   Publication 974 (2023)

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