Fillable Form 8962 IRS

What is Form 8962?

 

Form 8962 or the Premium Tax Credit (PTC) is an Internal Revenue Service (IRS) form used to calculate the premium tax credit you’re eligible to claim if you paid premiums for health insurance purchased through the Health Insurance Marketplace.

 

You may use the Form 8962 if:

 

You have received a Form 1095-A (Health Insurance Marketplace Statement) from the Marketplace. If you haven’t received one, view your form by logging into your Marketplace account online and

 

You want to claim the premium tax credit, or advanced premium tax credits were paid for you or a family member covered by your plan.

 

How to Fill Out the Form 8962?

 

Form 8962 is composed of five sections. You will need Form 1095-A to complete each part of the form, as well as your Form 1040 showing your modified adjusted gross income.

 

At the top of the form, provide your full legal name and Social Security Number.

 

Part I

 

Annual and monthly contribution amount

 

Line 1

 

Provide the number of exemptions from Form 1040 or Form 1040A.

 

Lines 2a & 2b

 

Provide the amounts related to modified Annual Gross Income (AGI).

 

Line 3

 

Input the household income by adding the amounts on lines 2a and 2b.

 

Line 4

 

Select the appropriate choice and enter the value.

 

Line 5

 

Enter Household income as a percentage of the federal poverty line. 

 

Line 6

 

If you entered 401% on line 5, then proceed to line 7. If not, then select yes.

 

Line 7

 

Input the applicable figure.

 

Line 8a

 

Enter the annual contribution amount by following the method shown.

 

Line 8b

 

Enter the monthly contribution amount by following the method shown.

 

Part II 

 

Premium Tax Credit Claim and Reconciliation of Advance Payment of Premium Tax Credit

 

Line 9 

 

Mark Yes and skip to Part IV or Part V if the below-mentioned conditions apply to you. If not, Mark No and continue to Line 10.

 

1. The policy covered at least one individual in your tax family and at least one individual in another tax family, and

 

2. Either:

 

— You received a Form 1095-A for the policy that does not accurately represent the members of your tax family who were enrolled in the policy, or

 

— The other tax family received a Form 1095-A for the policy that includes a member of your tax family.

 

Line 10

 

Select the appropriate choice by referring to Form 1095-A.

 

If you were enrolled in a qualified health plan for fewer than 12 months during 2019, check the "No" box and continue to lines 12 through 23.

 

Check the "Yes" box and continue to line 11 if all of the following apply for each qualified health plan you or a member of your tax family was enrolled in for 2019. 

 

You were enrolled in the qualified health plan for all 12 months during 2019.

 

Your enrollment premium was the same for every month of 2019. 

 

Your SLCSP premium is the same for every month of 2019. 

 

Otherwise, check the "No" box and continue to lines 12 through 23. 

 

Line 11

 

Fill the annual totals for the empty fields under each column.

 

Lines 12 to 23

 

Enter the monthly amounts under each column.

 

Line 24

 

Enter the total premium tax credit.

 

Line 25

 

Enter the Advance payment of PTC by following the method shown.

 

Line 26

 

Enter the Net premium tax credit by following the method shown.

 

Part III

 

Repayment of Excess Advance Payment of the Premium Tax Credit

 

Line 27

 

Provide the Excess advance payment of PTC.

 

Line 28 

 

Enter the Repayment limitation based on certain conditions. If the amount on Form 8962 Line 5 is:

 

less than 200, then enter on Line 28 $300 for a filing status of Single and $600 for any other filing status; or

 

at least 200 but less than 300, then enter $800 for a filing status of Single and $1,600 for any other filing status; or

 

at least 300 but less than 400, then enter $1,32500 for a filing status of Single and $2,650 for any other filing status; or

 

400 or 401, leave Line 28 blank.

 

Line 29

 

Provide the Excess advance premium tax credit repayment.

 

Part IV 

 

Allocation of Policy Amounts

 

Lines 30 to 33

 

1. Enter all the shared policy allocations.

 

2. Enter the marketplace assigned Policy Number.

 

3. Enter the Social Security Number of the other taxpayer with whom you are allocating policy amounts.

 

4. Enter the first month you are allocating policy amounts. 

 

5. Enter the last month you are allocating policy amounts. 

 

6. Enter the Premium Percentage as a decimal rounded to two places.

 

You will only input in this column if: 

 

You allocated the policy amounts under Allocation Situation 1. Taxpayers divorced or legally separated in 2019, earlier.

 

You allocated the policy amounts under Allocation Situation 4. Other situations where a policy is shared between two tax families, earlier.

 

In all other situations, leave this column blank because you do not allocate the applicable SLCSP premium reported in those situations

 

1. Enter the SLCSP Percentage as a decimal rounded to two places. 

 

Input on this column, if your allocation situation requires you to allocate the APTC on Form 1095-A, lines 21 through 32, column C. Otherwise, leave it blank.

 

2. Enter the Advance Payment of the PTC Percentage.

 

Line 34

 

Select the appropriate choice that applies to your allocation situation.

 

Refer to your Forms 1095-A, if you have completed your required allocations of policy amounts shown on using lines 30 through 33, check the "Yes" box. If you must make more than four allocations of policy amounts, check the "No" box and attach a statement providing the information shown on lines 30 through 33, columns (a) through (g) for each additional allocation.

 

Part V 

 

Alternative Calculation for Year of Marriage

 

This portion is optional, but this may reduce the amount of excess APTC you must repay. To be eligible to make this election, you must meet either of the following conditions.

 

You checked the "Yes" box on line 6, and you answered " Yes " to all 5 questions in Table 4.

 

You checked the "No" box on line 6, and the "Yes" box on line 14 of Worksheet 3.

 

Line 35

 

Provide all the Alternative entries for your SSN on the respective fields: (a) alternative family size, (b)alternative monthly contribution amount, (c) alternative start month, and (d)alternative stop month.

 

Line 36

 

Provide all the Alternative entries for your spouse's SSN on the respective fields: (a) alternative family size, (b)alternative monthly contribution amount, (c) alternative start month, and (d)alternative stop month.

 

Submission

 

If you’re filling out a paper tax return, mail the Form 8962 along with other requirements to the IRS regional office that covers your state of residence.

 

If you’re filing your taxes online, you may complete Form 8962 through the tax filing software program you’re using.

 

Make sure to fill this form because it determines whether or not you owe money to the IRS. If the amount of advanced premium tax credit received exceeds the amount of the premium tax credit you’re eligible to claim, you owe money back to the IRS. On the other hand, if the advanced premium tax credit received is less than the premium tax credit you’re eligible to receive, then the IRS owes you.