[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-301348-105":3,"detail-sidebar-cat-1-en-105":80,"doc-detail-301348-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","health-insurance-premium-tax-credit-and-cost-sharing-reductions-updated-april-9-2021","Health Insurance Premium Tax Credit and Cost-Sharing Reductions - Updated April 9, 2021","","Certain individuals without access to subsidized health insurance coverage may qualify for the Premium Tax Credit (PTC) under the Affordable Care Act, as expanded by the American Rescue Plan Act of 2021. The PTC amount depends on a statutory formula, and eligibility in 2021 includes meeting income, coverage, tax-filing, and enrollment requirements. The credit is refundable and advanceable via monthly APTC payments. Eligible individuals may also receive cost-sharing reductions (CSRs) that lower cost-sharing limits or specific requirements, with ARPA temporary changes affecting 2021 eligibility and calculations.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/general/","General",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/health-insurance-premium-tax-credit-and-cost-sharing-reductions-updated-april-9-2021/301348/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/health-insurance-premium-tax-credit-and-cost-sharing-reductions-updated-april-9-2021/301348.png","ImageObject",442,249,{"name":42,"@type":43},"Elsa","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-22","2026-09-19",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"Who may be eligible for the Premium Tax Credit in 2021?","Question",{"text":62,"@type":63},"Individuals generally must have annual household income at or above 100% of the federal poverty level, be ineligible for certain coverage types (with exceptions), file federal income tax returns, and enroll through an individual exchange in 2021.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How do advance Premium Tax Credit payments (APTC) work?",{"text":67,"@type":63},"APTCs are provided monthly to coincide with insurance premium payments, automatically reducing consumer costs associated with purchasing coverage.",{"name":69,"@type":60,"acceptedAnswer":70},"What are cost-sharing reductions (CSRs) and how do they affect consumers?",{"text":71,"@type":63},"CSRs include reductions that lower annual cost-sharing limits and reductions that directly reduce cost-sharing requirements (such as lowering a deductible). Eligible individuals may receive both types, though plans no longer receive direct reimbursement for providing them.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},301348,1789781235,{"code":4,"msg":81,"data":82},"success",[83,88,93,98,103,108,113,118,123],{"id":84,"doc_module":22,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},11,"Presentations",90,"presentations",{"id":89,"doc_module":22,"doc_module_name":25,"category_name":90,"show_sort_weight":91,"slug":92},12,"Resumes",80,"resumes",{"id":94,"doc_module":22,"doc_module_name":25,"category_name":95,"show_sort_weight":96,"slug":97},14,"Invoices",70,"invoices",{"id":99,"doc_module":22,"doc_module_name":25,"category_name":100,"show_sort_weight":101,"slug":102},15,"Posters",60,"posters",{"id":104,"doc_module":22,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},16,"Social Media",50,"social-media",{"id":109,"doc_module":22,"doc_module_name":25,"category_name":110,"show_sort_weight":111,"slug":112},17,"Forms",40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":4,"slug":125},158,"general-158",{"code":4,"msg":81,"data":127},{"doc_id":78,"user_id":128,"nickname":42,"user_avatar":129,"doc_module":22,"category_id":124,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":22,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":104,"language":135,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":12,"update_tm":79,"read_time":139},137455077381,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Health Insurance Premium Tax Credit and Cost-Sharing Reductions  \nUpdated April 9, 2021  \nCongressional ResearchService  \n[https://crsreports.congress.gov](https://crsreports.congress.gov)[ ](https://crsreports.congress.gov)R44425  \nSummary  \nCertain individuals without access to subsidized health insurance coverage may be eligible for the premium tax credit (PTC) established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) and amended under the American Rescue Plan Act of 2021 (ARPA, P.L. 117-2) to include several temporary provisions. The dollar amount of the PTC varies from individual to individual, based on a formula specified in statute. Individuals who are eligible for the PTC may be required to contribute some amount toward the purchase of health insurance.  \nIn order to be eligible to receive the premium tax credit in 2021, individuals must have annual household income at or above 100% of the federal poverty level; not be eligible for certain types of health insurance coverage, with exceptions; file federal income tax returns; and enroll in a plan through an individual exchange. Exchanges (or marketplaces) are not insurance companies; rather, exchanges serve as marketplaces forthe purchase of health insurance. They operate in every state and the District of Columbia.  \nThe PTC is refundable, so individuals may claim the full credit amount when filing their taxes, even if they have little or no federal income tax liability. The credit also is advanceable, so individuals may choose to receive advanced payments of the credit (or APTC). APTCs are provided on a monthly basis to coincide with the payment of insurance premiums , automatically reducing consumer costs associated with purchasing insurance. The credit is financed through permanent appropriations authorized under the federal tax code.  \nIndividuals who receive premium credit payments also may be eligible for subsidies that reduce cost-sharing expenses. TheACA established two types of cost-sharing reductions (CSRs). One type of subsidy reduces annual cost-sharing limits; the other directly reduces cost-sharing requirements (e.g., lowers a deductible). Individuals who are eligible for CSRs may receive both types. Although applicable health plans must provide these CSRs, such plans no longer receive direct payments to reimburse them for the cost of providing the subsidies to eligible consumers.  \nThe ARPA makes temporary changes to the PTC and to CSRs. Its provisions amend statute to  \n􀁸 expand eligibility for and the amount of the PTC applicable to certain exchange plans for tax years 2021 and 2022;  \n􀁸 suspend the requirement, for tax year 2020, that individuals pay back PTC amounts that were provided in excess; and  \n􀁸 expand eligibility for and the calculation of both the PTC and CSRs for individuals who receive unemployment compensation during calendar year 2021.  \nThis report describes current law (including the ARPA’s temporary changes) and applicable regulations and guidance, specifically how the PTC and CSR requirements apply in 2021.  \nContents  \nBackground.................................................................................................................... 1  \nPremium Tax Credit ........................................................................................................ 2  \nEligibility ................................................................................................................. 2  \nFile Federal Income Tax Returns ............................................................................ 3  \nEnroll in a Plan Through an Individual Exchange ...................................................... 3  \nHave Annual Household Income at or Above 100% of the Federal Poverty Level...........4  \nNot Eligible for Minimum Essential Coverage .......................................................... 5  \nDetermination of Required Premium Contributions and Premium Tax Credit Amounts.........","cbCaivdV1eNfiFaz","https://ap.wps.com/l/cbCaivdV1eNfiFaz","pdf",1183284,"English","# Background\n# Premium Tax Credit\n## Eligibility\n## File Federal Income Tax Returns\n## Enroll in a Plan Through an Individual Exchange\n## Have Annual Household Income at or Above 100% of the Federal Poverty Level\n## Not Eligible for Minimum Essential Coverage\n## Determination of Required Premium Contributions and Premium Tax Credit Amounts\n## Required Premium Contribution Examples\n## Reconciliation of Advance Premium Tax Credit Payments\n## Preliminary Tax Credit Data\n## Tax Year 2018\n## Enrollment Data\n# Cost-Sharing Reductions\n## Reduction in Annual Cost-Sharing Limits\n## Reduction in Cost-Sharing Requirements","[{\"question\":\"Who may be eligible for the Premium Tax Credit in 2021?\",\"answer\":\"Individuals generally must have annual household income at or above 100% of the federal poverty level, be ineligible for certain coverage types (with exceptions), file federal income tax returns, and enroll through an individual exchange in 2021.\"},{\"question\":\"How do advance Premium Tax Credit payments (APTC) work?\",\"answer\":\"APTCs are provided monthly to coincide with insurance premium payments, automatically reducing consumer costs associated with purchasing coverage.\"},{\"question\":\"What are cost-sharing reductions (CSRs) and how do they affect consumers?\",\"answer\":\"CSRs include reductions that lower annual cost-sharing limits and reductions that directly reduce cost-sharing requirements (such as lowering a deductible). Eligible individuals may receive both types, though plans no longer receive direct reimbursement for providing them.\"}]","Health Insurance Premium Tax Credit and Cost-Sharing Reductions - Updated April 9, 2021 | PDF",6]