In the beginning of 2015 I received financial assistance with my health insurance premiums in the form of the Advance Premium Tax Credit.

By midyear my income had increased substantially and I no longer qualified for the tax credit. I filed a change of income and my status was updated. My healthcare provider then billed me for 'repayment of the APTC', which I paid.

Now I am looking at my taxes and my 1095-A and it seems like the repayment of the Advance Premium Tax Credit is supposed to go from me to the IRS, not to my healthcare provider. Is that correct? Is there any circumstance where my healthcare provider would legitimately collect this money from me instead of the IRS?

My healthcare provider refuses to cooperate with me on this issue; the only clear answer I've gotten out of them is that they won't return the money to me. At this point I'm concerned they've effectively stolen it from me.

  • What does your 1095-A say? – BrenBarn Feb 19 '16 at 4:52
  • @BrenBarn The 1095-A says that I received hundreds of dollars in Advance Premium Tax Credit. It doesn't explicitly say on the 1095-A "you owe the IRS this much", but when I put it into my tax software, the sum of the APTC I received is added to what I owe on my taxes. The FAQ in the back of the 1095-A explicitly says that if my income increased, I may need to pay some or all of the premium assistance "back to the IRS". There is nothing about paying the healthcare provider. This seems like a clear-cut situation, it's just hard to believe my provider would so openly steal my money. – user45623 Feb 19 '16 at 20:28
  • I agree it doesn't sound good. You may need to contact a licensed tax advisor (and, eventually, an attorney, if it turns out the company wasn't supposed to take the money from you). An intermediate step might be to try to get clarification from your state insurance exchange (or the federal one if your state doesn't have its own). – BrenBarn Feb 19 '16 at 21:16

A healthcare provider is a doctor, medical group or healthcare facility, and have nothing to do with the premium paid to your insurance company or whether or not you receive advance premium tax credits from the federal government.

If by healthcare provider you mean your health insurance company, then what may have happened is that the Exchange in your state has told your insurance company to retroactively change or cancel your advance premium assistance, and the government has taken back from the insurance company the advance tax credits paid to the insurance company on your behalf.

That's my guess as to what happened based on your post. Like BrenBarn suggested, you may want to call your state Exchange to ask.

If that is what happened, no one has stolen anything, and when you file your tax return you'll get the correct amount of premium assistance for which you're eligible. Hope this helps!

  • It turns out that a bug in the computer system (I'm not sure if it was the government's system or my insurer's system) retroactively changed my Advanced Premium status in their records and made it look to the insurer as if I hadn't received any APTC when in fact I had. Unfortunately, while the government has confirmed this bug to me directly and verified that I did receive the APTC, my insurer refuses to discuss the subject with me entirely. At this point I feel comfortable saying they stole the money. I'm not sure what to do now that doesn't involve a court. – user45623 Apr 28 '16 at 23:35

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