Premium Tax Credit (PTC)

Published on January, 23 2023 by Leslie Bailey

The premium tax credit (PTC) assists eligible households by lowering the amount of their health insurance premium when they purchase a Qualified Health Plan on the marketplace (NY State of Health). The PTC offsets the amount of the health plan’s premium in the form of a tax credit.

The American Rescue Plan Act (ARPA) of 2021 temporarily expanded eligibility for the PTC by eliminating the rule that an individual with household income above 400% FPL cannot qualify for a premium tax credit. The Inflation Reduction Act of 2022 will continue waive the income of 400% FPL for an additional three years, through 2025, meaning that those with incomes above 400% FPL can continue to claim the PTC if otherwise eligible.

To qualify for the PTC, the consumer must

  • Purchase a qualified health plan (QHP) on the New York State of Health, Marketplace,
  • Not be eligible for public health coverage (Medicare, Medicaid, Essential Plan, or Child Health Plus) or enrolled in Veteran’s health coverage,
  • Not have access to health insurance through an employer and
  • Be a U.S. citizen or an individual who is lawfully present.

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