Yes, if you're separated but aren't divorced by the last day of the year, you must include your spouse's information if you are applying for a tax credit-eligible health insurance plan.*
The Affordable Care Act (ACA) requires applicants to provide information on everyone in their taxable household, even if other family members are not applying for coverage.
- The ACA requires married couples to file a joint federal income tax return to qualify for subsidies when purchasing health insurance.
- If you apply as "married filing separately", you won't qualify for subsidies.
Under IRS rules, you’re technically still married if your divorce is not yet final as of Dec. 31, even if you or your spouse filed for divorce during that year.
- However, if you obtain a final decree of divorce or "separate maintenance" by the last day of the tax year, then according to the IRS, "You are unmarried (single) for the whole year." In this case, you would be able to fill out an application for health insurance as a filing single. The same goes if you obtain a decree of annulment, which holds that no valid marriage ever existed.
The important thing to be aware of is that your premium tax credit subsidy is based off of your status. If the divorce isn't finalized by the end of the year and you file as "married filing separately," you may end up owing the IRS money around tax time.
*Those seeking the domestic violence exception should check “single” on their insurance applications and “married, filing separately” on their actual federal income tax filing.
How do I enroll in a tax-credit-eligible health plan if I am not yet divorced?
Under certain circumstances, a married taxpayer who is separated from their spouse may be “considered unmarried” and thus not required to file jointly to qualify for a tax credit.
To be “considered unmarried,” an individual must meet the following requirements:
- file a separate income tax return;
- pay more than half the cost of keeping up her home for the
- did not live in the same home as the spouse during the last
6 months of the tax year (the spouse is considered to live
in the home even if he is temporarily absent due to special
- provide the main home of the taxpayer’s child, stepchild,
or foster child for more than half the year; and
- be able to claim an exemption for the child.
Persons who are “considered unmarried” commonly use the tax filing status “head of household,” which provides a lower tax rate and higher deduction than “single.”
What if I'm legally separated from my spouse?
If you are separated but not divorced, you can still apply for coverage for yourself and any dependents, but you will not be eligible for a tax credit (subsidy) unless you file "married filing jointly" OR "head of household".
If you get divorced after purchasing your plan, you can update your plan information and application!
- If and when you do get divorced, simply head to your Stride Dashboard or marketplace account and update your application.
- Losing your insurance due to a divorce is a qualifying life event! You'll have 60 days before or after losing your coverage to apply for your own plan.
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