October is the perfect month to get your health insurance ready. Open Enrollment for the Health Insurance Marketplace (HealthCare.gov and state marketplaces) for 2026 coverage begins on November 1. If you get organized now, you may qualify for more government assistance, choose a plan that truly fits your budget and avoid problems with your 2026 taxes.

In this article, we explain in plain language how the Premium Tax Credit works, which steps to take in October and which mistakes to avoid so you don't overpay.

Key dates to keep in mind

• Open Enrollment (most states): November 1, 2025 through January 15, 2026.
• To have coverage starting January 1, 2026: you usually need to enroll by December 15, 2025.
• States with their own marketplace (such as CA, NY, NJ, DC and others) may have different dates. Check your state.

What is the Premium Tax Credit (PTC)?

• It's government assistance that lowers the monthly cost of health insurance you buy through the Marketplace (HealthCare.gov or state marketplaces).
• It can be applied in two ways:
  • APTC (advance credit): the government pays part of your premium each month directly to your insurer, and you pay the rest.
  • PTC when you file your taxes: if you don't take the advance credit, or if you're entitled to more assistance, you can receive the credit when you file your return.
• MAGI: your "modified adjusted gross income," an income measure the Marketplace and the IRS use to calculate your assistance. If you don't know how to estimate it, we'll guide you step by step.

Why this topic matters especially now

• More people than ever are using the Marketplace. More than 21.3 million people enrolled in 2024, an all-time record. This shows there are real, affordable options for families and business owners.
• The vast majority of enrollees get help lowering their premiums. In 2024, about 9 out of 10 people who bought their plan on the Marketplace received a subsidy to pay less each month.
• Congress extended the "enhanced" subsidies through 2025. This means that even families with incomes above 400% of the federal poverty level can qualify, with a cap on the percentage of income paid toward premiums. Put simply: more people qualify, and with bigger discounts than before.
• Good news for our community: the increase in coverage helped bring the uninsured rate down to historic lows in 2023. Gaps remain in Latino communities, so making good use of these benefits can make a difference in your family budget.

Who qualifies for assistance

• Individuals and families with incomes within certain ranges based on household size. Thanks to the extended rules, assistance may be available even at higher incomes than in previous years.
• Immigration status: people who are "lawfully present" (for example, permanent residents, certain visa holders, asylees, refugees and others) may qualify to buy coverage and receive assistance. People without eligible immigration status cannot buy coverage on the Marketplace or receive the credit, but they may have other options; ask us.

Cost-sharing reductions (savings on deductibles and copays)

• If your income is roughly between 100% and 250% of the poverty level, you may qualify for discounts that lower deductibles and copays, but only if you choose a "Silver" plan. This detail can save you hundreds or thousands of dollars in medical expenses each year.

Common mistakes that cost money

• Not updating your 2025-2026 income: if you choose APTC and your actual income ends up higher than estimated, you may have to repay part of the assistance when you file your taxes (Form 8962).
• Taking APTC and not filing a return with Form 8962: you could lose eligibility for advance assistance the following year.
• Choosing a plan "based on price" without checking the doctor network, medications and deductibles: cheap can turn out expensive if it doesn't cover your needs.
• Forgetting the December deadline for coverage starting January 1: enrolling late can delay the start of your coverage and leave you without protection for a month.

October checklist to pay less in 2026

• Gather your 2026 income estimates: wages, self-employment, tips, rentals, interest, etc.
• Update life changes: marriage, divorce, birth, a move, changes in work hours.
• Make a list of your doctors and medications: make sure the plans you're considering cover them.
• Compare at least 3 plans: monthly premium, deductible, copays and provider network.
• If you're between 100% and 250% of the poverty level: prioritize a Silver plan to unlock the discounts on deductibles and copays.
• Decide how to take the credit: all in advance (pay less each month), partially, or receive it when you file your taxes. We can run scenarios to see what works best for you.
• Schedule your appointment with Imfinita Tax Team: we'll help you estimate your MAGI, choose a plan and have everything ready for November 1.

How this connects to your taxes

• If you receive APTC, the IRS will ask you to reconcile it on your return with Form 8962, using the Form 1095-A the Marketplace sends you.
• Best practices:
  • Keep your Marketplace letters and your 1095-A.
  • Report income changes to the Marketplace during the year to avoid surprises when you file your taxes.
  • If you're self-employed, plan your estimated payments and build your health insurance into your tax strategy.

Business owners and self-employed workers

• If your income fluctuates, it's key to adjust your APTC during the year. We review it with you every quarter to reduce the risk of having to repay assistance on your return.
• Consider whether it makes sense to take part of the credit when you file your taxes to avoid monthly swings.

How Imfinita Tax Team helps you

• A clear, realistic income (MAGI) estimate for 2026.
• A review of your eligibility for subsidies and cost-sharing reductions (CSR).
• A plan comparison focused on your budget and your doctors/medications.
• APTC setup (advance, partial or on your return) based on your tax situation.
• Support throughout the year to update changes and avoid overpaying.
• Hassle-free reconciliation of the credit on your 2026 return.

Key facts and figures (with sources)

• 21.3 million people enrolled in Marketplace plans for 2024, an all-time record. Source: HHS/CMS.
• About 9 out of 10 enrollees receive help paying their premium. Source: KFF and CMS reports.
• The "enhanced" subsidies that make premiums more affordable are in effect through 2025 under the Inflation Reduction Act (IRA). Source: HHS/legal text.
• The uninsured rate reached historic lows in 2023, driven by the increase in Marketplace enrollment. Source: HHS/ASPE and CDC.

Ready to pay less for your insurance in 2026?

Schedule your consultation with Imfinita Tax Team today. We'll guide you step by step so you can make the most of the Premium Tax Credit and avoid surprises on your taxes.

Sources and references

• U.S. Department of Health and Human Services (HHS) – Record 2024 enrollment: https://www.hhs.gov/about/news/2024/01/24/final-numbers-show-21-3-million-people-signed-up-for-coverage-in-marketplaces.html
• Centers for Medicare & Medicaid Services (CMS) – 2024 Open Enrollment Report: https://www.cms.gov/newsroom/fact-sheets/2024-open-enrollment-report
• Kaiser Family Foundation (KFF) – Marketplace subsidies (share of enrollees receiving assistance): https://www.kff.org/health-reform/issue-brief/individual-market-enrollment/
• IRS – Premium Tax Credit (PTC) and reconciliation with Form 8962: https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit
• HealthCare.gov – Enrollment dates and deadlines: https://www.healthcare.gov/quick-guide/dates-and-deadlines/
• HealthCare.gov – Cost savings (Cost-Sharing Reductions): https://www.healthcare.gov/lower-costs/save-on-out-of-pocket-costs/
• HealthCare.gov – Immigrants and eligibility: https://www.healthcare.gov/immigrants/coverage/
• HHS – The Inflation Reduction Act extended Marketplace subsidies through 2025: https://www.hhs.gov/about/news/2022/08/16/president-biden-signs-inflation-reduction-act-lowers-health-care-costs-for-americans.html
• ASPE/HHS – Uninsured rate at historic lows in 2023: https://aspe.hhs.gov/reports/under-65-uninsured-rate-early-2023
• CDC/NCHS – Uninsured data: https://www.cdc.gov/nchs/fastats/health-insurance.htm

Note: The information here is general and may vary by state and personal situation. Always verify your local dates and consult an advisor before making decisions. Imfinita Tax Team does not provide immigration legal advice; we assess your Marketplace eligibility based on current rules and your documentation.