November is the key month to choose or change your Marketplace (Obamacare) health insurance. A smart choice now can save you thousands of dollars and prevent delays in your tax refund when you file. Here we explain, in plain language, what to do and why.

Why This Matters for Your Taxes

• If you receive government help to pay your monthly premium (it's called the “Advance Premium Tax Credit,” or APTC), when you file you must “reconcile” that assistance with your actual income on Form 8962. If you received too much help, you may have to pay part of it back; if you received less, you may get a larger credit.
• Without Form 1095-A (which the Marketplace sends you if you had a plan through it), your tax return can be delayed, and so can your refund.

Key Dates

• Open Enrollment: in most states, it runs from November 1 to January 15. If you don't enroll during that period, you can only sign up if you have a qualifying life event (for example, a move, loss of coverage or marriage).

Quick Facts for 2025 and the Health Insurance Marketplace

• 21.4 million people enrolled in Marketplace plans for 2024, an all-time record.
• About 90% of people who shop on the Marketplace receive financial help to lower their monthly premiums.
• If you live in California, the District of Columbia, Massachusetts, New Jersey or Rhode Island, your state charges a penalty if you go the year without qualifying health coverage.

How to Choose a Plan That Protects Your Wallet and Your Taxes

1) Estimate your 2026 income accurately

• The APTC is calculated based on your estimated annual income. If it goes up or down during the year (overtime, a new job, your own business), update your Marketplace application as soon as possible. That way you avoid receiving too much help and then having to pay it back at tax time.

2) Compare more than the premium

• Review the deductible, copays and out-of-pocket maximum. A plan with a very low premium can end up being expensive if you use services frequently.
• Make sure your doctor and your medications are “in network” so you don't overpay.

3) Consider an HSA-compatible plan if you're disciplined about saving

• An HSA (Health Savings Account) lets you contribute pre-tax money and use it for medical expenses. For 2025, the contribution limits are $4,300 (individual) and $8,550 (family). That contribution can reduce your taxable income.

4) If you're self-employed or own a business

• Keep your medical expenses separate. Track your premiums, deductibles and copays. In many cases, you can deduct the premium for your individual plan if you're not covered by a plan sponsored by your employer or your spouse's employer.
• If you hire employees, look at health benefit options that are sustainable for your cash flow and comply with the rules.

5) If you had a Marketplace plan in 2025

• Keep and review your Form 1095-A (you'll receive it in early 2026). Use it to reconcile your APTC on your tax return with Form 8962. This helps you avoid IRS letters and delays in your refund.

6) If you live in a state with an “individual mandate”

• If you're in CA, DC, MA, NJ or RI, compare the cost of the state penalty for not having coverage with the cost of a basic plan. Many families save more by enrolling with financial help than by paying the penalty.

Common Cases We Handle at Imfinita Tax Team

• Mixed-status families (some members with eligible immigration status and others without) who need to optimize their subsidies and taxes.
• Business owners who combine Marketplace coverage with deduction strategies.
• People who received too much APTC and want to plan ahead so they don't repeat the mistake next year.
• ITIN taxpayers who need guidance on how health coverage affects their tax return.

What We Do for You

• We estimate your annual income realistically and update it if your situation changes.
• We guide you in choosing a plan based on your doctors, medications and budget.
• We prepare your taxes, including reconciling your APTC on Form 8962, to avoid surprise repayments.
• We remind you of key documents (1095-A, 1095-B/C) and deadlines.

Call Us Today

• Schedule a consultation with Imfinita Tax Team before Open Enrollment closes. Taking action now can keep you from overpaying in taxes and state penalties.

Sources and References

• 21.4 million enrolled for 2024: Centers for Medicare & Medicaid Services (CMS). “Biden-Harris Administration Announces 21.4 Million People Selected 2024 Marketplace Coverage.” https://www.cms.gov/newsroom/press-releases/biden-harris-administration-announces-214-million-people-selected-2024-marketplace-coverage
• Open Enrollment dates: HealthCare.gov. “Dates & Deadlines.” https://www.healthcare.gov/quick-guide/dates-and-deadlines/
• About 90% receive financial help: Kaiser Family Foundation (KFF). “What to Know About Marketplace Open Enrollment.” https://www.kff.org/health-reform/issue-brief/what-to-know-about-marketplace-open-enrollment/ and CMS enrollment reports.
• Reconciling the Premium Tax Credit (APTC/PTC): IRS. “The Premium Tax Credit.” https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit
• 2025 HSA limits and high-deductible health plan requirements: IRS. “IRS provides 2025 amounts for Health Savings Accounts and High-Deductible Health Plans.” https://www.irs.gov/newsroom/irs-provides-2025-amounts-for-health-savings-accounts-and-high-deductible-health-plans
• Penalty for not having coverage in states with a mandate:
  • California: Franchise Tax Board. https://www.ftb.ca.gov/file/personal/health-care-mandate/
  • District of Columbia: https://dchealthlink.com/individual-mandate
  • Massachusetts: https://www.mass.gov/info-details/health-care-reform-individual-mandate
  • New Jersey: https://www.nj.gov/treasury/njhealthinsurancemandate/
  • Rhode Island: https://healthsourceri.com/mandate/

Note: This information is general and may vary depending on your state and situation. As of the date of our sources, the “enhanced” subsidies created by federal law were authorized through the end of 2025; check whether Congress extended them for 2026. This content is not individual legal or tax advice. Schedule an appointment with our team for a personalized review.