Lawfully Present and Not Lawfully Present Family Members Enrolled — How To Determine Your Monthly Enrollment Premiums and Applicable SLCSP Premium: Premium Tax Credit (2025 IRS Guide)
This guide covers “Lawfully Present and Not Lawfully Present Family Members Enrolled — How To Determine Your Monthly Enrollment Premiums and Applicable SLCSP Premium” within premium tax credit. The following material presents the IRS treatment of this topic, including the qualifications, exceptions, and examples in the source section. Read the rules alongside the facts of your own situation before deciding what to report, deduct, or document.
Adapted from Publication 974 (2025), Premium Tax Credit (PTC), published by the Internal Revenue Service. This guide retains the source edition’s years, amounts, deadlines, and examples. It is guidance for that edition, not a statement that the same figures apply to every tax year.
Context for these rules
The PTC is not allowed for the coverage of an individual who is not lawfully present in the United States. All APTC paid for an individual not lawfully present who enrolls in a qualified health plan must be figured. If all family members enrolled in a qualified health plan are not lawfully present, see the discussion immediately below. If you or a member of your family is not lawfully present and was enrolled in a qualified health plan with family members who are lawfully present for 1 or more months of the year, you must use the instructions under Lawfully Present and Not Lawfully Present Family Members Enrolled, later, to find out how much APTC, if any, was allowable.
Lawfully Present and Not Lawfully Present Family Members Enrolled — How To Determine Your Monthly Enrollment Premiums and Applicable SLCSP Premium
See Situation 1 or Situation 2 next for how to determine your monthly enrollment premium and applicable SLCSP premium.
Situation 1—not lawfully present family members enrolled and no other changes in enrollment or coverage family.
Situation 1 applies if you have family members who are not lawfully present that are enrolled for all or a part of the year, there are no changes in your coverage family during the year (counting only lawfully present family members), and there are no enrollment changes involving your lawfully present family members enrolled in the coverage during the year. If Situation 1 applies, you should enter on Form 8962 for every month of the year the enrollment premiums and applicable SLCSP premium the Marketplace reports on Form 1095-A for the months when only lawfully present individuals were enrolled in the coverage. If a not lawfully present family member was enrolled for the entire year, see No reference month, later.
Example 1.
Andrew enrolls himself and his three dependents, Terri, Phil, and Anne, in a qualified health plan. Anne is not lawfully present in the United States. The monthly enrollment premiums for the plan are $1,000. No one in Andrew’s family is eligible for MEC (other than Marketplace coverage) and the applicable SLCSP premium that would apply to all four members of Andrew’s family is $1,200. There are no changes involving the lawfully present members of the coverage family during the year. Anne is disenrolled from coverage as of April 1. The monthly enrollment premiums for Andrew and his other two dependents are $800 and the applicable SLCSP premium that applies to Andrew’s coverage family of three is $900. The Marketplace reports the following amounts in Form 1095-A, Part III.
| Months | Column A | Column B |
| January, February, March | $1,000 | $1,200 |
| April through December | $800 | $900 |
When completing Form 8962, Andrew enters $9,600 ($800 x 12) as the enrollment premiums on line 11, column (a), and $10,800 ($900 x 12) as the premium for the applicable SLCSP on line 11, column (b).
Situation 2—changes in enrollment or coverage family involving a lawfully present family member.
Situation 2 applies if you have family members who are not lawfully present that are enrolled for all or a part of the year, and there are either changes in your coverage family during the year (counting only lawfully present family members) or enrollment changes involving your lawfully present family members enrolled in the coverage during the year. If Situation 2 applies, use these rules to determine the enrollment premiums and the applicable SLCSP premium for the months any not lawfully present family members are enrolled. First, use Worksheet A to determine if you have a reference month for enrollment premiums or for the applicable SLCSP premium. You may have a reference month for enrollment premiums (discussed next) or a reference month for the applicable SLCSP premium (discussed later), or for both.
Reference month for enrollment premiums.
A reference month for enrollment premiums is a month in which the not lawfully present family member is not enrolled in coverage and there are no other changes in the members of your family who are enrolled in the coverage. In other words, your enrolled family members are the same during the reference month as for a month the not lawfully present family member was enrolled, except that the not lawfully present family member is not enrolled. Enter in Form 8962, Part II, column (a), the enrollment premiums for the reference month as the enrollment premiums for the months the not lawfully present family member was enrolled.
Reference month for SLCSP premium.
A reference month for the applicable SLCSP premium is a month in which the not lawfully present family member is not enrolled in coverage and there are no other changes in your coverage family. In other words, your coverage family is the same during the reference month as for a month the not lawfully present family member was enrolled, except the not lawfully present family member is not included in your coverage family. Enter in Form 8962, Part II, column (b), the applicable SLCSP premium for the reference month as the applicable SLCSP premium for the months the not lawfully present family member was enrolled.
No reference month.
If you do not have a reference month for enrollment premiums, you may have to contact your insurance company to find out what the amount of the enrollment premiums would have been if the policy had covered only lawfully present family members. If you do not have a reference month for the applicable SLCSP premium, you must look up the SLCSP premium that applies to your coverage family (without any not lawfully present family members). See Determining the Premium for the Applicable Second Lowest Cost Silver Plan (SLCSP), later.
Tip:
You may use Worksheet A to determine whether you have any reference months.
Example 2.
The facts are the same as in Example 1, earlier, except that Andrew becomes eligible for employer-sponsored coverage on September 1, notifies the Marketplace, but remains enrolled in the qualified health plan (although he cannot take the PTC for his coverage for the months after August). The applicable SLCSP premium that applies to Terri and Phil is only $400. The Marketplace reports the following amounts in Form 1095-A, Part III.
| Months | Column A | Column B |
| January, February, March | $1,000 | $1,200 |
| April through August | $800 | $900 |
| September through December | $800 | $400 |
Andrew must complete lines 12 through 23 of Form 8962. April through August are reference months for both enrollment premiums and the applicable SLCSP premium for January through March (the months Anne was enrolled in coverage) because Andrew’s coverage family and enrolled family members for April through August (Andrew, Phil, and Terri) are the same as for January through March except for Anne who is not lawfully present. (September through December are also reference months for enrollment premiums.) The enrollment premiums and SLCSP premium for April through August are the same amounts they would have been for January through March without Anne. Therefore, for the months January through March, Andrew enters on Form 8962, lines 12 through 23, $800 (the enrollment premiums for April through August) in column (a) and $900 (the SLCSP premium that applies to the coverage family for April through August) in column (b).
Example 3.
The facts are the same as in Example 1, earlier, except that Andrew becomes eligible for employer-sponsored coverage on April 1, notifies the Marketplace, but remains enrolled in the qualified health plan. The Marketplace reports the following amounts in Form 1095-A, Part III.
| Months | Column A | Column B |
| January, February, March | $1,000 | $1,200 |
| April through December | $800 | $400 |
Andrew does not have a reference month for the applicable SLCSP premium for the months Anne was enrolled in the qualified health plan because there is another change in his coverage family for the months April through December (Andrew is not in the coverage family because he is eligible for employer-sponsored coverage). Thus, there are no months when Andrew’s coverage family is the same (except for Anne) before and after Anne is disenrolled from coverage. Andrew must look up the SLCSP premium that applies to his coverage family without Anne. Andrew determines that the correct applicable SLCSP premium to enter on Form 8962 for the months January through March for a coverage family consisting of Andrew, Terri, and Phil is $900.
April through December are reference months for Andrew for enrollment premiums because the family members who are enrolled for those months are the same family members who were enrolled in January through March, except for Anne.
Therefore, for the months January through March, Andrew enters on Form 8962, lines 12 through 23, $800 (the enrollment premiums for April through December) in column (a) and $900 (the SLCSP premium that would apply to the coverage family of Andrew, Terri, and Phil) in column (b).
Worksheet A. Do You Have Any Reference Months? Keep for Your Records
Use this worksheet to determine whether you have any reference months.
| Months in 2025 | Jan. | Feb. | Mar. | Apr. | May | Jun. | Jul. | Aug. | Sep. | Oct. | Nov. | Dec. | ||
| 1. | Check a box for each month in which any family members not lawfully present were enrolled in coverage | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | |
| 2. | Check a box for each month in which:
| ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | |
| The months for which you checked boxes on line 2 are your reference months for enrollment premiums. Use the enrollment premium reported in Form 1095-A, Part III, column A, for the reference month as your enrollment premium on Form 8962 for the month(s) you checked on line 1. Note: If you did not check any boxes on this line, see No reference month, earlier. | ||||||||||||||
| 3. | Check a box for each month in which:
| ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | ❑ | |
| The months for which you checked boxes on line 3 are your reference months for the applicable SLCSP premium. Use the applicable SLCSP premium reported in Form 1095-A, Part III, column B, for the reference month as your applicable SLCSP premium on Form 8962 for the month(s) you checked on line 1. Note: If you did not check any boxes on this line, see No reference month, earlier. | ||||||||||||||
| * See Terms You May Need To Know, earlier, for the definitions of tax family and coverage family. | ||||||||||||||
Using the guidance
Keep the documents that establish the dates, amounts, and circumstances described above. References to other chapters, forms, worksheets, or earlier and later sections refer to the linked IRS publication. Check the full publication and its updates before relying on a rule for a different tax year or a situation not addressed here.
Sources and further reading
- Publication 974 (2025), Premium Tax Credit (PTC): Individuals Not Lawfully Present in the United States Enrolled in a Qualified Health Plan — Lawfully Present and Not Lawfully Present Family Members Enrolled — How To Determine Your Monthly Enrollment Premiums and Applicable SLCSP Premium — Internal Revenue Service; 2025 edition.
The cited U.S. government text is in the public domain. Source accessed October 28, 2026. Fynoptic has organized this material for educational use and is independent of, and not endorsed by, the IRS.