Calculate Modified Adjusted Gross Income without Tax Return

Eligibility for the premium tax credit is calculated based on multiple factors, including your age, tax filing status and projected annual household income. To determine your household income, we use an income calculation method called “Modified Adjusted Gross Income” or MAGI. If you are interested in applying for up-front financial assistance, you will need to provide us with your MAGI. Use this form if you DO NOT have your tax return from last year to help you determine your MAGI for the year in which you are seeking health care coverage.

You can also buy health insurance without applying for financial assistance and, if eligible, claim the tax credit when you file your federal taxes. At tax filing, the IRS is expected to determine your eligibility and provide the tax credit as a refund or reduction on your tax liability.