Got a Marketplace subsidy notice? What to do now in 2026

If you got a Health Insurance Marketplace notice in 2026 saying your premium tax credit changed, your monthly premium is rising, or your coverage could end, the most important step is to read it carefully and check the deadline. Many of these notices can be resolved, but waiting too long can make the problem harder to fix.

This matters now because CMS reported on March 27, 2026, that nearly 1.5 million people in HealthCare.gov states had advance premium tax credits, coverage, or both removed through program-integrity actions tied to 2025 and 2026 enrollment reviews. At the same time, CMS said about 23.1 million people selected or were automatically re-enrolled in 2026 Marketplace coverage nationwide. In other words, the Marketplace is still covering millions of people, but it is also checking eligibility and enrollment records more closely.

For households already under financial pressure, even a temporary subsidy loss can be a major hit. A March 2026 KFF survey found many Marketplace enrollees said their costs were a lot higher, and many expected to cut back on basic household expenses. That is one reason these notices are worth dealing with right away.

First, figure out what kind of notice you got

Most 2026 subsidy or coverage notices fall into one of four buckets:

Possible overlapping Medicaid or CHIP coverage
Failure to file a federal tax return and reconcile past premium tax credits
Missing verification documents
Unauthorized enrollment or a plan you do not recognize

The fix is different for each one. If your notice asks for documents, HealthCare.gov says to submit the documents first when possible. In many cases, that may solve the issue without a separate appeal. In general, HealthCare.gov says Marketplace appeals must be requested within 90 days of the eligibility notice.

Problem type 1: the Marketplace says you also had Medicaid or CHIP

One major reason people lost subsidies in HealthCare.gov states was overlapping public coverage. In plain language, that means Marketplace records showed someone had subsidized Marketplace coverage while also being enrolled in Medicaid or CHIP.

If your notice says this happened, start by checking whether you or a family member was actually enrolled in Medicaid or CHIP for the months listed. If your household changed, you moved, or you switched programs, records may not have updated the way you expected. Gather any letters from your state Medicaid or CHIP office and compare them with the Marketplace notice.

If you use a state-based Marketplace instead of HealthCare.gov, the workflow can differ somewhat, so follow your state exchange’s instructions. Either way, treat the notice as time-sensitive.

Problem type 2: you may not have filed and reconciled past tax credits

If you received advance premium tax credits in a prior year, federal tax rules generally require you to file a federal tax return for that year and reconcile the amount you got in advance with the amount you were actually eligible for. The IRS says people who received advance credit payments must file a return for that year and reconcile those payments. The IRS also says you should report changes that could affect your subsidy, including income, family size, address, and eligibility for other coverage.

If this sounds like your notice, the practical question is whether you filed the missing return and whether Form 8962 was included. If you already fixed the issue, collect proof before contacting the Marketplace. If you have not fixed it yet, you may need help from a qualified tax preparer or another trusted tax-assistance resource.

Problem type 3: you did not send verification documents in time

Some notices are not about fraud or taxes at all. They are data-matching notices asking you to verify information such as your estimated yearly income, citizenship, immigration status, or other eligibility details.

HealthCare.gov says you generally have at least 90 days from the date of your eligibility notice to resolve most data-matching issues, and 95 days for citizenship or immigration issues. If you miss the deadline, the Marketplace may make a new eligibility decision using other data sources instead of the information on your application.

That can mean your premium tax credit changes, your cost-sharing help changes, or coverage for a household member ends. If your notice asks for documents, upload or submit the requested records as soon as you can.

Problem type 4: the policy is not yours, or you did not approve the enrollment

Another issue flagged in CMS integrity actions was unauthorized enrollment. If your notice involves a plan you do not recognize, a policy you never approved, or a plan switch you did not authorize, act quickly.

Contact the Marketplace right away and ask your insurer what coverage is currently active under your name. Keep notes with dates, names, and confirmation numbers. If you live in a state that runs its own Marketplace, contact that state exchange rather than HealthCare.gov.

If the problem is affecting scheduled care or prescriptions, tell your doctor, pharmacy, or care team there may be an insurance issue so they can help you plan around delays. If you have a medical emergency, seek emergency care right away.

What Form 1095-A and Form 8962 mean in plain English

These two tax forms matter in many subsidy disputes:

Form 1095-A is the Marketplace statement that shows your plan information, the benchmark premium used in the credit calculation, and any advance premium tax credits paid on your behalf.
Form 8962 is the federal tax form used to reconcile those advance payments with the premium tax credit you were actually allowed based on your final yearly income.

HealthCare.gov explains that you use information from Form 1095-A to complete Form 8962. The IRS says Form 8962 is used both to claim the premium tax credit and to reconcile advance payments.

The simplest way to think about it is this: Form 1095-A shows what the Marketplace says happened during the year, and Form 8962 tells the IRS whether the subsidy you got in advance matched what you qualified for when the year ended.

What to do now if you got one of these notices

Read the exact reason on the notice. Do not assume every subsidy notice means the same thing.
Check the deadline immediately. For many document problems, the general deadline is 90 days, and 95 days for citizenship or immigration issues.
If the notice asks for documents, submit those first. HealthCare.gov says that may resolve the issue without an appeal.
Pull your tax records. If you had Marketplace coverage, look for Form 1095-A and confirm whether Form 8962 was filed with the relevant return.
If you do not recognize the plan, act fast. Contact the Marketplace and your insurer and keep records of every contact.
If you disagree with a final eligibility decision, review appeal rights quickly. HealthCare.gov says the general appeal window is 90 days from the eligibility notice.

What is known, and what is still uncertain

What is known is that CMS has been taking a harder look at Marketplace eligibility, duplicate coverage, missing tax reconciliation, missing documents, and unauthorized enrollment. What is not always clear from the start is whether your notice reflects a correct final decision, a fixable paperwork problem, or a record mismatch that can be corrected.

That is why the safest approach is to treat the notice as urgent but not hopeless. Keep copies of everything you send, save screenshots and confirmation numbers, and get help early if the paperwork does not make sense. For many people, the most useful next step is simply identifying which bucket the notice falls into and responding before the deadline passes.

Sources

Editorial note: Weence articles are researched from cited public-health, medical, regulatory, journal, and reputable news sources and may be drafted with AI assistance. They are checked for source support, clarity, and safety guardrails before publication.

This article is for general informational purposes only and is not medical advice. Research findings can be early or incomplete, and health guidance can change. Always talk with a qualified healthcare professional about personal symptoms, diagnosis, medications, vaccines, screenings, or treatment decisions. If you think you may have a medical emergency, call emergency services right away.