Jane Dotson
If you need to prove you have medical insurance, you will need a Form 1095. There are three types of Form 1095: Form 1095-A, Form 1095-B, and Form 1095-C. The type of form you receive depends on how you got your health insurance. Form 1095-A is for marketplace health insurance bought on HealthCare.gov or your state exchange. Form 1095-B is for plans bought directly from an insurance company, health insurance through the government, or plans through your job if you work for a small business. Form 1095-C is for workplace health insurance if you work for a large company. All 1095 forms will include basic information about your health insurance, such as coverage dates and how much you paid for insurance.
| Characteristics | Values |
|---|---|
| Form name | 1095-A |
| Who sends it? | Health insurance providers, Health Insurance Marketplace, or the IRS |
| Who receives it? | Individuals enrolled in a marketplace health plan |
| Purpose | Prove health insurance coverage, file taxes, apply for tax credits |
| Information included | Coverage dates, premium cost, APTC paid, household members covered |
| How to obtain | By mail or online through the Marketplace account |
| When to file taxes | After receiving Form 1095-A |
| Additional forms | Form 8962 for tax credits, Form 1095-B and 1095-C for different coverage types |
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What You'll Learn
Form 1095-A for marketplace plans
If you were enrolled in a marketplace health plan during the past year, you will receive Form 1095-A, a Health Insurance Marketplace Statement. This form will be sent to you by the health insurance marketplace (either HealthCare.gov or your state's health care exchange) and will include information about your medical insurance coverage and policy. It will also include information about the amount of advanced premium tax credit (APTC) you received during the previous year. This form is also reported to the IRS.
Form 1095-A is important for your tax filings. You must wait to file your income tax return until you receive this form. You can use the information from Form 1095-A to complete Form 8962, Premium Tax Credit (PTC), to reconcile your APTC with the premium tax credit you are allowed or claim the premium tax credit. You can also use Form 1095-A as proof of health insurance, which you may need to do depending on the state you live in.
If you had Marketplace coverage, you should carefully read the instructions on the back of Form 1095-A and make sure the information is correct. If anything about your coverage or household is wrong, contact the Marketplace Call Center. The "monthly enrollment premium" on Form 1095-A (Part III, Column A) may be different from the monthly premium you paid. This doesn't always mean this amount is wrong, as your plan may have included benefits in addition to the essential health benefits required by the health care law, like adult dental or vision benefits. In this case, the monthly enrollment premium on your Form 1095-A may only show the amount of your premium that applied to essential health benefits.
Your 1095-A should include information for only the months you had a Marketplace plan. If you were enrolled in a stand-alone dental plan and a dependent under 18 was enrolled in it, the monthly enrollment premium on your Form 1095-A may be higher than you expect because it includes a portion of the dental plan premiums for pediatric benefits.
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Form 1095-B for insurance bought from a company
If you need proof of your health insurance for taxes, you will need to obtain a 1095 form. There are three types of 1095 forms: 1095-A, 1095-B, and 1095-C. Form 1095-B is for health insurance plans bought directly from an insurance company, health insurance through the government (such as Medicare, Medicaid, or CHIP), or plans through your job if you work for a small business. This form will provide basic information about your health insurance coverage, including the dates of coverage and how much you paid for insurance.
If you purchased insurance through the marketplace, you should receive Form 1095-A by mail or online. This form will include information about your health insurance coverage, such as the effective date, the amount of the premium, and any advance payments of the premium tax credit (APTC) made on your behalf. You will need this form before filing your taxes. If you do not receive Form 1095-A, you should contact the marketplace where you purchased your plan.
Form 1095-B is typically sent by health insurance providers to individuals they cover. This form provides information about who was covered and when. If you need to correct any errors on your Form 1095-B, you should contact the company that sent the form, and they will issue a new form marked as "corrected".
It is important to note that you do not need to attach Form 1095-B to your tax return. However, you can use the information on the form to itemize your healthcare costs and keep it for your records as proof of health insurance. Additionally, if you received advance payments of the premium tax credit (APTC) for your health insurance coverage, you must complete Form 8962, Premium Tax Credit (PTC), and attach it to your tax return. This form will help you reconcile your APTC with the premium tax credit you are allowed to claim.
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Form 1095-C for workplace insurance
Form 1095-C is used to verify employer-sponsored health coverage and administer the shared employer responsibility provisions. It is used by applicable large employers (ALEs) with at least 50 full-time workers or full-time equivalents. A full-time worker is defined as someone who works at least 30 hours per week.
Form 1095-C identifies the employee and employer, the months the employee was eligible for coverage, and the cost of the cheapest monthly premium under the plan. Every employee of an ALE who is eligible for insurance coverage should receive a 1095-C. Eligible employees who decline to participate in their employer's health plan will still receive a 1095-C. If an ALE does not offer insurance, this will be indicated on the 1095-C, and they may be subject to financial penalties.
Form 1095-C is sent by employers to their eligible employees and the IRS. Employees should receive the form by the end of January. Employers typically have until the end of February to send them to the IRS if filing paper forms or until the end of March if filing electronically. Employers with 250 or more forms must file them electronically.
Form 1095-C is not attached to your tax return, but you can use the information your employer sent on the form if you want to itemize your healthcare costs. You can also keep it for your records to prove you had health insurance.
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Using W2 Box 12-DD to prove health insurance
If you need proof of health insurance for tax purposes, you can refer to one of three types of tax forms: Form 1095-A, Form 1095-B, or Form 1095-C. These forms provide basic information about your health insurance coverage, including the dates of coverage and the amount you paid for insurance.
Form 1095-A is for individuals who purchased marketplace health insurance through HealthCare.gov or their state's health care exchange. Form 1095-B is for plans purchased directly from an insurance company, government-provided health insurance (such as Medicare, Medicaid, or CHIP), or plans obtained through your employer if you work for a small business. Form 1095-C is relevant for those who receive their health insurance through their workplace, specifically if they work for a large company.
While you can usually find your health insurance rates on your W-2 form in Box 12, using W2 Box 12-DD to prove health insurance is not typical. This is because Box 12-DD provides an annual summary that lacks the detailed information included in the aforementioned tax forms. The Affordable Care Act requires employers to report the cost of coverage under an employer-sponsored group health plan on an employee's Form W-2, in Box 12, using Code DD. This amount includes both the portion paid by the employer and the employee, and it may also include the cost of dental and vision insurance, depending on the employer's plan. The 12-DD reporting requirement applies to employers who issue 250 or more W-2s for the year 2023 by each unique FEIN.
Therefore, while W2 Box 12-DD provides valuable information about the cost of employer-sponsored health insurance, it is not commonly used as proof of health insurance due to its lack of detailed information compared to the dedicated health insurance tax forms.
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No longer needing to prove insurance
Since 2019, you no longer need to prove that you have health insurance on your federal tax returns. This change occurred when Congress ended the tax penalty for not having health insurance. However, some states, like California, Massachusetts, New Jersey, Rhode Island, and Washington, D.C., still enforce penalties for those without health insurance.
While you may no longer need to prove health insurance for your taxes, there are other situations where you may need to provide proof of insurance. For example, if you are pulled over by a police officer while driving, you are required by law to prove that your vehicle has at least the state's minimum required coverage. Failing to provide proof of insurance when requested by authorities is a separate offence from driving without insurance, but both can result in fines, suspensions, impounding of your vehicle, or even jail time. Therefore, it is always a good idea to carry a physical insurance card with you when operating a vehicle. While some states allow electronic proof of insurance on smartphones, most states still require a physical copy.
In addition to driving, you may need to provide proof of insurance in other situations, such as when renting or buying a home. Your landlord, home lender, or condo association may require proof of insurance before approving your rental or purchase. In these cases, you usually won't need an insurance card, and you can provide your insurance policy's declarations page instead. This page contains detailed information about your insurance coverage, limits, and deductibles.
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Frequently asked questions
You will receive Form 1095 by mail or online. There are three types of Form 1095: Form 1095-A, Form 1095-B, and Form 1095-C. The type of form you receive depends on how you got your health insurance.
Form 1095-A is for marketplace health insurance bought on HealthCare.gov or your state exchange. You will receive this form if you were enrolled in a marketplace health plan during the past year.
Form 1095-B is for plans bought directly from an insurance company, health insurance through the government (like Medicare or Medicaid), or plans through your job if you work for a small business.
Form 1095-C is for workplace health insurance if you work for a large company.
If you bought insurance through the marketplace and didn't get a Form 1095-A either by mail or online, contact the marketplace where you bought the plan.
