Jeffrey Wade
If you had health insurance coverage during the previous year, you may receive one or more forms providing information about your coverage. These forms provide information that you may need when filing your federal tax return. Form 1095-A, Health Insurance Marketplace Statement, is sent to individuals who enrolled in coverage there, with information about the coverage, who was covered, and when. If you received advance payments of the premium tax credit for your health insurance coverage through the Health Insurance Marketplace, you must complete Form 8962, Premium Tax Credit, and attach it to your return.
| Characteristics | Values |
|---|---|
| Form name | 1095-A |
| Other names | Health Insurance Marketplace Statement |
| Who sends it | The Health Insurance Marketplace |
| Who receives it | Individuals who enrolled in coverage there |
| What it includes | Information about the coverage, who was covered, and when |
| When to file | By mid-February or January 31 |
| How to use | Complete IRS tax Form 8962 and reconcile your premium tax credit |
| Notes | Do not attach to your tax return, but keep with your tax records |
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What You'll Learn
Form 1095-A and Form 8962
Form 1095-A, also known as the Health Insurance Marketplace Statement, is a document that contains information about the individuals in your household who were enrolled in a qualified health plan through the Marketplace in 2024. It includes names, social security numbers, coverage dates, and the monthly premiums for the second-lowest-cost Silver Plan (SLCSP). This form is typically sent out by mid-February, and you must have it before filing your taxes.
Form 8962, officially known as the Premium Tax Credit (PTC) form, is used to reconcile the amount of premium tax credit you used during the year. This form guides you through calculating the yearly amount of your premium tax credit. You will need to complete Form 8962 and attach it to your tax return if you received financial help to lower your monthly premium payment or if you wish to take the PTC. It is important to note that you must include Form 8962 with your tax return, and if it is missing, you may need to resubmit your tax return.
To complete Form 8962, you will need to refer to the information provided on Form 1095-A. Therefore, it is important to ensure that the information on Form 1095-A is accurate before using it to fill out Form 8962. If there are any discrepancies or errors, you should contact the Marketplace Call Center or your insurance provider to request a corrected form.
Both Form 1095-A and Form 8962 are crucial when filing your federal income tax return, especially if you have utilized the premium tax credit to lower your monthly insurance premiums. These forms help you determine whether you owe additional taxes or are eligible for a refund based on the amount of premium tax credit you used during the year.
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Premium tax credits
The premium tax credit is a refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace. The size of the premium tax credit is based on a sliding scale, meaning those with lower incomes get a larger credit to help cover the cost of their insurance.
When you apply for Marketplace coverage, you will find out if you qualify for the premium tax credit. The amount of the credit depends on the estimated household income for the year you want coverage. You can apply some or all of this credit to your monthly insurance premium payment. The Marketplace will send your tax credit directly to your insurance company, so you pay less each month. This is called taking an "advance payment of the premium tax credit".
If your income changes, or if you add or lose members of your household, your premium tax credit will probably change too. It is important to report income and household changes to the Marketplace as soon as possible. If your income goes up or you lose a family member, you will likely qualify for a lower premium tax credit. Conversely, if your income goes down or you gain a household member, you will likely qualify for a bigger premium tax credit.
If you choose to have advance payments of the premium tax credit made on your behalf, you will reconcile the amount paid in advance with the actual credit you compute when you file your tax return for the year. Either way, you will complete Form 8962, Premium Tax Credit (PTC) and attach it to your tax return for the year.
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Health Insurance Marketplace Statements
If you or anyone in your household had a Marketplace plan in 2024, you should receive Form 1095-A, the Health Insurance Marketplace Statement, by mail no later than mid-February. It may also be available in your Marketplace account from mid-January to February 1.
Form 1095-A includes information about Marketplace plans that anyone in your household had in 2024. It is sent by the Marketplace, not the IRS, and includes details about the second lowest-cost Silver Plan (SLCSP). You must have your Form 1095-A before you file your taxes. If anything about your coverage or household is wrong, contact the Marketplace Call Center.
If you purchased coverage through the federally facilitated Marketplace and set up a HealthCare.gov account, you can get a copy of Form 1095-A online from your account. If you purchased coverage through a state-based Marketplace, you may be able to get an electronic copy of Form 1095-A from your state-based Marketplace account. If you have not received your Form 1095-A or received an incorrect form, you should contact the Marketplace from which you received coverage. If you receive a corrected or voided Form 1095-A, you may need to amend your return.
In addition to Form 1095-A, you may receive other health coverage information forms, such as Form 1095-B and Form 1095-C, which have important differences from Form 1095-A. You may receive more than one Form 1095-A if members of your household were not all enrolled in the same health plan, you updated your family information during the year, you switched plans during the year, or you had family members enrolled in different states.
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Form 1095-B
The Affordable Care Act mandates that taxpayers must have health insurance coverage. For tax years prior to 2019, those who didn't have the minimum essential coverage (or a waiver) were required to pay a penalty when filing their tax returns. This requirement no longer applies, but Form 1095-B still serves as proof of compliance with the minimum health insurance standards.
It is important to note that Form 1095-B is not solely for those with employer-sponsored insurance. It also applies to individuals who had health insurance coverage before the Affordable Care Act was implemented. To determine whether your insurance plan provides minimum essential coverage, you can consult your insurer.
In summary, Form 1095-B is a crucial document for taxpayers to verify their compliance with the Affordable Care Act's health insurance requirements. It provides detailed information about the insurance policyholder, the insurer, the employer (if applicable), and the covered dependents. This form helps ensure that individuals and their dependents have the necessary health coverage, as mandated by law.
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Form 1095-C
It is important to note that Form 1095-C is different from Form 1095-B. Form 1095-B is sent by the insurance provider and provides details about an employee's actual insurance coverage, including family members covered. On the other hand, Form 1095-C is sent by the employer and describes the coverage that was made available to the employee. In the case of self-insured employers, where the employer pays workers' medical bills directly instead of paying premiums to an insurance company, the employer can send Forms 1095-B and 1095-C on a single combined form.
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Frequently asked questions
Form 1095-A is a Health Insurance Marketplace Statement that provides information about the health care coverage that you had or were offered during the previous year.
Form 1095-B is a Health Coverage form that provides information about who was covered and when.
Form 8962 is a Premium Tax Credit form that allows you to reconcile your premium tax credit and find out if you used the correct amount during the year.
