Form 1095-A is a tax document Americans need to file if they buy health insurance through the government health insurance marketplaces established by the Affordable Care Act (commonly known as Obamacare). This is not a form you will fill out yourself. Rather, you will get it from the healthcare exchange you use after your purchase is complete, and from there you will file it as part of your federal income taxes. If you want help with taxes and other financial issues, consider working with a financial advisor.
Form 1095-A Definition
Form 1095-A is the federal health insurance marketplace statement. Just about anyone who enrolled in a health insurance plan through federal or state marketplaces will need to have a copy of the form before they file their taxes. It comes from the marketplace and shows both you and the IRS what you paid out-of-pocket for your insurance premiums.
If you have health insurance from a private insurer outside of the marketplace or that you receive from an employer, your coverage will be reported to the IRS on Form 1095-B (for coverage from other insurers) or Form 1095-C (for employer-sponsored coverage). Form 1095-A is only for those with marketplace coverage.
With the information on Form 1095-A, you’ll be able to complete Form 8962. That’s the form required for taxpayers trying to claim the Premium Tax Credit.
In most cases, you won’t get a copy of Form 1095-A if you have Medicaid, Medicare, catastrophic healthcare coverage, healthcare through the Veterans Administration or your kids have insurance through the Children’s Health Insurance Program (CHIP). If your family members had different healthcare plans or there were changes made to your coverage, you might have multiple versions of the form.
IRS Form 1095-A Contents
When you receive your form, you’ll see that it has three parts. Part I will show your name, your address, your spouse’s name, your Social Security numbers and your dates of birth. You’ll also see details about your health insurance policy provider, such as the name of your insurance company and the dates that you were covered under their plan.
Part II will list everyone in your family who’s covered under your marketplace healthcare plan. Part III will include information that’s relevant to anyone who wants to take the Premium Tax Credit or account for their advance premium tax credit payments. You’ll see the amount of premiums you paid each month and any advance credit payments that were made on your behalf.
How the Premium Tax Credit Works
The Premium Tax Credit is a refundable tax credit that lowers the cost of health insurance for low- to moderate-income families. Your eligibility depends on your income level, your filing status and the number of people in your household. For example, you could have been eligible for tax year 2023 if you’re single, you have no dependents and you made between $20,385 and $54,360. To take advantage of this credit, you’ll need to use the information reported on Form 1095-A to complete Form 8962.
If you’re claiming the Premium Tax Credit, you have two options. You can agree to apply the whole credit to your final tax bill. That will reduce the size of the bill or boost your tax refund. Or you can request to have part of the credit paid to your insurance company in advance. These advance credit payments lower the cost of your monthly insurance premiums.
Sometimes taxpayers have advance credit payments that exceed the amount for which they qualify. When that happens, they may be asked to repay those extra funds, depending on their filing status and how their household income stacks up against the federal poverty line.
What to Do If You’re Missing Form 1095-A
Everyone who’s supposed to have Form 1095-A should receive it by Jan. 31. If you’ve been checking your mailbox for weeks and the form is nowhere to be found, you’ll need to verify whether it’s available online in PDF form on healthcare.gov. To do that, you’ll have to log in to your account, choose the right tax year and click on the tax forms section.
If your health insurance plan is part of your state’s marketplace instead of the federal government’s, you can check your account to find out whether you’ll be able to view the form online. If you can’t access your form that way, you’ll need to call the appropriate marketplace call center number. The contact number you need will depend on the kind of marketplace plan you have (a state-based plan or a federally-facilitated plan) and whether you’re an employee or an employer.
It’s a good idea to call your marketplace if you notice any errors on your form. Since the document is mandatory, you might need to file an extension if you don’t have an accurate version of Form 1095-A in hand before the April tax filing deadline (Tax year 2023 gets filed on April 15, 2024). Just keep in mind that you will not need to attach the form to your tax return. Once you’ve used it, keep it at home with your other tax documents.
Bottom Line
Under the Affordable Care Act, most Americans must either have health insurance or pay a fee. If you buy health insurance through the federal marketplaces, you’ll need to have Form 1095-A to file your income tax return and claim the Premium Tax Credit. But remember, this is not a form you will actually fill out yourself. Instead, you will get it from the federal healthcare exchange or your state marketplace.
Healthcare Tips
- A financial advisor can help make sense of healthcare costs and any other financial queries you have. Finding a financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with up to three vetted financial advisors who serve your area, and you can have a free introductory call with your advisor matches to decide which one you feel is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
- Medical care is an important, and sometimes overlooked, component of planning for retirement. Having enough money to cover your health care needs is vital, so saving for retirement now is key. There is not a better way to do so than with a 401(k) or similar workplace savings program.
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