Tax forms and calculator on desk

Want to file your taxes, but not sure what to do with your 1095-A and 8962 tax forms or why you even need them? Or maybe you’re asking, “How do I get my 1095-A form?” Luckily, you’ve come to the right place to get answers to common questions about these Marketplace tax forms.

What Tax Forms Do I Need if I Have Marketplace Coverage?

Form 1095-A is the main Marketplace tax form you need if you or any member of your household were enrolled in a health insurance plan in 2016 that was administered through the Health Insurance Marketplace—which can be state-run or federally facilitated through healthcare.gov. You must wait until you get an accurate 1095-A form before filing your taxes. This is because your 1095-A has information you need to calculate your premium tax credit, which is reported on IRS form 8962. However, you’re not obligated to complete form 8962 if you didn’t get any premium tax credit during 2016.

What If I Didn’t Have Marketplace (Obamacare) Coverage?

If you didn’t buy health insurance through healthcare.gov or a state-based insurance exchange, you will not get form 1095-A and therefore do not need this form for tax preparation purposes. You will get a similar form—1095-B or 1095-C—if you had employer-sponsored health coverage in 2016. Health insurance companies outside of the Marketplace, as well as government agencies such as Medicare or CHIP, also send out 1095-B forms. According to the IRS, the 1095-B and 1095-C forms may be helpful in preparing your taxes, but they are not required.

What Is the Purpose of Form 1095-A?

Form 1095-A is called the Health Insurance Marketplace Statement. Health insurance Marketplaces use this form to report information on qualified health plan enrollments in the individual market that were completed through the Marketplace. Your 1095-A includes the following information about you and/or people in your household enrolled in Marketplace health coverage in 2016:

  • Premiums paid
  • Premium tax credits used
  • A figure called “second lowest cost Silver plan” (SLCSP)

Do not file IRS form 1095-A with your tax return—the form is for informational purposes only to keep for your records. A blank copy of the 1095-A form, along with its instructions, can be viewed on the IRS website. We will discuss how to get your actual 1095-A that shows your Marketplace insurance information shortly.

What Is the Purpose of Form 8962?

Form 8962 is the Premium Tax Credit form. You use the information on the 1095-A tax form to fill out Part II of the 8962 form, which is how you find out if there’s any difference between the advanced payments of premium tax credit (APTC) you used and the amount of premium tax credit you qualify for—this process is called “reconciling.” Follow the 8962 instructions on how to reconcile by comparing these 2 figures:

  1. The amount of premium tax credit you used in advance during the year, which was paid directly to your health plan to make your monthly premium lower.
  2. The premium tax credit you actually qualify for based on your final income for the year.

If there’s any difference between these 2 figures, it will affect the amount of your refund or tax payment owed.

Note: This Marketplace tax form won’t have any information on it until you fill it out. So you can access the 8962 form and 8962 instructions yourself from the IRS website.

What If I Didn’t Get Any Premium Tax Credit?

Tax credit written on notebookIf you didn’t get any premium tax credit because you paid full price for your Marketplace health insurance, you will still get form 1095-A. Part III, Column C of the form—which is the section for monthly advance payment of premium tax credit—will be blank or have the number “0.” If you’re sure that you don’t qualify for a premium tax credit, you don’t have to complete the 8962 form.

If you would like to check whether you qualify for a premium tax credit based on your final 2016 income, you would need to find your premium for the second lowest cost Silver plan (SLCSP) to fill in the 8962 form. You can find your SLCSP by using the healthcare.gov tax tool, which you can access by clicking “1095 & Tax Info” on the homepage. If you qualify for a premium tax credit, this would either increase your tax refund or reduce the amount of tax you owe. If you don’t qualify for a premium tax credit, you don’t have to include form 8962 with your tax return.

How Do I Get My 1095-A?

Form 1095-A comes directly from your state or federal Marketplace, not from the IRS. The Marketplace through which you enrolled in coverage should mail this form to you by mid-February. This form may also be available in your healthcare.gov account. You may also be able to access this form online in your state-based Marketplace account. You may get more than one 1095-A form if any of these situations apply:

  1. You changed Marketplace plans during the year.
  2. You updated your coverage application with new information—such as adding or removing a family member—that resulted in a new enrollment in your plan.
  3. Different members of your household had different plans.
  4. More than 5 members of your household are on the same plan.

What If I Didn’t Get My 1095-A or I Lost It?

If you didn’t get form 1095-A in the mail or you received your form but lost it, first check to see whether you can find your form in your online Marketplace account. If you bought coverage through healthcare.gov, follow the steps in the next section below. For coverage purchased through a state-run insurance exchange, you would need to contact your state Marketplace because each will have its own 1095-A instructions on how to access the form on its website. If you can’t find your form in your online account, you will need to contact the Marketplace directly.

How Do I Get My 1095-A Online From Healthcare.gov?

  • Step 1: Log into your account at healthcare.gov. If you don’t have an account, you will need to create one. If you can’t log into your existing account, do not create a new one. Follow the forgot password/username steps, or contact the Marketplace Call Center if you need help logging in.
  • Step 2: Choose the green button to “Start a new application or update an existing one.”
  • Step 3: Select “Go to my application & coverage” at the bottom of the screen.
  • Step 4: Under “Your existing applications,” select your 2016 application—not your 2017 application. The 2016 application will appear below your 2017 application.
  • Step 5: Select “Tax forms” from the menu on the left.
  • Step 6: Download all 1095-As shown on the screen.

If you follow these steps and still can’t find your 1095-A tax form(s), you must contact the healthcare.gov Marketplace Call Center.

I Have My 1095-A—Now What?

  1. Woman reading tax formFirst, read the 1095-A instructions on the back of the form.
  2. Verify whether the information on form 1095-A is accurate. If you received advanced payments of premium tax credit, make sure the information about the “second lowest cost Silver plan” (SLCSP) is correct. Your SLCSP premium is incorrect if:
    • Part III, Column B shows “0” or is blank for any month a member of your household was enrolled in the Marketplace plan.
    • You had a life event change that you didn’t report to the Marketplace, such as getting married or divorced, losing a dependent, having a baby, or moving.
    • If either of these SLCSP situations apply, use the healthcare.gov tax tool—which you can access from the homepage “1095 & Tax Info” link—to calculate the premium for your SLCSP. If these situations don’t apply and you have an accurate 1095-A form and SLCSP amount, you can begin filling out form 8962.
  3. If you paid full price for your Marketplace coverage, verify whether basic information about your plan and household members on Parts I and II of the form is correct. Also, check Part III, Column C to make sure it’s blank or has a “0.”

What If Information on My 1095-A Form Is Wrong?

If you think information about your insurance coverage or household on form 1095-A is wrong, you should contact the Marketplace where you purchased coverage. This would either be healthcare.gov or your state-run exchange. It may be that the Marketplace will need to send you a corrected form. Note: If you filed your tax return based on information on your 1095-A form and you later get a corrected form, you may need to file an amended tax return.

If the information you think is wrong has to do with your monthly enrollment premium shown in Part III, Column A of the form, it doesn’t necessarily mean there is an error. The monthly enrollment premium reported may be different from what you paid if any of these reasons apply:

  1. If your health plan included supplemental benefits, such as dental or vision, in addition to essential health benefits, your 1095-A may only report the premium for your essential health benefits.
  2. If you or someone in your household started and ended coverage midmonth, the form will only show the premium for the parts of the month coverage was provided.
  3. If you were enrolled in a stand-alone dental plan and a dependent under 18 was also enrolled in the plan, the monthly premium shown on the form may be higher because it includes a portion of the dental plan premiums for pediatric benefits.

How Do I Enter Information From My 1095-A to Form 8962?

Once you have an accurate 1095-A tax form and an accurate amount for the second lowest cost Silver plan premium, you’re ready to fill out the 8962 Premium Tax Credit form. After you complete the 8962 form, you will attach it to either Form 1040, 1040A, or 1040NR when you submit your tax return*. Below are 1095-A instructions on how to enter information from IRS form 1095-A to form 8962.

What information do I need from my 1095-A? Where do I find it on my 1095-A? Where do I enter it on Form 8962?
Enrollment Premiums Part III: Column A
Annual amount: line 33
Monthly amounts: lines 21 — 32
Part II: Column a
Annual amount: line 11
Monthly amounts: lines 12 — 23
Second lowest cost Silver plan (SLCSP) premium Part III: Column B
Annual amount: line 33
Monthly amounts: lines 21 — 32
Part II: Column b
Annual amount: line 11
Monthly amounts: lines 12 — 23
Advance payment of premium tax credit Part III: Column C
Annual amount: line 33
Monthly amounts: lines 21 — 32
Part II: Column f
Annual amount: line 11
Monthly amounts: lines 12 — 23
Complete all sections of IRS form 8962. On Line 26, you’ll find out if you used more or less premium tax credit than you qualify for based on your final 2016 income. This will affect the amount of your refund or tax due.

How Do I Contact My Health Insurance Marketplace?

For health insurance purchased through healthcare.gov, contact the Marketplace Call Center at (800)-318-2596 (TTY: 1-855-889-4325). For coverage purchased through a state-run insurance exchange, contact the Marketplace for your state, shown below.

States Marketplace Provider
California Covered California
Colorado Connect for Health Colorado
Connecticut Access Health CT
District of Columbia DC Health Link
Idaho Your Health Idaho
Maryland Maryland Health Connection
Massachusetts Health Connector
Minnesota MNsure
Mississippi Individual and family coverage done through healthcare.gov
Small business coverage done through One, Mississippi
New Mexico Individual and family coverage done through healthcare.gov
Small business coverage done through New Mexico Health Insurance Exchange
New York New York State of Health
Rhode Island HealthSource RI
Utah Individual and family coverage done through healthcare.gov
Small business coverage done through Avenue H
Vermont Vermont Health Connect
Washington Washington Healthplanfinder

Can My Insurance Agent Get My 1095-A Form?

Unfortunately, your insurance agent can’t get your 1095-A because only the Marketplace can give you access to the form through postal mail or your Marketplace online account. Also, HealthMarkets licensed insurance agents cannot provide you with tax or legal advice. So consult your tax or legal professional to discuss details about your individual tax needs. If one of our agents helped you enroll in coverage through healthcare.gov or a state-based insurance exchange, your agent can help with information specifically regarding your health insurance plan. If you have questions about finding affordable health insurance, call us at (800) 304-3414, or connect with an agent near you.

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References

*If you paid full price for your Marketplace plan and you completed the 8962 form and don’t qualify for a premium tax credit, you don’t have to attach this form to your tax return.

https://www.irs.gov/pub/irs-pdf/f1095a.pdf
https://www.irs.gov/affordable-care-act/individuals-and-families/health-insurance-marketplace-statements
https://www.healthcare.gov/tax-form-1095/
https://www.irs.gov/pub/irs-pdf/f8962.pdf
https://www.healthcare.gov/tips-and-troubleshooting/logging-in/
https://www.healthcare.gov/contact-us/
https://www.irs.gov/affordable-care-act/questions-and-answers-about-health-care-information-forms-for-individuals
https://www.healthcare.gov/taxes-reconciling/
https://www.healthcare.gov/taxes/marketplace-plan-without-savings/
https://www.healthcare.gov/marketplace-in-your-state/
https://www.irs.gov/affordable-care-act/questions-and-answers-about-health-care-information-forms-for-individuals

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