Understanding Your Form 1095-A and Health Care Gov

When you purchase health insurance through the Marketplace, often accessed via Health Care Gov, tax season brings important forms like the Form 1095-A, Health Insurance Marketplace Statement. This document is crucial for accurately completing your federal income tax return. Form 1095-A confirms health coverage for you and your family throughout the year. If you had full-year coverage as indicated on Form 1095-A, you simply need to check the “full-year coverage” box on your tax return.

Form 1095-A provides essential details, including the total monthly health insurance premiums you paid to your insurance company through the Marketplace. It also details any premium assistance you received in the form of advance payments of the premium tax credit, which were directly paid to your insurer. Should you find any discrepancies or incorrect information on your Form 1095-A, it’s important to address these issues. Resources are available to guide you through correcting or understanding Incorrect Forms 1095-A.

The Role of Premium Tax Credits and Form 8962

If you opted to have advance payments of the premium tax credit sent directly to your insurance provider to lower your monthly premiums, you’re required to complete Form 8962, Premium Tax Credit, and file a federal income tax return. This is mandatory, even if you aren’t typically required to file taxes. The process of filing Form 8962 involves reconciling the advance payments you received with the actual premium tax credit you’re eligible for based on your annual income.

Even if you didn’t receive advance payments, filing a tax return is necessary to claim the premium tax credit if you are eligible. Failing to reconcile these advance payments by not filing Form 8962 can lead to delays in your tax refund and may impact your eligibility for future advance credit payments. It’s crucial to understand the implications of not reconciling your advance payments to ensure smooth processing and continued benefits.

Accessing Your Form 1095-A Online Through HealthCare.gov

For those who enrolled in coverage through the federally facilitated Marketplace and have a HealthCare.gov account, accessing your Form 1095-A online is straightforward. You can conveniently obtain a copy of your Health Insurance Marketplace Statement directly from your account. Visit the HealthCare.gov website and navigate to your account to find the specific steps for accessing your Form 1095-A online.

Whether you choose to use the online information or the mailed Form 1095-A, ensure you use this document to accurately complete your tax return. Both sources provide the necessary information for tax filing purposes related to your health coverage obtained through the Marketplace.

Consequences of Not Filing Taxes on Future Advance Payments

The IRS emphasizes the importance of timely tax filing, especially for taxpayers receiving advance payments of the premium tax credit. Filing your tax return on time is essential to ensure your eligibility for advance payments in the upcoming year from the Marketplace. If advance payments were made on your behalf or for a family member, and you fail to file a tax return to reconcile these payments, you risk losing eligibility for both advance payments of the premium tax credit and cost-sharing reductions in the subsequent coverage year. This means you would be responsible for the full cost of your monthly premiums and all covered health services.

Furthermore, the IRS may contact you to recover some or all of the advance payments of the premium tax credit if reconciliation does not occur through tax filing. Marketplaces assess eligibility for advance tax credit payments and cost-sharing reductions each fall, before the new coverage year begins. E-filing your tax return with Form 8962 by the tax return due date significantly increases your chances of avoiding any interruption in receiving this financial assistance.

Contacting the Marketplace for Form 1095-A Queries

If you have questions about the information on your Form 1095-A, need to obtain the form, or received a related letter that you need clarification on, reaching out to your Marketplace is recommended. You can contact your Marketplace using the details provided in the table below or visit HealthCare.gov/taxes for more comprehensive information.

State Marketplace name and website Telephone number TTY number
All states not listed below HealthCare.gov 800-318-2596 TTY: 855-889-4325
California Covered California 800-300-1506 TTY: 888-889-4500
Colorado Connect for Health Colorado 855-752-6749 TTY: 855-346-3432
Connecticut AccessHealthCT 855-805-4325 TTY: 855-789-2428
District of Columbia DC Health Link 855-532-5465 TTY: 711
Idaho Your Health Idaho 855-944-3246 Not available
Kentucky KYnect 855-459-6328 TTY: 855-326-4654
Maryland Maryland Health Connection 855-642-8572 TTY: 855-642-8573
Massachusetts Massachusetts Health Connector 877-623-6765 TTY: 877-623-7773
Minnesota MNsure 855-366-7873 TTY: 800-627-3529
Nevada Nevada Health Link 855-768-5465 TTY: 855-853-8100
New Mexico Be Well NM 855-996-6449 TTY: 855-889-4325
New York NY State of Health 855-355-5777 TTY: 800-662-1220
Oregon OregonHealthCare.gov 855-268-3767 TTY: 800-735-2900
Rhode Island HealthSource RI 855-840-4774 TTY: 888-657-3173
Vermont Vermont Health Connect 855-899-9600 TTY: 888-834-7898
Washington Washington Health Benefit Exchange 855-923-4633 TTY: 855-627-9604

For more detailed information about Form 1095-A, you can also visit the Health Insurance Marketplace Statements page.

Open Enrollment, Special Enrollment, and Updating Your HealthCare.gov Information

Each year, the Health Insurance Marketplace, accessible through health care gov, has specific enrollment periods. These include an open enrollment period and special enrollment periods for individuals who qualify due to certain life events. For detailed schedules and eligibility for enrollment periods, visit HealthCare.gov or contact your state-based Marketplace directly.

If you’re enrolled in health coverage through the Marketplace, it’s crucial to report any changes in your circumstances to the Marketplace as soon as they occur. Changes such as income fluctuations or changes in family size can impact your advance payments of the premium tax credit. Reporting these changes promptly via HealthCare.gov may qualify you for a special enrollment period, allowing you to adjust your health insurance coverage outside the standard open enrollment timeframe. Visit HealthCare.gov for further guidance on reporting changes and special enrollment opportunities. To estimate how changes might affect your premium tax credit, you can utilize the Premium Tax Credit Change Estimator tool.

SHOP Marketplace for Small Businesses via HealthCare.gov

For small businesses looking to provide health coverage to their employees, the Small Business Health Options Program (SHOP) Marketplace, also available through HealthCare.gov, offers a valuable resource. SHOP is designed to assist small businesses, including non-profit organizations, in offering comprehensive health and dental coverage.

SHOP provides businesses with flexibility, a range of coverage choices, and streamlined online application and account management processes. Businesses can enroll in SHOP at any time throughout the year; there are no restricted enrollment periods for starting a SHOP plan. Furthermore, businesses offering health coverage through the SHOP Marketplace may be eligible for the small business health care tax credit.

For more information on the Premium Tax Credit and other aspects of the Affordable Care Act, please visit IRS.gov.

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