Tax Refund

When tax season arrives, it can be hard to make sure you’re filling out the right forms and doing your taxes properly. That includes forms for your health insurance.

Did you know that there are actually a few health insurance tax forms you might need to file depending on what type of health insurance you have? For some taxpayers, only one form is needed, while for others, there might be several that you’re waiting on to come in the mail before you submit your return for the year.

So, which health insurance tax forms do you need to file? Here’s everything you need to know.

Understanding health insurance tax obligations

As a taxpayer, you have certain obligations to fulfill when you file your taxes. When it comes to health insurance, these obligations can vary from person to person.

Understanding your health insurance tax obligations is important because it allows you to file your taxes properly and receive any tax benefits you may be eligible for. For example, some people may be able to deduct health insurance premiums while others can’t.

The health insurance tax forms you receive in the mail contain important information that you’ll need when you file your tax return.

What are the health insurance tax forms?

The health insurance tax documents you need will vary depending on what type of health insurance you have and several other factors.

You’ll receive Form 1095-A if you purchased a Marketplace health insurance plan or Form 1095-B if you have employer-sponsored health insurance. The common health insurance tax forms include:

  • Form 1095-A
  • Form 8962
  • Form 1095-B

We’ll take a closer look at each of these health insurance tax forms — including who should receive them and what to do with them — in the sections below.

Man at the doctor’s getting his blood pressure checked.

What is Form 1095-A?

If you purchased health insurance through a Health Care Exchange (or Marketplace), you’ll receive Form 1095-A. This form contains information about your health insurance policy, premiums, and the people in your household who are covered.

Form 1095-A also includes information about your advance premium tax credit. If you claimed your advance premium tax credit throughout the year, your 1095-A will reflect that.

Once you receive your Form 1095-A, you can use that information to fill out Form 8962 to claim the premium tax credit. This tax credit can help you lower your monthly insurance premiums, but it can also be claimed with your tax return to increase your refund or reduce your taxes owed.

Keep in mind that you’ll only receive Form 1095-A if you have a health insurance policy that was purchased through the Marketplace during open enrollment. If you have an employer-sponsored health insurance policy, you’ll receive Form 1095-B instead.

If you received an advance premium tax credit through the Marketplace during the tax year, you’re required to file Form 8962. An advance premium tax credit is a tax credit you can take in advance to lower your monthly health insurance payment (or “premium”). When you apply for coverage in the Health Insurance Marketplace®, you estimate your expected income for the year. If you qualify for a premium tax credit based on your estimate, you can use any amount of the credit in advance to lower your premium.

  • If at the end of the year you’ve taken more premium tax credit in advance than you’re due based on your final income, you’ll have to pay back the excess when you file your federal tax return.
  • If you’ve taken less than you qualify for, you’ll get the difference back.

  However, you’re not required to do anything with Form 1095-A if you didn’t receive an advance premium tax credit.

Form 1095-A deadlines

What is Form 8962?

Form 8962 is what you file if you have a Marketplace health insurance plan and received Form 1095-A in the mail or online from your account. Form 8962 allows you to claim health insurance tax deductions if you didn’t claim your advanced premium tax credit throughout the year.

If you received a Form 1095-A, keep it and use that information to complete Form 8962. If you received a 1095-B in the mail, you don’t need to complete an 8962 form.

Keep in mind that not everyone is eligible for the premium tax credit. In addition to having a Marketplace health insurance plan, your estimated income also needs to fall between 100% and 400% of the federal poverty line.

Completing Form 8962 will determine whether you’re eligible for the premium tax credit. If you used more or less of the PTC that you qualify for at the end of the year, you’ll either repay the difference or receive a refundable credit on your return.

You can find Form 8962 instructions on the form itself, or you can consult a tax professional at the end of the year.

Premium Tax Credit income requirements

What is Form 1095-B?

Form 1095-B is sent to individuals who have employer-sponsored health insurance. This tax form tells you what type of insurance you have, who’s covered under your policy, and the period of coverage for the previous year.

While you don’t need to fill out Form 8962 if you receive a 1095-B in the mail, you still have tax obligations. When you file your taxes at the end of the year, you can use your 1095-B to prove that you have the minimum health insurance benefits required by the Affordable Care Act.

Only employers with fewer than 50 full-time employees are required to send out a 1095-B to each employee. If you work for a larger company, you may receive Form 1095-C instead of 1095-B.

Until 2019, taxpayers were penalized if they didn’t have the minimum coverage or a waiver. While minimum coverage is still required, the penalty on the Federal tax return no longer applies to taxpayers who aren’t covered. Some states (California, the District of Columbia, Massachusetts, New Jersey, and Rhode Island) have an individual health care mandate and can impose a penalty for not having health insurance. Vermont also has a health care mandate, but there’s currently no financial penalty attached to the mandate.

How do I get my health insurance forms?

You don’t have to do anything special to get your health insurance forms. Around tax season, you should receive any forms you need in the mail.

If you have Marketplace insurance but didn’t receive your Form 1095-A or you received an incorrect 1095-A, you should contact the Marketplace from which you received coverage. 

If you work for an employer with fewer than 50 full-time employees, they’re required by law to send out a 1095-B. If your employer has more than 50 full-time employees, they’ll send out a 1095-C. Some people may even receive a 1095-B and a 1095-C in the same tax year.

Regardless of whether you receive a 1095-B or 1095-C, the information is essentially the same. You only need to worry about completing Form 8962 if you received a 1095-A for a Marketplace health plan.

Reminders for filing health insurance tax forms

It’s important to provide accurate information when you’re filing any tax form. Make sure the information on your 1095-A matches the information on Form 8962. If you received a 1095-B or 1095-C instead, verify the information on it to make sure it’s accurate.

Inaccurate information on tax forms can affect the timing of your return and the amount you receive, so it’s important to provide accurate information.

Enrollment deadlines and plan selection

If you’re looking for a new health insurance plan, there’s some basic information you should know first.

Open Enrollment for Marketplace health insurance starts on November 1st, and December 15th is the last day you have to enroll or make changes to your plan. Any changes you make will take effect on January 1st — which is also when you’ll pay your first premium.

Man shopping for health insurance online.

There are four tiers of Marketplace plans, with each tier representing how much you pay versus your insurance provider:

  • Bronze: You pay 40%, the insurance company pays 60%
  • Silver: You pay 30%, the insurance company pays 70%
  • Gold: You pay 20%, the insurance company pays 80%
  • Platinum: You pay 10%, the insurance company pays 90%

Higher tiers come with higher premiums, so consider the monthly cost of your plan versus the benefits.

There are also several different types of plans and networks, so you need to choose the right plan if you want to use your preferred providers:

  • Exclusive Provider Organization (EPO): You only receive coverage when you use doctors, specialists, and hospitals within the plan’s network.
  • Health Maintenance Organization (HMO): Coverage is limited to doctors who work for or contract with the HMO, with no coverage for out-of-network care. HMOs are more focused on preventative care and maintaining your health.
  • Point of Service (POS): You can get coverage from providers outside your plan’s network, but you pay less for in-network care. You’ll also need to get a referral to see any type of specialist.
  • Preferred Provider Organization (PPO): You pay less if you use providers in your plan’s network, but you can still use providers and specialists outside of the network with no referral for an additional cost.

Assess your needs and find a plan that fits your budget as well. You can get help from an expert if you’re not sure about enrolling in Marketplace insurance.

Maximize savings: Premium tax credits and more

You have several opportunities to save on health insurance, including the premium tax credit. The premium tax credit allows you to save on your monthly premium by completing Form 8962, but you’re only eligible if you received Form 1095-A.

Providing up-to-date tax information can help you maximize your benefits. Report any income and household changes and make sure your information is accurate and up-to-date to make sure you’re eligible for any benefits you deserve. Your premium tax credit amount is based on how many people live in your household and your annual income.

Saving money on premiums can also be accomplished by raising your deductible. The deductible is the amount you have to pay before your coverage kicks in. The higher your deductible, the lower your monthly premium will be.

If you decide to raise your deductible, it’s important to find a balance. You don’t want to prioritize saving money on premiums if it means you’re going to have trouble paying your deductible when you file a claim.

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