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  5. What is Form 1095-A: Health Insurance Marketplace Statement

What is Form 1095-A: Health Insurance Marketplace Statement

Updated for Tax Year 2017


OVERVIEW

If you bought health insurance through one of the Health Care Exchanges, also known as Marketplaces, you will receive a Form 1095-A which provides information about your insurance policy, your premiums (the cost you pay for insurance) and the people in your household covered by the policy.


The Affordable Care Act, also known as Obamacare, requires most U.S. residents to have health insurance, but it also offers a tax break, the Premium Tax Credit, to help offset the costs of health coverage. If you bought coverage through one of the health insurance marketplaces, you should receive a copy of Form 1095-A, which provides information needed to claim the tax credit.

doctor with a child

The role of the Marketplace

The "Marketplace" is the government's term for the online insurance markets or "exchanges" set up under the law known as Obamacare. Only people who buy coverage through the Marketplace can be eligible for the Premium Tax Credit.

If you bought your plan there, you will get a Form 1095-A, also called the "Health Insurance Marketplace Statement." The IRS also gets a copy of the form. The form provides information about your insurance policy, your premiums (the cost you pay for insurance) and the people in your household covered by the policy.

Insurance companies in web-based health care exchanges provide you with the 1095-A form. This form includes:

  • your name
  • the amount of coverage you have
  • any tax credits you were entitled to
  • if you used them to pay for your health insurance and the amount you paid for coverage

You use this information to complete your income tax filing, adjust any tax credit payments and claim any premium tax credits that may be due.

Who qualifies for the Premium Tax Credit

Your income has to be within a certain range to qualify for the Premium Tax Credit. That income range is between 100% - 400% of the federal poverty level. As of 2017, the federal poverty level for most of the United States was $12,060 for a single person.

Multiply the total by 4 to get 400% of the level. Therefore, the eligible ranges for use with your 2017 taxes were:

  • For one person: $12,060 - $48,24
  • For a family of two: $16,240 - $64,960
  • For a family of three: $20,420 - $81,680
  • For a family of four: $24,600 - $98,400
  • For a family of five: $28,780 - $115,120
  • For a family of six: $32,960 - $131,320
  • For a family of seven: $37,140 - $148,560
  • For a family of eight: $41320 - $165,280

For households with more than 8 people, add $4,160 for each additional person per year.

Poverty levels are higher in Alaska and Hawaii, where the cost of living is higher.

Two ways to take the tax credit

Taxpayers who are eligible for the Premium Tax Credit have a choice in how they receive it. You generally make the choice at the time you buy coverage in the Marketplace. The options are:

  • Use the credit to reduce your taxes when you file your return at tax time.
  • Use the credit to reduce your insurance premiums in advance.

The first option is pretty straightforward: At tax-filing time, you figure the amount of your credit and then subtract that amount from your tax liability.

The second option is more complicated, because the government gives you the credit in advance—by sending money to your insurer to reduce your premiums. In this case, you figure the amount of your credit and compare it to the amount paid to your insurer to reduce your premiums.

Using the information on the form

Whichever option you choose for taking the Premium Tax Credit, you claim it by filing Form 8962 with your tax return. You'll need your Form 1095-A to fill out this form.

  • If you used your credit to reduce your premiums, Form 8962 will tell you if you have any of the credit left over, in which case you could use it to reduce your taxes.
  • On the other hand, if the amount paid to your insurer actually exceeded your credit, you would have to make up the difference.

This can happen if your income increases during the year and you didn't update your information with the Marketplace.

If you use TurboTax to prepare your tax return, the software will ask you the questions necessary to complete Form 8962 and attach it to your tax return for you.

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The above article is intended to provide generalized financial information designed to educate a broad segment of the public; it does not give personalized tax, investment, legal, or other business and professional advice. Before taking any action, you should always seek the assistance of a professional who knows your particular situation for advice on taxes, your investments, the law, or any other business and professional matters that affect you and/or your business.


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