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7 FAQs About Form 1095-A, Health Insurance Marketplace Statement

Credits & Deductions Health Insurance Healthcare Taxes

What is 1095-A Tax Form?

You will receive the 1095-A Tax Form if you bought health insurance through the government health insurance marketplace. The 1095-A form is a Health Insurance Marketplace Statement that comes in the mail and you need to include in your tax return. This form should arrive in your mailbox by January 31, 2020.

Read on to get answers to 7 of the most common questions about Form 1095-A.

Why Do I Need Form 1095-A?

You need Form 1095-A to complete IRS Form 8962 – Premium Tax Credit (PTC).

This information provided on this form will help you complete your income tax return, claim premium tax credits and adjust any tax credit payments.

How Do I Fill Out Form 1095-A?

While Form 1095-A is not filed with your tax return, the information is needed to complete Form 8962, Premium Tax Credit. Form 8962 should be filed as part of your tax return for 2019.

If you use TaxAct to prepare your return, the program asks you questions and completes Form 8962 for you if required. For the direct steps, view our help topic Entering in Program – Form 1095-A Health Insurance Marketplace Statement

Do I qualify for the premium tax credit?

To qualify for the premium tax credit you must be in the low- to mid-income ranges, not qualify for insurance through a government program, such as Medicare, Medicaid or CHIP, or not offered a qualifying, employer-sponsored plan considered affordable for your income level.

As you determine your eligibility, keep in mind no one else can claim you as a dependent on their tax return. This includes your parents.

In addition, you can’t claim the premium tax credit if your filing status is married filing separately.

How much can I make before I no longer qualify for a premium tax credit?

Credit is phased out at 100 percent to 400 percent of the federal poverty level. (The limits in Hawaii and Alaska are higher.)

If your income is above the upper limit, you don’t qualify for the premium tax credit.

The following income limits apply to residents of most states for 2019, based on family size:

  • Family size 1: 12,140 up to 48,560
  • Family size 2: 16,460 up to 65,840
  • Family size 3: 20,780 up to 83,120
  • Family size 4: 25,100 up to 100,400

Typically, the lower your income, the more help you receive through a premium tax credit.

How do I calculate my household income for the premium tax credit?

To determine your household income for this purpose, start with your adjusted gross income.

Your adjusted gross income includes all your taxable income, reduced by “adjustments,” including moving expenses and retirement plan contributions.

Add back the following items to calculate your household income:

  • Nontaxable Social Security benefits
  • Tax-exempt interest income
  • Excluded foreign income

TaxAct calculates your household income and allowable credit for you making it easy to determine your income.

If my income disqualifies me for advance credit payments I’ve already received, how much could I have to pay back?

If your income was more than you expected during a year when you received advance credit payments, and your income is above 400 percent of the federal poverty level, the entire amount of advance credit payments you received must be paid back.

However, if you made more than you expected to, but your income is still below 400 percent of the federal poverty level, the amount paid back is capped.

For example, if your income is less than 200 percent of the federal poverty level ($24,280 for an individual in 2019), you will not have to pay back more than $300 of advance credit payments.

If your income is less than 300 percent of the federal poverty level, the maximum amount you will pay back as an individual is $800.

If your income is less than 400 percent of the federal poverty level, as an individual you won’t have to pay back more than $1,325.

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