FAQ

How does irs know if you had health insurance

medical insurance purchased through the market

If you purchased health insurance through the Marketplace, you should receive a Form 1095-A, Statement from the Health Insurance Marketplace, at the beginning of tax filing season. The information shown on the 1095-A form helps you complete your individual federal income tax return. If the 1095-a shows coverage for you and all members of your family for the entire year, check the box for coverage for the entire year on your tax return. Among other things, Form 1095-A reports the total monthly health insurance premiums paid to the insurance company you selected through the Marketplace. lists the amount of premium assistance you received in the form of advance payments of the premium tax credit that were paid directly to your insurance company, if applicable. If you received a 1095-a with incorrect information, see our questions and answers about corrected, incorrect, or voided 1095-a forms to find out how it affects your taxes.

If you choose to have advance payments of the premium tax credit paid directly to your insurance company, you must complete Form 8962, Premium Tax Credit, and file a federal income tax return, even if you are not required to file one . You must reconcile, or compare, these payments to the premium tax credit that you will calculate for your tax return. even if you did not elect to receive advance payments, you must file a federal income tax return to claim the premium tax credit. Filing your return without reconciling your advance payments will delay your refund and may affect future credit advance payments. see below for more information on the effect of failing to reconcile advance payments of the premium tax credit.

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If you purchased coverage through the federally-facilitated Marketplace and created a healthcare.gov account, you can get a copy of your Form 1095-a, Health Insurance Marketplace Statement online from your account. visit your market’s website to learn the steps you need to take to get a copy of your 1095-a form online. You can use your online account information, if available, or the 1095-a form that was mailed to you to complete your tax return.

failure to file tax returns will prevent early payments in the next year

The IRS reminds taxpayers who received advance payments of the premium tax credit to file their tax return on time to ensure they can receive advance payments next year from their market.

If advance payments of the premium tax credit were paid on behalf of you or a family member, and you do not file a tax return reconciling those payments, you will not be eligible for advance payments of the credit. premium tax or cost-sharing reductions to help pay for your Marketplace health insurance coverage in the next year. this means you will be responsible for the full cost of your monthly premiums and all covered services. In addition, we may contact you to pay some or all of your advance payments of the premium tax credit.

Marketplaces will determine eligibility for advance tax credit payments and cost-sharing reductions for the coverage year in the fall before the new coverage year begins. You will substantially increase your chances of avoiding a gap in receiving this aid if you e-file your tax return with Form 8962 before your return is due.

If you have any questions about the information shown on your Form 1095-a, or how to receive your Form 1095-a, or about a letter you received, please contact your marketplace as shown in the table below or visit healthcare.gov/taxes.

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market contact information

all states not listed below

health.gov

800-318-2596

tty: 855-889-4325

california

Covered California

800-300-1506

tty: 888-889-4500

red

connect for health colorado

855-752-6749

tty: 855-346-3432

connecticut

accesshealthct

855-805-4325

tty: 855-789-2428

district of Colombia

dc health link

855-532-5465

tty: 711

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idaho

your health in 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

safe

855-366-7873

tty: 800-627-3529

snowfall

nevada health link

855-768-5465

tty: 855-853-8100

new mexico

get well nm

855-996-6449

tty: 855-889-4325

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new york

any health condition

855-355-5777

tty: 800-662-1220

oregon

oregonhealthcare.gov

855-268-3767

tty: 800-735-2900

rhode island

ri health source

855-840-4774

tty: 888-657-3173

vermont

vermont health connection

855-899-9600

tty: 888-834-7898

washington

washington health benefits exchange

855-923-4633

tty: 855-627-9604

Visit our Health Insurance Marketplace Statements page for more information on Form 1095-a.

buy health care coverage through the marketplace and report changes

Each year, the Health Insurance Marketplace has an open enrollment period and special enrollment periods for eligible payers. For information on enrollment periods, visit healthcare.gov or contact your state marketplace.

If you signed up for insurance coverage through the Marketplace, you must report any changes in your circumstances, such as changes in your household income or family size, to the Marketplace when they occur. changes in circumstances may affect your advance payments of the premium tax credit. When you report a change in circumstances, you may be eligible for a special enrollment period, which allows you to purchase health care insurance through the Marketplace outside of open enrollment. visit the marketplace at healthcare.gov for more information on reporting changes in circumstances and special enrollment.

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To estimate the effect that changes in circumstances may have on the amount of premium tax credit you can claim, see the Changes in Premium Tax Credit Estimator on our Premium Tax Credit Estimator Tools page. health care at a low price.

Learn more about the premium tax credit and other tax provisions of the Affordable Care Act at irs.gov

marketplace for small business health options programs

The Small Business Health Options Program Marketplace, also known simply as a store, helps small businesses provide health coverage to their employees. While the Store Market was previously only open to employers with 50 or fewer full-time equivalent employees, as of 2016, some states may make the Store Market available to businesses with up to 100 employees. If you have more than 50 employees and don’t know if you can use the store marketplace, contact your state insurance department or store call center.

The store marketplace, which is also open to nonprofits, allows you to offer medical and dental coverage that meets the needs of your business and employees. shop offers flexibility, choice, and online application and account management. you can sign up at the store at any time of the year. there is no restricted enrollment period when you can start offering a purchase plan.

Businesses that offer health coverage through the marketplace may be eligible for the small business health care tax credit.

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