What Should I Do With My Health Form for Taxes?

Tax season can be confusing, especially when dealing with health insurance forms. If you received a 1095 form, you might wonder what to do with it and whether it’s necessary for filing your taxes. While not always required, these forms provide key details about your health coverage that could affect your tax return.

Understanding how this form impacts your taxes is essential, especially if it’s missing or contains errors.

Role of 1095 Forms in Reporting Health Coverage

The IRS uses 1095 forms to track whether individuals, employers, and insurance providers meet health coverage requirements. These forms document the months you were enrolled in a qualifying health plan and whether you received government assistance like premium tax credits. While the federal mandate penalty was eliminated in 2019, some states, including California, Massachusetts, and New Jersey, still impose penalties for lacking coverage. If you live in one of these states, your 1095 form may be necessary to prove compliance.

Employers and insurance providers send these forms to both individuals and the IRS to ensure accurate reporting. If you purchased insurance through the Health Insurance Marketplace, the form will indicate whether you received advance premium tax credits, which must be reconciled when filing. Incorrect reporting could lead to owing additional taxes or a reduced refund.

Types of 1095 Forms

There are three types of 1095 forms: 1095-A, 1095-B, and 1095-C. Each corresponds to a different type of health insurance coverage.

1095-A

This form is issued to individuals who purchased health insurance through the Health Insurance Marketplace. It details coverage information, including monthly premiums, the second-lowest-cost Silver plan (SLCSP) premium, and any advance premium tax credits (APTC) received. You must use this form to complete IRS Form 8962, which reconciles the APTC with the actual premium tax credit (PTC) you qualify for based on your income.

If you received more APTC than you were eligible for, you may need to repay the excess. If you qualified for a larger credit than you received in advance, you could claim the difference as a refundable credit. The IRS requires this form to be included with your return if you received APTC, and failing to do so could delay processing or result in penalties.

1095-B

Issued by insurance providers, including government programs like Medicaid, Medicare, and certain employer-sponsored plans, this form confirms whether you had minimum essential coverage (MEC) for some or all months of the year. While not required for federal tax filing, it serves as proof of coverage for state tax filings or personal records.

For individuals in states with their own health insurance mandates, such as California or Rhode Island, this form may be necessary to avoid state penalties. In California, for example, the 2023 penalty for lacking MEC was $850 per adult and $425 per dependent child, up to a maximum of $2,550 per family. If your 1095-B contains errors, such as incorrect coverage months, contact the issuer for a correction before filing.

1095-C

Provided by large employers (50 or more full-time equivalent employees), this form documents whether they offered health insurance to employees. It includes details about the type of coverage, cost to the employee, and whether the plan met affordability and minimum value standards under the Affordable Care Act (ACA).

Even if you did not enroll in your employer’s plan, you may still receive this form, as employers must report whether coverage was offered. In 2023, an employer-sponsored plan was considered affordable if the lowest-cost plan offered did not exceed 9.12% of an employee’s household income. While not required for federal tax filing, it can help verify whether you were offered qualifying coverage, particularly if you applied for Marketplace subsidies.

Steps to Include the Form on Your Return

If you received a 1095-A, you must complete IRS Form 8962 to reconcile any advance premium tax credits. This requires entering details such as the total monthly premium, the second-lowest-cost Silver plan (SLCSP) premium, and the advance credit amount received. Accuracy is important, as discrepancies could lead to IRS notices or delays.

For those with a 1095-B or 1095-C, no additional forms are required for federal filing. These documents serve as proof of coverage and should be kept for your records. However, if you live in a state with its own health insurance mandate, you may need to reference the information when completing your state tax return. New Jersey and Rhode Island, for example, require taxpayers to indicate whether they had minimum essential coverage for the entire year.

If filing electronically, most tax software will prompt you to enter relevant health coverage details. When using a tax preparer, bring your form to ensure all necessary data is included. Those filing a paper return should double-check that any required forms, such as Form 8962, are attached. Missing or incorrect information could trigger an IRS review, leading to delays or requests for additional documentation.

What to Do If the Form Is Missing

If you expected a 1095 form but haven’t received it, check whether it was issued. Insurance providers and employers must send these forms by January 31, but delays can occur. Checking your online account with your insurer, employer, or the Health Insurance Marketplace may provide a digital copy. If no form is available, contact the issuer directly.

In the meantime, reviewing past pay stubs, insurance premium statements, or employer benefits summaries can help verify coverage details. If you were enrolled in an employer-sponsored plan, your W-2 may indicate health coverage in Box 12 with code DD, which reflects the cost of employer-sponsored health benefits. While this amount does not impact tax liability, it can confirm whether coverage was provided.

Correcting Information

Errors on a 1095 form can complicate tax filing, especially if incorrect details affect tax credits or state compliance. If you notice a mistake, such as an incorrect Social Security number, coverage dates, or premium tax credit amounts, contact the issuer for a corrected version. The issuer must submit an updated form to both you and the IRS.

If a correction is not received before the filing deadline, you may need to estimate the correct information based on other records, such as insurance statements or employer benefits documentation. If an incorrect 1095-A affects your premium tax credit calculation, filing an amended return may be necessary once the corrected form is issued. The IRS provides guidance on handling discrepancies, and in some cases, they may accept alternative documentation if the form cannot be corrected in time. Keeping records of communications with the issuer and any supporting documents can help substantiate your claim if the IRS requests verification.