Do I Need Form 1095 to File a Tax Return?

February 07, 2016 : Lindsey Buchholz

As with most things tax, the answer is: it depends.

If you know which 1095 group you are this quick summary outlines whether you need your 1095 form or not.

  1. Those who had insurance through their employer, a government program or other non-marketplace source, and receive Form 1095-B or Form 1095-C, DO NOT need to have these 1095 forms to file a tax return.
  2. Those who got health insurance through a federal or state marketplace, and receive Form 1095-A, DO NEED to have the 1095-A form to file a tax return.

If you’re not sure or have more questions, read on for additional details.

You will get a 1095 form that correlates to the type of insurance coverage you had for the year. Let’s look at each one.

Form 1095-A: Marketplace Insurance Statement

Form 1095-A is issued by state and federal marketplaces to individuals who had marketplace coverage for the year. This form is absolutely required for taxpayers who received advance payments of the premium tax credit (APTC) to help pay for health insurance coverage during the year. The information on the 1095-A is used to complete the reconciliation of the premium tax credit. Those with marketplace coverage that did not receive APTC will also use information from this from if they wish to claim the premium tax credit. Form 1095-A had to be mailed to the recipient by Feb. 1, 2016. It is also generally available in the online marketplace account. If you were due a 1095-A and have not received it, contact the state or federal marketplace from which you secured coverage.

Form 1095-B: Health Coverage

Form 1095-B is the catchall form that is issued for any type of coverage that is not reported on a Form 1095-A or C. This includes coverage from insurance companies, the government (Medicaid, CHIP, Medicare Part A, TRICARE, VA, etc.), small self-insured employers and more. This form was originally due to be mailed to the recipient by Feb. 1, 2016, but the IRS has extended the due date to March 31, 2016.

Don’t worry about being forced to wait, though. You do not need this form to file your tax return. The 1095-B will report which months individuals in a household had health insurance coverage. While the coverage status of the household must be reported on the tax return, most filers will already know this information and therefore will not need to refer to a 1095-B. For filers that are unsure, coverage information can be obtained through other means, such as by contacting the insurance provider. 

Form 1095-C: Employer-Provided Health Insurance Offer and Coverage

Form 1095-C is issued by large employers – those that are required to offer coverage to employees or pay a penalty for failing to do so. This form is unique in that it repots both an offer of coverage to an employee and the coverage of the employee if the employer is self-insured and the employee enrolls in coverage. This form was also originally due to be mailed by Feb. 1, 2016, but the due date has been extended to Mar. 31, 2016.

However, just like with the 1095-B, most individuals already know this information and won’t need to refer to a 1095-C to complete their tax returns. So, there’s no need to delay filing until this form is received. If you do not know the necessary information, contact your employer or insurance company for help.

Amended Return Relief for 1095-B and 1095-C Recipients

When filing without Form 1095-B or C, taxpayers should make a good faith effort to accurately report their insurance coverage status on their tax returns by gathering information from other sources, such as calling their insurance provider or employer to obtain information needed to file returns in cases where the taxpayer is unsure.

What if you make a mistake? It’s OK. The IRS has granted amended return relief to taxpayers whose 1095-B or C is mailed after Feb. 1, 2016. This means taxpayers do not need to amend their returns if the 1095-B or C they receive after filing does not match what was reported on their tax return.

Example: Paul and Mary had employer coverage and had not received their 1095-Bs by the time they filed their return on Feb. 2. The couple reported full year coverage for 2015. In April, Paul received a 1095-B, which indicates he only had coverage for 10 months. Paul had forgotten that there was a 60-day waiting period for coverage at his new job, which he started in January. Paul and Mary do not need to amend their return.

When taxpayers receive forms 1095-B or C after filing they should review them for accuracy and report any inaccuracies to the issuer for correction. The form should then be stored with other important tax documents.

Related Topics

Related Resources

Have a Missing W-2? Here’s What to Do…

Don't panic if you have a missing w2 form. The Tax Institute can help - find out what you should do with this article.

Original Issue Discount (OID) -Form 1099-OID

Learn more about original issue discounts on Form 1099-OID and get tax answers at H&R Block.

Form W-2

Do you need to know how to read Form W-2? Learn more about this wage and tax statement and get tax answers at H&R Block.

What is a Schedule C Tax Form — Will I also have to file a Schedule SE Tax Form?

What is a Schedule C Tax Form and when do you need to file it? Learn more from the tax experts at H&R Block.

Lindsey Buchholz

Lindsey Buchholz

The Tax Institute, H&R Block

Lindsey Buchholz, JD, LLM, MBA, is a program manager at The Tax Institute. Lindsey leads research teams and regulatory implementation of the Patient Protection and Affordable Care Act across H&R Block.