Do I need Form 1095 to file a tax return?

March 23, 2021 : H&R Block

What is a 1095?

Many people wonder, “what is a 1095?” Here’s a summary of the form series. With the passing of the Affordable Care Act, three new tax forms came into the scene: Form 1095 A, B, and C. These tax forms were used to report your healthcare coverage during a tax year. But, in 2019, the healthcare penalty went away. So many people were wondering if they need Form 1095 health insurance statements for their tax returns any longer. As with most things tax, the answer is: it depends.

Here’s a quick summary to outline if you need your Form 1095.

1095 formsYou don’t need your Form 1095 to file your federal return if:

  • You had health insurance through your employer, a government program or other non-marketplace source
  • You get Form 1095-B or Form 1095-C

You do need your Form 1095 to file your federal return if:

  • You got health insurance through a federal or state marketplace
  • You get Form 1095-A

If your state does, you may need to report coverage information on your state tax return.

If you receive a 1095, keep your copy with your tax records.

1095 tax form

If you’re not sure or have more questions about the health insurance information you need for your tax return, continue reading for more details.

Form 1095-A: Marketplace Insurance Statement

Form 1095-A is sent by state and federal marketplaces to anyone 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. You’ll use the information on the 1095-A to see if you got too much or too little of the premium tax credit.

If you had marketplace coverage but didn’t get the APTC, you’ll still use this form if you want to claim the Premium Tax Credit. Form 1095-A should be mailed to you, but you can also usually find it in your online marketplace account. If you were due a 1095-A and didn’t get it, contact the state or federal marketplace in charge of your coverage.

Form 1095-B: Health Coverage

Form 1095-B is the catchall form that is issued for any type of coverage not 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.

Don’t worry about waiting, though. You don’t need this form to file your tax return. The 1095-B will report which months everyone in your household had health insurance coverage. You usually don’t need this info for your return, and you probably already know when you were covered and won’t need to refer to a 1095-B. If you’re unsure, or you have health coverage that may overlap marketplace insurance reported on Form 1095-A and impact the premium tax credit, you can get that info in other ways, like contacting your insurance provider.

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

Form 1095-C is issued by large employers required to offer coverage to employees. This form reports both:

  • Offer of coverage to an employee
  • Coverage of the employee if the employer is self-insured and the employee enrolls in coverage

However, just like with the 1095-B, most people already know this info 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 you get this form. If you don’t know the necessary information, or you have health coverage that may overlap marketplace insurance reported on Form 1095-A and impact the premium tax credit, contact your employer or insurance company for help.

Note: If you had health insurance coverage through your employer, you might see the code “DD” on your W-2, Box 12. That indicates you had employer-provided insurance.

When taxpayers receive forms 1095-B or C after filing, they should review them for accuracy and report any issues to the issuer for correction. Then, store the form with other important tax documents.

Where to go for more help with 1095 and other tax forms

If you need more guidance on Form 1095 or other healthcare tax topics, we can help. For guidance on understanding tax guidance related to healthcare or otherwise, call 1-800-HRBLOCK or visit a local H&R Block office.

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