Do I Need Form 1095 to File a Tax Return?

February 07, 2016 : Lindsey Buchholz

Wondering if you need Form 1095 health insurance statements for your tax return? As with most things tax, the answer is: it depends.

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

  • You don’t need your Form 1095 to file your 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 if:
    • You got health insurance through a federal or state marketplace
    • You get Form 1095-A 

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.

If you’re using an H&R Block Online tax filing program or H&R Block Software, we’ll ask you about this topic when you’re working on the Health Care section of your return.

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. While you need this info for your return, you probably already know when you were covered and won’t need to refer to a 1095-B. If you’re unsure, 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, 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.

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

When filing without Form 1095-B or C, you should make a good faith effort to accurately report their insurance coverage status on their tax returns. You can do this by gathering info from other sources.

Ex: 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 shows 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 don’t need to amend their return.

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.

Related Topics

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.

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