The Affordable Care Act (ACA) and Your Taxes
Marketplace Coverage Changes and Coronavirus
There have been many changes to the Marketplace health coverage due to the Coronavirus and changes to health care in general:
- Lower costs for Marketplace coverage
- New qualifications to help pay for health coverage
- Longer enrollment periods
- Changes reporting the excess advance payments for the Premium Tax Credit (APTC) on your 2020 tax return only
- 2021 and 2022 Health Plans and Prices
Go to Healthcare.gov site to see more information and details about signing up for health insurance via the Markeplace (Healthcare.gov).
You only need to report your health insurance on your return if you or a family member were enrolled in health insurance through the Marketplace and advance payments of the Premium Tax Credit were made to your insurance company to reduce your monthly premium payment.
When you start a free tax return on eFile.com, we will automatically report the required information regarding your health insurance and the Premium Tax Credit on the correct tax forms. If you need to report health insurance information because of the Premium Tax Credit or if you need general information about obtaining health insurance via the Marketplace, see below.
Reporting Your Health Insurance for the Premium Tax Credit
You no longer need to report health insurance coverage for the tax year unless you or a family member were enrolled in health insurance through the Marketplace and advance payments of the Premium Tax Credit were made to your insurance company to reduce your monthly premium payment. When you prepare your tax return on eFile.com and indicate that you need to report your advance payments to compare with your Premium Tax Credit for the year, we will prepare the proper tax forms to report this on your tax return, so you don't have to!
Start Your 2021 Tax Return Now!
How To Report Your Health Insurance - You will only need information from your Form 1095-A to report your payments for the Premium Tax Credit on your tax return on eFile.com. During the tax interview questions about Health Care you will be asked about these payments. Here is more information on the 1095-A, and other insurance forms provided to you for your information only.
- Form 1095-A - Health Insurance Marketplace Statement - You will receive this form if you purchased health insurance via the Health Insurance Marketplace exchange. It will provide information for you if you need to include Form 8962 for the Premium Tax Credit. If you or your family members enrolled in more than one health plan via the Marketplace, you will receive a Form 1095-A for each policy. A copy of each Form 1095-A will also be sent to the IRS. You will not need to include the Form 1095-A with your return however you will use the information from it when you prepare your return on eFile.com and a Form 8962 will be prepared for you to file with your return. Form 8962 is needed with your return to claim the credit and reconcile your advance credit payments.
- Form 1095-B - Health Coverage - This form is provided by your insurance provider and has the information you need to report on your tax return showing that you, your spouse, and any dependents have qualifying health insurance coverage for some or the entire year. This form is for your information only and is not included in your tax return. You will only need to enter healthcare information if you were insured through the Marketplace and received Form 1095-A.
- Form 1095-C - Employer-Provided Health Insurance Offer and Coverage - This form will be provided to you by your employer and contains information about the health coverage offered to you by your employer. This form is for your information only and is not included in your tax return. You will only need to enter healthcare information if you were insured through the Marketplace and received Form 1095-A.
- Form 8962 - Premium Tax Credit - This form will be prepared for you on eFile.com if you purchased health insurance through the Marketplace and you are eligible for the Premium Tax Credit and you wish to claim it.
If you did not receive Form 1095-A, you can go Healthcare.gov and print it from there.
If you receive a letter from the IRS about your 2021 Marketplace coverage then based on their records, they have received a Form 1095-A from the Marketplace for you, and the letter might be informing you that you did not file a 2021 tax return with this information. The letter is a reminder that if you do not file a return (or if you still need to file the information from your 1095-A), you may not be able to qualify for advance tax payments for your Marketplace coverage in 2022. For more information about the IRS health insurance letter, visit our Premium Tax Credit page. If you already e-filed your return on eFile.com and you still need to report your healthcare information to the IRS, you can enter the information in your account and re-generate your return, then print and mail Form 8962 to the IRS.
If You Don't Have Health Insurance
You will no longer have to report that you had health insurance all year and pay a fee if you did not have health insurance on your 2021 Return. However, below is information if you still wish to obtain health insurance via the Marketplace.
If you don't get health insurance from your employer you can purchase it via the Marketplace during the Open Enrollment period (Nov. 1 to Dec. 15, 2021 or Jan. 15, 2022 - See Health Insurance Events below). If you miss the Open Enrollment period you might be eligible for the Special Enrollment Period that lets you buy coverage via the Marketplace on Healthcare.gov outside the Open Enrollment period. You might get coverage during the Special Enrollment Period if any of these situations applies to you:
1) Life Changes for Special Enrollment Period:
- Loss of health coverage
- Changes in household size such as getting married, birth or adoption of a child, divorce, legal separation, death
- Moving to a new residence
- Gaining citizenship or lawful presence in the U.S.
- Released from incarceration (detention, jail, prison)
- No longer eligible for Medicaid or CHIP
- Being a member of a federally recognized tribe or as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- AmeriCorps starting or ending service.
2) Medicaid and CHIP:
- You can enroll in coverage through Medicaid and the Children's Health Insurance Program (CHIP) if you qualify. There is no limited enrollment period for these programs which provide free or low-cost health coverage to millions of Americans and you can apply any time.
If you do not qualify for the 2 circumstances described above, your employer may be required to offer you health insurance, so you should check with them as well. If your employer employs 50 or more people, they are required to offer you health coverage. If you can get coverage through your employer, you can still opt to get your insurance privately or through the Marketplace at HealthCare.gov (during the Open Enrollment period), but you will not qualify for a health insurance premium called a subsidy.
3) If You Cannot Afford Health Insurance:
If your household income is between 100% and 400% of the federal poverty guidelines, and you do not qualify for Medicare, Medicaid, or employer-sponsored health coverage, then you may qualify for a subsidy to pay some or all of the cost of health insurance purchased through an exchange.
Subsidy - A health insurance premium subsidy is actually a federal tax credit, which the IRS calls the Premium Tax Credit. However, the credit is applied directly to the price of your premium and acts like a discount. The amount of your subsidy depends on your family size and income. The lower your income (and the larger your family), the higher your subsidy.
For individuals and families with incomes from 100% to 400% of the federal poverty level, the out-of-pocket cost for health coverage will be from around 2% to 9.5% of the actual price (based on a plan that covers 70% of healthcare costs). Additional funds, called cost-sharing assistance, will be made available to households with incomes lower than 250% of the poverty level.
Households with incomes less than 100% of the federal poverty level will generally qualify for Medicaid. More people, including single individuals, may qualify for Medicare, if their resident states are participating in the Medicaid expansion offered by the Affordable Care Act.
Federal Poverty Level - The federal poverty guidelines are established each year by the U.S. Department of Health and Human Services. The official poverty level for 2021 for residents of most states ranged from $12,880 for an individual to $44,660 for a family of 8.
Open Enrollment or Change Plans Begins for 2022 Coverage
November 1, 2021
Open Enrollment or Change Plans Period for 2022 Coverage
November 1, 2021 - December 15, 2021 OR January 15, 2022
Coverage for 2022 Begins if you enrolled by December 15, 2021 and paid your first premium
January 1, 2022
Coverage for 2022 Begins if you enrolled by January 15, 2022 and paid your first premium
February 1, 2022
2021 Tax Return Deadline
April 18, 2022
Report Income and Household Changes to Healthcare.gov
All Year 2021 and 2022
Related Health Care Tax Information
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