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Filling Out a Medical Form

Understanding IRS Form 1095 and Why It Matters for Your Health Insurance

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If you’ve ever filed taxes while having health insurance, you may have heard of IRS Form 1095. These forms are important tax documents that provide proof of your health insurance coverage throughout the year. Understanding what these forms are and why they matter can help you file your taxes correctly and avoid unnecessary confusion or delays.

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What Is Form 1095?

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Form 1095 is an IRS tax form that shows whether you and your family had qualifying health coverage during the previous year. The Affordable Care Act (ACA) requires health insurance providers, employers, and the federal government to report who had health coverage and for how long.

In short, your 1095 form serves as proof of health insurance coverage—it helps the IRS verify that you met the individual shared responsibility requirement (the ACA rule that used to require everyone to have health coverage).

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Why Do You Need a 1095 Form?

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You’ll need your Form 1095 when you file your federal income tax return. It helps you confirm:

  • Whether you had minimum essential coverage (MEC) for the year.

  • If you received a Premium Tax Credit (PTC) to lower your monthly premium cost through the Health Insurance Marketplace.

  • Whether you need to reconcile advance payments of your tax credit when you file your return.

Even though you don’t always have to submit the form with your tax return, you should keep it for your records. It’s an important document that verifies your health insurance history for the year.

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The Three Types of 1095 Forms

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There are three different types of Form 1095, depending on where your health coverage came from:

1. Form 1095-A: Health Insurance Marketplace Statement

  • Issued by the Health Insurance Marketplace (Exchange).

  • Sent to individuals who enrolled in coverage through HealthCare.gov or a state exchange.

  • Used to complete Form 8962, which reconciles your Premium Tax Credit when filing taxes.

2. Form 1095-B: Health Coverage

  • Sent by insurance companies, small employers, or government programs (like Medicaid or CHIP).

  • Shows proof that you and your family members had minimum essential coverage for each month.

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

  • Sent by large employers (with 50 or more full-time employees).

  • Details what type of health coverage was offered to you and whether you enrolled.

  • Helps the IRS determine if the employer met its obligations under the ACA.

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When to Expect Your 1095 Form

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You typically receive your 1095 form by early February each year. If you haven’t received it, you can contact:

  • Your health insurance provider

  • Your employer’s HR department

  • The Health Insurance Marketplace (if you bought coverage through it)

You can also log in to your Marketplace account to download your 1095-A form directly.

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Key Takeaway

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Form 1095 may seem like just another tax form, but it’s an important document that helps confirm your health insurance coverage for the year. Keeping your 1095 forms organized ensures a smoother tax filing process and helps you stay compliant with Affordable Care Act (ACA) requirements.

If you have questions about your 1095 form or need help understanding your health insurance coverage, contact us today or schedule an appointment.

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