Under the federal Affordable Care Act (ACA)—also known as Obamacare or the Patient Protection and Affordable Care Act (PPACA)—you have certain obligations regarding health coverage (health insurance) and must provide information about the status of your health coverage on your federal income tax return. For example:
• If you are a U.S. citizen or a non-U.S. citizen living in the United States, you must have qualifying health care coverage, qualify for a health coverage exemption, or make a payment when you file your income tax return.
• If you had coverage or an employer offered coverage to you in the previous year, you will receive one or more of the following forms: (1) Form 1095-A, Health Insurance Marketplace Statement; (2) Form 1095-B, Health Coverage; or (3) Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.
• If you had health coverage through an employer or under a government program (such as Medicare, Medicaid, or coverage for veterans) for the entire year, simply check the full-year coverage box on your Form 1040 tax return.
• If you did not have coverage for any month of the year, you should check the instructions to Form 8965, Health Coverage Exemptions, to see if you are eligible for an exemption.
• If you were eligible for an exemption from coverage for a month, you must claim the exemption or report an exemption already obtained from the marketplace by completing Form 8965, Health Coverage Exemptions, and submitting it with your tax return.
• If you did not have coverage and were not eligible for an exemption from coverage for any month of the year, you are responsible for making an individual shared responsibility payment when you file your federal income tax return.
• If you are responsible for making an individual shared responsibility payment, you must report it on your income tax return and make the payment with your income taxes.
• If you need qualifying health care coverage for the current year, you can visit HealthCare.gov to find out about the dates of open and special enrollment periods for purchasing qualified health coverage.
• If you enroll in health insurance through the Marketplace for yourself or someone else on your tax return, you might be eligible for the premium tax credit.
• If you received the benefit of more advance payments of the premium tax credit than the amount of credit for which you qualify on your tax return, you will repay the amount in excess of the credit you are allowed subject to a repayment cap.
• If you did not enroll in health insurance from the Marketplace for yourself or anyone else on your tax return, you cannot claim the premium tax credit.
• If you are eligible for the premium tax credit, you can choose when you enroll in coverage to get premium assistance sent to your insurer each month to lower your monthly payments or get all the benefit of the credit when you claim it on your tax return.
• If you are claiming the premium tax credit and did not benefit from advance payments of the premium tax credit, you must file a tax return and IRS Form 8962, Premium Tax Credit (PTC) and claim the credit on the line labeled “Net premium tax credit.”
• If you get the benefit of advance payments of the premium tax credit and experience a significant life change—such as a change in income or marital status—you should report these changes in circumstances to your Marketplace when they happen.
• If you get the benefit of advance payments of the premium tax credit, you will report the payments on your tax return and reconcile the amount of the payments with the amount of credit for which you are eligible.
Under the Affordable Care Act (ACA), Texas residents, like those in other states, must either have qualifying health insurance, qualify for an exemption, or pay a penalty when filing their federal tax return. Forms 1095-A, 1095-B, or 1095-C are provided to individuals to indicate their insurance status for the previous year. If covered for the entire year, individuals can simply check a box on Form 1040. Those without coverage may need to see if they qualify for an exemption using Form 8965. If not exempt, they may owe an individual shared responsibility payment, which is reported and paid with their tax return. Texans can purchase insurance through HealthCare.gov during open or special enrollment periods. The premium tax credit helps lower insurance costs, and changes in circumstances affecting this credit should be reported to the Marketplace. If advance payments of the credit are higher than the eligible amount, the excess must be repaid. Form 8962 is used to claim the premium tax credit when filing taxes.
