Next StepsWhat else do you need to know? Now what do you do?
Taxes and the Affordable Care Act Insurance
If you received advance premium tax credits that made health insurance affordable – you are required to file a tax return to reconcile those credits received. If you fail to do this, you will no longer qualify for future tax credits.
You should have received a Form 1095a from the marketplace that shows 3 dollar amounts for each month that you had health insurance coverage. Your tax preparer must have this form to complete your tax return. If you have not received it – call the Marketplace at 800-318-2596 to get a copy; or make an appointment with a Navigator for help in obtaining this.
Form 1095a includes the following information that is transferred to Form 8962 of your tax return:
A) Monthly enrollment premiums – this represents the actual premium charged by the insurance company and thus includes any advanced payments made to them on your behalf to lower your out of pocket insurance costs
B) Monthly second lowest cost silver plan (SLCSP) premium – this amount was used to calculate the amount of advanced payments made on your behalf (based on your estimated income for the year at time of application) and will also be used to reconcile the correct tax credits based on your actual income as reported on the tax return.
C) Monthly advance payment of premium tax credit – this amount was paid to the insurance company on your behalf as an advance against your final tax credits as calculated on your tax return
Didn’t have health insurance?
If you didn’t have health insurance during the year, you may be subject to an Individual Shared Responsibility Payment (often called a “penalty”) when you file your tax return. Keep in mind that less than 5% of people are actually subject to this – so make sure your tax preparer reviews your situation for any exemptions to the penalty – or make an appointment with a Navigator for help with this. And if you did owe a penalty – make sure you check out insurance options for next year since often the cost of insurance is less than the penalty!
We’re here to help you understand your options
Our goal is always to support you in making the best choices for your personal circumstances – whether that’s obtaining Affordable Care Act Health Insurance, seeing if you’re subject to a fee for not having health insurance (most people aren’t) or finding medical help that is available for the uninsured and underinsured.
Contact Us and let us know how we can help (we’ll get back to you by phone or email – your choice!)
Preview 2017 Health Insurance Plans and Prices available at Healthcare.gov (or we’ll guide you through this during your appointment) (This quick preview does not require you to submit an application.)
Next Open Enrollment is Nov 1, 2017 to Dec 15, 2018. Be sure to get help before then and pay your initial premium prior to the insurance start date.
Be aware of your choices! If you purchase a plan outside of the Federal Marketplace you will not qualify for financial assistance with premium tax credits or cost sharing reductions. And if that plan doesn’t offer minimum essential coverage (as required for all Federal Marketplace plans offered through Healthcare.gov) you may still be liable for the fee that people without coverage pay when filing their tax returns. Click here to see the types of health insurance plans that qualify as minimum essential coverage. If you’re purchasing a plan outside of the Federal Marketplace, be sure to review their summary of benefits and coverage to verify if that plan counts as minimum essential coverage.
To purchase health insurance through the Federal Marketplace after Jan 31st, you must qualify for a Special Enrollment Period. There are a number of major life changes that will enable you to purchase insurance – but you must usually apply within 60 days before or after the qualifying event. For example, loss of minimum essential health coverage is a qualifying event. So if you know you’ll be quitting a job that currently provides you with health insurance – be sure to make an appointment with a Navigator up to 60 days before you quit to apply for individual insurance to replace your employer coverage. And if you are unexpectedly terminated, you have up to 60 days after losing employer health coverage to apply for affordable care act healthcare insurance. Be sure to act quickly as there is often a small time period after applying before your new insurance begins. Click here to access the Federal Marketplace screener to see if you might qualify for a special enrollment period. (This quick screener does not require you to submit an application.)
Get ready for 2018 now – make sure you’ve filed your tax returns to reconcile any financial help you may have received in paying for your Affordable Care Act insurance. This is an important requirement so that you can continue to receive advance premium tax credits for future years.
What else do you need to know and what do you do next?
You’re ready to move forward but might need to ask a few questions first.
You can give us a call, submit your question online, make an appointment, or attend an informational event. We’ll guide you in the right direction and be by your side through the whole process.
Help for Uninsured
There are still way too many people left without medical insurance. Some are among the poorest who are caught in the NC Medicaid Gap and do not qualify for any financial help. Others just can’t afford to buy insurance (even with subsidies.) We’ve listed some of the free and sliding-scale options in your county here.
Health Care Minutes
with Susan Wilson
Affordable Care Act Project Navigator
Council on Aging of Buncombe County
ACA and Taxes 1
ACA and Taxes 2
We have both staff and volunteer navigators in 11 counties in Western North Carolina who are happy to answer your questions about the Affordable Care Act and help you enroll in the best plan to meet your personal needs.
Buncombe, Henderson, and Transylvania counties in Western North Carolina
Staff Navigator: Susan Wilson
Health Insurance and Outreach Specialist: Bruce Birdsall
Burke, McDowell, Polk and Rutherford counties in Western North Carolina
Staff Navigator: Lisa McAlpine