Form 1095-A FAQs

What is Form 1095-A?

Form 1095-A is the tax form that shows every month of the year when you and your tax household members had health insurance coverage through CoverME.gov. If you received health insurance through another source, this form will not reflect that coverage. This form also shows the premium costs and any advance premium tax credits (APTC) your tax household got during the year.

You will use your Form 1095-A to fill out Form 8962 (PDF) when you file your taxes. IRS Form 8962 is a form used by the IRS to determine if the tax credits your health insurance company received based on what you estimated your income to be matches the amount of financial assistance you qualify for, based on your actual income, as reported on your federal tax return. Any difference between the estimated and actual income amounts will affect your refund or tax owed. For a more detailed explanation, see the IRS' website.

Health coverage tax tool

Use this tool to figure out the information needed to complete IRS Form 8962 when you file your taxes.

When should I expect to receive Form 1095-A?

CoverME.gov will mail your Form 1095-A by January 31. You should receive a paper copy of Form 1095-A in the mail by early February. You will be able to access a printable electronic copy of Form 1095-A through your CoverME.gov account starting on January 31.

In order to receive this form in the mail, you must have an updated mailing address – if your mailing address has changed and you have not updated your CoverME.gov account accordingly, call the Consumer Assistance Center at 1-866-636-0355 TTY: 711.

What should I do when I receive Form 1095-A?

 

1. Check to make sure the information on your Form 1095-A is correct. If you think the information is wrong or if you need another copy, contact CoverME.gov’s Consumer Assistance Center at 1-866-636-0355.

2. Use the information on your Form 1095-A to fill out IRS Form 8962. Form 8962 is an IRS form used to reconcile the tax credits your health insurance company received based on your estimated income with the amount that you qualify for based on your actual income, as reported on your federal tax return.

3. If your Form 1095-A Part III is empty or incomplete, if you applied to receive a tax credit through CoverME.gov and you believe your Form 1095-A Part III ‘Coverage Information’ is incorrect, or if you had a change in your household during the plan year that you did not report to CoverME.gov, contact CoverME.gov’s Consumer Assistance Center at 1-866-636-0355.

What information is included on Form 1095-A?

Form 1095-A has information about the tax household, specifically, the tax household members who were enrolled in health insurance coverage through CoverME.gov and their health insurance coverage for the previous year. This information will be used to complete your federal tax return, including Form 8962.

  • Part I-Recipient Information
    • Demographic information about the tax household member and their CoverME.gov health insurance policy.

 

  • Part II-Covered Individuals
    • Demographic information about all tax household members enrolled in health insurance coverage through CoverME.gov, along with their coverage start and termination dates. All members of the tax household who were enrolled will be included regardless of whether they were eligible for APTC.

 

  • Part III-Coverage Information
    • The full monthly premium of your health insurance plan.
      • If you purchased pediatric stand-alone dental benefits, your premium amount will include that coverage as well. For example, if you purchased a family stand-alone dental plan, but have a child under the age of 19 using the pediatric portion of those benefits, the premium for those pediatric benefits will be added to the total premium. If you purchased a stand-alone pediatric dental plan that premium amount will be included.
    • The premium amount of the second lowest cost silver plan (SLCSP) (also referred to as the ‘benchmark plan’) available to you and members of your tax household for the coverage year.
      • If you are eligible for, but did not receive advance premium tax credit (APTC) and want to claim the tax credit on your return, you will need to refer to the premium amount for your applicable SCLSP on your 1095-A form. You will need the monthly amount of your benchmark plan premium to complete Form 8962.
      • If APTC was applied to your coverage, you will need the amount of any advance payments of the premium tax credit paid to the health insurance company on your behalf to complete Form 8962.
    • The amount of APTC applied to your coverage, if any.
What is the second lowest cost silver plan (SLCSP) premium amount? Why is this on my form?

The premium amount for the applicable SLCSP is used to calculate the maximum amount of advanced premium tax credit that could be applied to your coverage each month and to find the total amount of premium tax credit you can claim on your return. If you or a member of your tax household wants to claim the premium tax credit on your tax return, you will need the premium amount for your applicable SLCSP to complete Form 8962 and claim the tax credit.

Why are some of the fields in Part III of my Form 1095-A blank?

These columns will be completed only for the months that you had coverage.

Why did I receive more than one Form 1095-A?

You will receive one Form 1095-A for each CoverME.gov health insurance plan that you or members of your tax household enrolled in during the year. If you received identical forms, then only use one when filing your tax return and disregard other. If you received more than one Form 1095-A that reports coverage for the same month, please see the instructions for Form 8962 for more information.

You will also receive more than one Form 1095-A for the following reasons:

  • If you updated your household information on CoverME.gov during the year
  • If the primary enrollee on your CoverME.gov account changed during the year
  • If you switched health insurance plans during the year
  • If you had a gap in health insurance coverage during the year
  • If you received a corrected or voided Form 1095-A due to errors on your original Form 1095-A
  • If you or members of your tax household were not all enrolled in the same CoverME.gov health insurance plan
Should I receive a Form 1095-A for my dental coverage?

No, you will not receive a separate 1095-A for a stand-alone dental plan purchased through CoverME.gov.

What should I do if I haven’t received my Form 1095-A in the mail yet?

If you have not received your Form 1095-A by early February:

  • First check your CoverME.gov account to see if the form is in your ‘Messages.’ You can print the form from your account.
  • Enrolled only in a catastrophic plan or a stand-alone dental plan (these are not eligible for premium tax credits).
  • Got health coverage from a job, a private plan outside of CoverME.gov, MaineCare, and/or Medicare only.

Form 1095-A will not be sent to consumers who:

  • Enrolled only in a catastrophic plan or a stand-alone dental plan (these are not eligible for premium tax credits).
  • Got health coverage from a job, a private plan outside of CoverME.gov, MaineCare, and/or Medicare only.

If the form is not available in your account, or you would like a form mailed to you, call the CoverME.gov Consumer Assistance Center at 1-866-636-0355 to confirm your mailing address. If the address listed on your account is not correct, your form will not be delivered. If you moved and did not inform CoverME.gov of your address change, you will not receive a form unless you have a mail forwarding order in place.

Why is the monthly premium amount on my Form 1095-A different from the premium amount on the bill I received from my insurance company?

Federal regulations allow premium tax credits to be used only for benefits that are considered essential health benefits and may not be used for benefits that are not considered essential health benefits, such as acupuncture.

Your Form 1095-A provides information for you to either claim your tax credits as a lump sum or to reconcile the tax credits you received in advance each moth to help pay for your premium. Because of this, the form only includes the premium amount that covers essential health benefits.

Why does my Form 1095-A reflect that I received a tax credit during a month I didn’t pay my monthly premium?

If you are receiving a tax credit, the law requires your insurer to keep you covered in your health insurance for a certain period of time, even if you aren’t paying premiums (a ‘grace period’).

If you don’t start paying your premiums again by the end of the grace period (after 90 days), your coverage is terminated. Even if your coverage is terminated, your insurer counts you as covered during the first month you stopped paying.

If your coverage is terminated because you did not pay your monthly bills, the IRS will hold you responsible for the tax credit applied to your coverage during the first month you stopped paying when you file your taxes.

I should have been eligible for the advanced premium tax credit. Why isn’t this reflected on my Form 1095-A?

Form 1095-0A reflects the advanced premium tax credit (APTC) amount that was actually paid to the health plan for your coverage during the year. This information is included in Column C of Part III. If APTC payments are not applied to your coverage, then Column C will be marked as zero.

You can complete Form 8962 (Premium Tax Credit) to determine if you can claim the premium tax credit on your income tax return. Form 8962 is used to reconcile the amount of any APTC that was applied to your coverage during the year or to claim the premium tax credit if you are eligible.

If you have questions about Form 8962 or other tax-related questions, please visit www.irs.gov or contact a tax preparer for assistance.

What if I think my Form 1095-A has errors?

To report an error on your Form 1095-A, please call the CoverME.gov Consumer Assistance Center at 1-866-636-0355 right away. CoverME.gov will review your account and send you a corrected Form 1095-A if needed. Call the CoverME.gov Consumer Assistance Center if you think your Form 1095-A has:

  • Months of coverage for you or any members of your household that are different than what you expected
  • Tax household members that are missing from the form
  • Incorrect demographic information: address, social security number, or date of birth
  • Monthly enrollment premiums and/or the monthly advance payment of premium tax credit amounts that are different than what you thought you received for one or more months
  • Reported changes that are not represented: If you reported a life event or correction to your CoverME.gov account information and it is not represented on your form, please contact CoverME.gov at the number above to find out if you need a corrected Form 1095-A.
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I received a corrected Form 1095-A. What is it?

If the ‘CORRECTED’ box at the top of Form 1095-A is checked, it means CoverME.gov has researched and corrected inaccurate enrollment information originally provided to you and to the IRS. You should use the information on the corrected form to file your tax return.

I received a voided Form 1095-A. What is it?

If the ‘VOID’ box is checked at the top of your 1095-A form, it means the 1095-A you previously received was sent in error. You shouldn’t have received a Form 1095-A for the plan listed on the original form.

What if I already filed my tax returns?

You might need to file an amended federal and Maine income tax return if:

  • You filed your tax return before you got a Form 1095-A; OR
  • You got a corrected or voided Form 1095-A but you used information from the previous Form 1095-A to file your tax return. If the ‘CORRECTED’ box at the top of Form 1095-A is marked, then this means CoverME.gov has changed the information we originally provided. If the ‘VOID’ box at the top of Form 1095-A is marked, then this means you should not have a Form 1095-A because you did not have coverage under the CoverME.gov health insurance plan for the indicated month(s) during the tax year.

If you file an amended federal return, you may also need to amend your Maine state tax return.

For more information, visit www.irs.gov and enter the keywords ‘amended return.’

How do I find more help?

CoverME.gov can answer questions about Form 1095-A, but we cannot give you tax advice or answer questions on how to file your tax return.

The IRS has developed helpful information on how the Affordable Care Act (ACA) may impact your federal tax return. Please visit www.irs.gov/aca for an extensive list of questions and answers and other resources you may find useful. You can also call the IRS at 1-800-829-1040.

If you need assistance completing your tax return, you are encouraged to consult a qualified tax preparer. The IRS has a free tax preparation help directory. Enter your zip code and search for information on free tax preparation services in your area. Please note that while the default setting on the IRS directory is to search for help within five miles of your zip code, the tool can be adjusted to search for help within up to a 100-mile radius.