How to Claim Your Premium Tax Credit and Other ACA Issues


It doesn’t matter how often you hear the cries for tax simplification, taxpayers and preparers alike every year are introduced to new regulations, new complexity. With the implementation of the Affordable Care Act, healthcare coverage has become the predominant issue this year. Congress passed on enforcement responsibilities to the IRS who in turn passed on policing of compliance to tax preparers. Therefore, there are new tax laws to learn and three new forms that may be required for completion of a tax return.

If you purchased healthcare coverage through the Marketplace, you will have received IRS Form 1095-A Health Insurance Marketplace Statement, which provides all the information needed to complete the new forms for your tax return.

According to a statement released February 4, by the IRS, “Form 1095-A will tell you the dates of coverage, total amount of the monthly premiums for your insurance plan, information you may use to determine the amount of your premium tax credit, and any amounts of advance payments of the premium tax credit.”

You may receive more than one Form 1095-A if different members of your household had different health plans or if you changed or updated your coverage during the year.

Using the information provided on the Form 1095-A, you can reconcile advance payments and claim a tax credit for premiums paid on IRS Form 8962 Premium Tax Credit (PTC), which will be filed with your income tax return.

If you haven’t yet received Form 1095-A and you had purchased health care coverage last year from the Marketplace, contact them immediately to get the form. Or if you think any information is incorrect on the form you did receive, contact the Marketplace for a corrected Form 1095-A.

If for any reason you did not have health care coverage last year, you will be required to pay a penalty based on your income level and beginning at $95.  However, you may enjoy an exemption based on your particular circumstances. To claim the exemption, you will be required to file IRS Form 8965 Health Coverage Exemptions.

Exemptions can be enjoyed for a variety of reasons from having income below the poverty level to being covered by Medicaid to other hardship issues. In fact, there are a total of 18 qualifying exemptions. Check out page 2 of the Instructions for Form 8965 to see a listing of the qualifying exemptions.

If your exemption is based on poverty or for another reason granted by the Marketplace, you will be required to list the Certificate number of the exemption issued to you by the Marketplace on Form 8965. This number will have been issued to you at the time you applied for coverage. If you  don’t have the certificate number, contact the Marketplace to acquire it.