The Health Insurance Marketplace

Premium Tax Credit: Act Now to Keep Getting Advance Payments

Due to COVID-19, IRS processing delays can affect your premium tax credit advance payments.

Self-attest now that you’ve filed a tax return to resolve previous advance payments to keep receiving premium tax credit advance payments in 2021. Log in to your marketplace account and follow the directions there to self-attest.

Particular Enrollment Period Through May 15, 2021

There is a particular enrollment period for health insurance through HealthCare.gov from now until May 15, 2021. During this time, if you don’t have health insurance, you can sign up for coverage through the Health Insurance Marketplace. You or your family members could be eligible for premium tax credit advance payments if you or your family members participate in the range via the Health Insurance Marketplace. Visit HealthCare.gov for more information.

For guidance about how to contact the federally facilitated and state-based marketplaces, see the map below.

The Health Insurance Marketplace, also known as the Health Insurance Exchange, is a website where individuals who do not have health insurance can learn about their choices and buy health insurance. There’s also information on whether you’re eligible for aid paying your premiums and lowering your out-of-pocket expenses. The Marketplace has an open enrollment period once a year.

There is a state-based Marketplace in addition to the federally-facilitated Marketplace, HealthCare.gov. The state in which you reside determines whether you use the federally-facilitated Marketplace or a state-based Marketplace. You will be asked for your ZIP code when you visit HealthCare.gov. If you live in a state-based Marketplace’s service area, you’ll be redirected to that state’s Marketplace’s website.

Health care insurance purchased through the Marketplace.

At the start of the tax filing season, you can obtain a Form 1095-A, Health Insurance Marketplace Statement, if you bought health insurance via the Marketplace. Form 1095-A contains information that will assist you in completing your federal individual income tax return. Check the full-year coverage box on your tax return if Form 1095-A indicates coverage for you and everybody in your family for the entire year. The total monthly health insurance premiums paid to the insurance provider you chose via the Marketplace are reported on Form 1095-A, among other items. It shows the amount of premium assistance you got in the form of premium tax credit advance payments made directly to your insurance provider if any were made. See our Corrected, Wrong, or Voided Forms 1095-A questions and answers to see how it affects your taxes if you got a Form 1095-A with incorrect details.

Even if you are not expected to file a federal income tax return, you must complete Form 8962, Premium Tax Credit, and file a federal income tax return if you chose to have advance payments of the premium tax credit paid directly to the insurance provider. These fees must be reconciled — or compared — to the premium tax credit you’ll calculate on your tax return. You must file a federal income tax return to accept the premium tax credit, even though you did not want to collect advance payments. If you file your return without reconciling your advance payments, your reimbursement may be deferred, and any advance credit payments will be affected. See the section below for more information on the consequences of failing to reconcile advance premium tax credit payments.

You will get a copy of Form 1095-A, Health Insurance Marketplace Statement, from your account if you bought coverage via the federally facilitated Marketplace and set up a HealthCare.gov account. Visit your Marketplace’s website to learn how to obtain a copy of your Form 1095-A via the internet. To complete your tax return, you can use either the details from your online account, if it is available, or the Form 1095-A that was mailed to you.

Failing to file tax returns will prevent advance payments in the next year.

The IRS advises taxpayers who received advance payments of the premium tax credit to file their tax returns on time to collect advance payments from their Marketplace the following year.

If you or a member of your family received advance payments of the premium tax credit and did not file a tax return reconciling those payments, you would not be eligible for future advance payments of the premium tax credit or cost-sharing reductions to help pay for your Marketplace health insurance coverage. You will be responsible for the entire cost of the monthly premiums as well as all covered programs. Also, we can contact you to request payment of any or all of the premium tax credit advance payments.

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In the fall, before the new coverage year begins, marketplaces will decide eligibility for advance tax credit payments and cost-sharing reductions for the previous coverage year. If you electronically file your tax return with Form 8962 by the due date, you will significantly increase your odds of receiving this assistance.

If you are concerned about the details on your Form 1095-A, or about getting Form 1095-A, or about a letter you got, contact your Marketplace or go to HealthCare.gov/taxes.

Marketplace Contact Information