Health Insurance and Your Tax Return

The IRS has added questions to its tax return to see if your health care plan provided minimum essential coverage in 2015. As of Jan. 1, 2014, most of us must have health insurance that qualifies as minimum essential coverage.* You can use the 1095 tax form to help answer questions about minimum essential coverage when filing your taxes.

Download this image if you had health insurance last year; you made need to complete the 1095 tax form

 

To learn if your plan is considered minimum essential coverage, choose the section below that describes how you enrolled in your health plan. The information below may help to determine whether your plan provided minimum essential coverage. However, please talk to your tax advisor about how these rules affect you.

I got my medical plan on the Health Insurance Marketplace.

Your plan is considered minimum essential coverage. In fact, all our medical plans that you can get on the Marketplace are minimum essential coverage.

Your plan's Summary of Benefits and Coverage (SBC) also lets you know that it provides minimum essential coverage. You’ll find this section on your SBC:

The Marketplace will send you IRS Form 1095-A to use when you file your taxes. You can also find a copy of the form by logging into your Marketplace online account .

If you have questions about the 1095-A form you received from the Marketplace, please call the Marketplace at the number shown on your form.

I enrolled in my plan directly with Blue Cross and Blue Shield of Texas (BCBSTX).

All of our individual and family major medical plans are minimum essential coverage. These include:

  • Metallic plans (Gold, Silver, Bronze plans)
  • Catastrophic plans
  • Government plans, such as Medicare Advantage
  • Grandfathered and non-grandfathered plans

Your plan's Summary of Benefits and Coverage (SBC), which you received when you enrolled in your plan, also lets you know that it provides minimum essential coverage. You'll find this section on your SBC:

In addition, BCBSTX sent you IRS Form 1095-B to use when you file your taxes. Your 1095-B form was mailed in January.

If you need additional information, contact your tax advisor or visit IRS.gov  to see what — if any — documents you may need.

Stand-alone dental plans are not minimum essential coverage.

I had coverage through my job.

Plans offered by employers can differ from company to company, so check your Summary of Benefits and Coverage (SBC). You should have received your SBC when you enrolled in your plan. You can also contact your employer’s benefits or HR department for a copy.

Your plan's Summary of Benefits and Coverage (SBC) will let you know if it provides minimum essential coverage. You'll find this section on your SBC:

In addition, BCBSTX may have sent you IRS Form 1095-B to use when you file your taxes. BCBSTX sent out forms to members of fully insured groups. If you are unsure if this applies to you, speak with your HR department or benefits advisor for more information.

If you need additional information, contact your tax advisor or visit IRS.gov  to see what — if any — documents you may need.

I didn't have insurance. What does this mean for me?

If you didn’t have minimum essential coverage in 2015, you may have to pay a penalty with your federal tax return unless you qualify for a health coverage exemption .

To ensure that you have minimum essential coverage next year, enroll in a plan during the open enrollment period. If the open enrollment period has ended, certain life events may qualify you for special enrollment. If you qualify, you can enroll in an individual plan with minimum essential coverage this year.

Still have questions? Talk with your tax advisor, visit healthcare.gov/taxes or IRS.gov/aca .

* Individuals generally have to have minimum essential coverage throughout the year to avoid a tax penalty. But there are exemptions to this requirement. Contact your tax advisor for more information about the individual mandate.

The information and content provided on this page is for informational purposes only. It is not intended, nor should it be construed as, or relied upon, as legal or tax advice. Please consult with an attorney or tax advisor to address your particular circumstance.