Understanding Advanced Premium Tax Credits (APTCs) and Reconciling Your 1095-A for ACA Health Insurance

Receiving a 1095-A form can raise concerns, especially if you notice unexpected premium amounts or tax credits. This blog will guide you through understanding Advanced Premium Tax Credits (APTCs), the 1095-A form, and how to address discrepancies.

Advanced Premium Tax Credits (APTCs):

APTCs are subsidies provided by the Affordable Care Act (ACA) to help low- and moderate-income individuals and families afford health insurance premiums. These credits are available through the Health Insurance Marketplace (also known as the Exchange).

The 1095-A Form:

The 1095-A form is a tax document issued by health insurance companies to individuals who enrolled in health coverage through the Marketplace. This form provides information about your health insurance plan, premiums, and any APTCs you received.

Reconciling Your 1095-A:

If you received a 1095-A, you need to reconcile it with your tax return. The 1095-A will show the total amount of APTCs you received during the year, which affects your tax liability.

Discrepancies on Your 1095-A:

If you notice any discrepancies between the information on your 1095-A and what you expected, there are a few possible reasons:

Incorrect income information: When you apply for health insurance through the Marketplace, you provide an estimate of your income. If your actual income is different than what you estimated, it can affect the amount of APTCs you receive.
Changes in coverage: If you made changes to your health insurance plan during the year (e.g., changing plans or terminating coverage), the information on your 1095-A may not accurately reflect your entire coverage.
Other factors: There may be other factors that can affect the amount of APTCs you receive, such as your family size and household income.

Resolving Discrepancies:

If you believe there is a discrepancy on your 1095-A, you should contact your health insurance company or the Marketplace. They can help you review your coverage and determine if there are any errors.

Seeking Professional Help:

If you are having difficulty reconciling your 1095-A or resolving discrepancies, it is recommended that you seek assistance from a licensed health insurance agent or tax professional. They can guide you through the process and ensure that your tax return is accurate.

Conclusion:

Understanding APTCs and reconciling your 1095-A are important steps in filing your taxes accurately. If you have any questions or concerns, do not hesitate to reach out to your health insurance company, the Marketplace, or a licensed professional for assistance. By being informed and proactive, you can ensure that you receive the benefits you are eligible for and avoid any unnecessary tax penalties.