Question: Hi do I have to file a 1095-A when my exemption code is D?
— Chaim in New York
Mandi Woodruff, Executive Editor of MagnifyMoney, responds…
First, let’s talk about the form you mentioned, Form 1095-A[1]. Health insurance marketplaces issue Form 1095-A. They send one copy of the form to the IRS. The agency uses it to provide information about the people who purchase qualified health coverage through the marketplace. Another copy goes to the individuals who enroll in those plans to help them prepare their tax returns.
So to answer your question, no. You don’t have to file Form 1095-A – because individuals don’t prepare that form. The marketplace will only issue it. However, if you purchased health insurance through a marketplace during any month of the year, you should receive Form 1095-A from the marketplace. And you may need to include it with your tax return.
From your question, it sounds like you might be confusing Form 1095-A with Form 8965[2]. Form 8965 is used to report an exemption to the minimum essential coverage requirement. It’s also used to calculate a penalty if you didn’t qualify for an exemption.
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Some people may need to include both Form 1095-A and Form 8965 with their tax return. This would apply if you were covered by insurance purchased through a marketplace for part of the year and qualified for an exemption during other months of the year. If that’s the case, you still won’t need to prepare Form 1095-A. You’ll just receive it from the marketplace and attach a copy to your return. Then you’ll follow the instructions for Form 8965 to report your exemption.
An educated guess
Chaim, it sounds like you’re dealing with the Affordable Care Act’s requirement to maintain minimum essential health care coverage, and you might be confusing a few of the tax forms created to deal with the ACA’s requirements. There are a lot of them, so your confusion is understandable.
Let’s back up and explain the minimum essential health care coverage requirement.
Starting in 2014 and continuing through the 2018 tax year, the ACA penalized individuals who weren’t covered by health care coverage for every month of the year. Individuals could avoid a penalty by being covered by health insurance through work, buying a health insurance policy directly from an insurance company, applying for coverage through a Health Insurance Marketplace (either the federally-facilitated HealthCare.gov[3] or a state-based marketplace), or having coverage through a government-sponsored program such as Medicare or Medicaid.
If you didn’t have minimum essential coverage for those years, you could avoid a penalty by qualifying for an exemption. There are several possible exemptions, but it sounds like the one you’re using is Exemption D – which means you’re a member of a health care sharing ministry.
A health care sharing ministry is an alternative to health insurance. Its members typically share ethical or religious beliefs. They make monthly payments to help cover the health care expenses of other members. You could claim an exemption to the minimum essential coverage mandate for any month in which you or the other members of your household were a member of a health care sharing ministry for at least one day of that month.
To qualify, the ministry (or a predecessor) must have been in existence and sharing medical expenses continuously and without interruption since December 31, 1999. If you’re not sure whether your ministry qualifies, you can contact the ministry for more information.
The good news
A lot of the confusion over minimum essential coverage will go away when you file your tax return next year. The Tax Cuts and Jobs Act of 2017 eliminated the individual mandate starting in 2019.
