Do I Have to Have Form 1095-A Before I Can File?

Image courtesy of user stevepb on
Image courtesy of user stevepb on

Scenario: Client received insurance through a health insurance exchange and received a credit to reduce his monthly premiums. The client has not received the Form 1095-A from the exchange yet. Form 1095-A reports the amount of credits received.

The client is antsy to get his return filed and get his refund, so he calls the insurance exchange to find out when the 1095-A will be sent. The person who answered the phone at the exchange told him: 1) they’re having problems getting the forms out (this is in Iowa) and 2) “you don’t need the form before you can file; there’s a box you can check on your return.”

Question: Is item #2 correct? If you received credits through the exchange, can you file without the Form 1095-A?

Analysis: I’m not an ACA specialist, but in this case the answer is clearly “no.”

You must have the Form 1095-A before you can file because you must perform a reconciliation of the credit you received versus the credit you were entitled to.

What about the “box you can check” that the person at the insurance exchange referenced? To answer, let’s review the two ways the ACA affects individuals:

  1. The individual mandate, which requires that we all carry health insurance
  2. Premium tax credits that people might receive if they purchased insurance through an exchange.

The “checkbox” refers to a box on Line 61 of Form 1040. If you were covered by health insurance for the entire year, you can check this box to show that you met the individual mandate.

There is no such checkbox for the premium tax credit reconciliation, which is accounted for on Line 69 of Form 1040.

There are two morals:

  1. Yes, you need the Form 1095-A if you got premiums through an insurance exchange
  2. You probably won’t get good advice from the people at the exchange that you might talk to on the phone