News Center

If anyone in your household had Marketplace health insurance in 2019, you should have already received Form 1095-A, Health Insurance Marketplace Statement, in the mail. Here are 5 important things to know about this form.

Helpful tips about tax Form 1095-A:

• You should already have Form 1095-A. It comes from the Marketplace, not the IRS. If your form didn’t come by mail or you can’t find it, check your online Marketplace account before contacting the Marketplace Call Center.
• Store it in a safe space with other important tax information, like W-2 forms. This way, you can easily find it when you sit down to file.
• Before doing anything with the form, make sure it’s accurate. Check basic coverage and household member information, and confirm the premium for your second lowest cost Silver plan (SLCSP). Contact the Marketplace Call Center to report any errors.
• If you request a new, updated form, it’s important that you don’t file until we send you the correct version. If you already filed, you may need to file an amended return using the information from your new 1095-A.
• You’ll use the information from your 1095-A to “reconcile” your premium tax credit. To do this, you’ll compare the amount of premium tax credit you used in advance during the year against the premium tax credit you actually qualify for based on your final income for the year. Any difference will affect your refund or tax owed. See a step-by-step guide to “reconciling” your premium tax credit.

{% box %} Coronavirus.gov is the source for the latest information about COVID-19 prevention, symptoms, and answers to common questions.

USA.gov has the latest information about what the U.S. Government is doing in response to COVID-19. {% endbox %}

You may be hearing about the coronavirus (officially called 2019-novel coronavirus or COVID-19) in the news. Currently, the rules in your Marketplace health plan for treatment for COVID-19, remain the same as for the treatment of any other viral infection. Check with your health insurance company for their specific benefits and coverage policy. Here are some other things to know about how your Marketplace health plan works when it comes to coronavirus:

Understanding your coverage

• Lab and other services: Individual and small group market issuers are generally required to include laboratory services as a category of Essential Health Benefits. Coverage for a specific diagnostic or laboratory service can vary by plan, so check with your health insurance company about their coverage for lab tests and related services for diagnosis and treatment of COVID-19. Standard cost sharing may apply. This is also true for your health plan’s coverage for physician and hospital services related to the diagnosis and treatment of COVID-19.
• Telehealth: Telehealth services or home health visits may already be covered by many health insurance companies. You should check with your health insurance company to determine whether these services are covered and what you’ll pay.
• Enrolling in coverage: If you aren’t currently enrolled in coverage, you can see if you qualify for a Special Enrollment Period. As a reminder, federal law and regulations provide protections against pre-existing condition exclusions in health insurance coverage. If you are eligible, health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Marketplace plans can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.

For more information about the Coronavirus, please visit: coronavirus.gov

You have until April 15, 2020 to file your 2019 federal income tax return. If you had a Marketplace plan in 2019 and used advance payments of the premium tax credit (APTC) to lower your monthly payment, you’ll have to "reconcile" your tax return.

Through “reconciling,” you’ll find out if there's any difference between the premium tax credit you used and the amount you qualify for. Any difference between the two figures will affect your refund or tax owed.

How to "reconcile" your premium tax credit on 2019 taxes:

1. Find your Form 1095-A, and verify its accuracy. If you didn’t get one, check your online Marketplace account. If it’s not there, try the Call Center. See how to be sure the information is correct.
2. Print Form 8962 (PDF, 112 KB) and instructions (PDF, 356 KB).
3. Use the information from your 1095-A form to complete Part II of Form 8962. Refer to this table as a guide.

Get more information on 2019 health coverage and your federal taxes.

Now that Open Enrollment is over, you can enroll in or change Marketplace coverage only if you have a life event, like getting married, having a baby, or losing health coverage, that qualifies you for a Special Enrollment Period.

Does my life event make me eligible for a Special Enrollment Period?

There are 4 basic types of qualifying life events:

• Loss of health coverage: Losing job-based coverage (whether through yourself or a family member) or eligibility for Medicaid, Medicare, or the Children’s Health Insurance Program (CHIP)
• Household changes: Marriage, child birth or adoption, divorce, or death
• Residence changes: Certain household moves, like moving to a new ZIP code or county
• Other qualifying events (like income changes): Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP), leaving incarceration, etc.

See the full list of life events.

How do I apply for 2020 coverage through a Special Enrollment Period?

• If you qualify for a Special Enrollment Period, create an account or log into an existing one to enroll in a plan for 2020.
• You may be asked to submit documents to confirm the life event that makes you eligible.

Not sure your life event counts as a Special Enrollment Period? Just answer a few quick questions to find out.

Health coverage pays for provider services, prescriptions, hospital care, and special equipment when you're sick. It's also important when you're not sick. Now that you're enrolled in a health plan for 2020, here's how you can use your new coverage throughout the year no matter your situation.

Understanding & using your new coverage

• Preventive health: Most coverage includes immunizations for children and adults, annual visits for women and seniors, obesity screening and counseling for people of all ages, and more for free.
• Prescriptions: Health plans will help pay the cost of certain prescriptions. You may be able to buy other medications, but those on your plan's "formulary" (approved list) usually will be less expensive. To find out which prescriptions are covered through your new Marketplace plan, visit your insurer's website, call them directly, or check your Summary of Benefits and Coverage.
• Regular & emergency care: Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan. While you may be able to see doctors who don’t contract with your plan, visiting an "in-network" provider usually means you'll have lower out-of-pocket costs. But in an emergency, get care from the closest hospital that can help you.

Learn more about using your insurance coverage.

Attention: 2019 tax filing season has started. Here’s what you can do now to get ready.

3 steps to get ready for 2019 tax filing:

1. Look for Form 1095-A.

   • If you or anyone in your household had a 2019 Marketplace plan, you’ll get Form 1095-A, Health Insurance Marketplace Statement in the mail by early February. It comes from the Marketplace, not the IRS.
   • It may also be available online in your HealthCare.gov account.

2. Check Form 1095-A for accuracy.

   • You’ll use Form 1095-A to "reconcile" your premium tax credit if you used advanced payments of the premium tax credit to lower your monthly premium payment, so it’s important the information on it is correct. If you file with an incorrect version, you may need to file an amended return later.
   • Confirm things like your coverage and household information, monthly enrollment premium, and “second lowest cost Silver Plan” (SLCSP).
   • If you find errors, contact the Marketplace Call Center. We’ll send you an updated copy. Wait to file until you have it.

3. Use your correct 1095-A to “reconcile.”

   • Now that you have an accurate 1095-A and second lowest cost Silver plan premium, you’re ready to fill out Form 8962, Premium Tax Credit.
   • See this step-by-step guide to reconciling for next steps.

With Marketplace coverage, you have access to free preventive services, like flu shots, check-ups, and screening tests. Getting these recommended services is an important step toward good health and well-being.

What are preventive services?

• Preventive services are routine health care procedures, like screenings, check-ups, and counseling to prevent illnesses, disease, and other health problems.
• Taking advantage of these free services can help detect illness early, when treatment is likely to work best, so talk to your provider about what’s right for you.
• Note: Preventive services are free only when provided by a doctor or other provider in your plan’s network. (A network is the facilities, providers, and suppliers your health insurer has contracted with to provide health care services. Contact your insurance company to see which providers are “in-network.”)

Where can I learn more?

• Get more information on preventive and wellness services, including chronic disease management.
• See specific lists of preventive services for adults, women, and children.

Congratulations on your enrollment in a 2020 Marketplace plan! Now that you’re covered, don’t forget to pay your monthly premium to your health insurance company (not the Marketplace) to activate your coverage. Your coverage won’t start until you do.

{% box %}Important: Continue to pay all monthly premiums on time

If you don’t, your insurance company could end your coverage.{% endbox %}

Can I pay my premium online?

It depends. Each insurance company handles premium payments differently, so follow your plan’s instructions carefully. If you have the option to pay online, follow these steps:

1. Log into your Marketplace account.
2. Choose your application under "Your Existing Applications."
3. Click the blue button "Pay Your First Health Insurance Monthly Premium."
4. Choose the green button "Pay for Health Plan Now" to go to your insurance company’s website to pay.

Not sure you’ve paid?

• Find out if your health insurance is active by checking your online Marketplace account.
• If you think you're enrolled but have questions about your plan, contact your insurance company. You can also check your plan materials. Your plan should send you a membership package with enrollment materials and a health insurance card.

Marketplace Open Enrollment for 2020 coverage ended December 15. If you missed the deadline, you may still be able to get or change 2020 coverage two ways:

With a Special Enrollment Period

• Since the 2020 Open Enrollment Period is over, you can now enroll in or change a Health Insurance Marketplace plan only if you have a life event that qualifies you for a Special Enrollment Period.
• A change in your situation, like getting married, having a baby, or losing health coverage, may make you eligible.
• Answer a few questions to see if you may qualify.

Through Medicaid or the Children’s Health Insurance Program (CHIP)

• Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
• You can apply for either program any time, all year. If you qualify, you can enroll immediately.
• Select the second button and answer a few questions to see if you may qualify.

Learn more about your health insurance options outside Open Enrollment.

Time’s running out for 2020 Marketplace insurance! Open Enrollment for 2020 Marketplace insurance ends Sunday, December 15. This means you have only 3 days to enroll in, re-enroll in, or change a 2020 Marketplace plan.

Act now for coverage that starts January 1

• First time applying at HealthCare.gov? Create an account.
• Have 2019 Marketplace coverage? Log in to update your application and compare plans for 2020. If you don’t, you could miss out on new plans, and any savings could be wrong. This means you could end up paying more for your monthly premium or owing money on your federal taxes.

Need enrollment help?

• See tips on choosing the best plan for you.
• Get help logging in.
• Connect in person with someone in your community.