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Health Insurance Blog -

Tips for “reconciling” your premium tax credit on 2019 taxes

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.

Image: {How to "reconcile" your premium tax credit}

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.

Recent life change? You may qualify for a Special Enrollment Period

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.

What are the qualifying life events for Special Enrollment Period eligibility?

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.

3 routine ways to use your 2020 Marketplace coverage

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.

Woman holding sign that reads "Tips"

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.

2019 tax season is here! Here’s how to prepare

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

2019 tax forms

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 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.

Take advantage of free preventive services in 2020

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.

Image: {Magnifying glass over doctor's order}

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?

Now that you’re covered for 2020, don’t forget to pay your premium

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.

Image: {Cartooned calculator and money stack}

{% 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.

2020 Open Enrollment is over, but you may have options

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:

Image: {Woman carrying moving boxes qualifies for Special Enrollment Period}

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.

Last chance: The 2020 Open Enrollment deadline is days away!

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.

Image: {Countdown clock for Open Enrollment deadline}

Act now for coverage that starts January 1

  • First time applying at 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?

Time’s running out! Update & compare Marketplace plans by December 15

If you enrolled in Marketplace health insurance for 2019, you can renew, change, or update your plan for 2020 until Sunday, December 15, 2019. That’s less than 2 weeks away! If you miss the deadline, you may be automatically enrolled for 2020, but that’s not your best option.

Image: {Smartwatch flashing important reminder to update and compare plans}

Why update & compare for 2020 — even if you want to keep the same plan

  • New, affordable plans may be available this year. Just like people, plans and prices change every year. You may find 2020 plans with coverage and features that better meet your needs, especially if you’ve had or expect income or household changes.
  • Get the right amount of financial help for 2020. Savings are based on your expected income for 2020 (not 2019). If your information isn’t current, your premium tax credit and other savings could be wrong. This means you could end up paying more for your monthly premium or owing money on your federal taxes.
  • Sometimes you won't be automatically enrolled. You should enroll in an available plan by December 15, 2019 to be on the safe side.

How to change or renew 2020 coverage

  • Log in to update your application with your expected 2020 income and household information.
  • Compare your current plan with other available 2020 plans. If you want to keep your same plan, you should still update your information and check out all the plans available to you. If you don’t, you could miss out on savings and a plan that better meets your needs.
  • Learn more about changing and renewing coverage for 2020.

Why enroll in 2020 Marketplace coverage

You may think you don't need health insurance, that it's too expensive, or not worth the trouble. While nobody plans to get sick or hurt, bad things happen, even to healthy people. The good news is that enrolling in a 2020 Marketplace health plan may be more affordable and easier than you think. You have until December 15, 2019 to sign up. Coverage starts January 1, 2020.

Image: {Friends stand together holding signs that read "More affordable and easier"}

You may be eligible for savings

Applying can be fast & simple


NOTICE: The links and articles found on or within this news center are simply for informational purposes that we believe may be of benefit to our clients and/or website visitors. By providing these links on our website, we are not recommending or endorsing the use of the particular products or services these third parties offer. Nor does Insurance Advisors confirm, corroborate or agree to the statistics or opinions on these links and articles. We urge you to review each website’s Privacy Policy, Disclaimers, and develop an independent opinion of the service or product for any link pursued.

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