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pferris9
Level 2
February 27, 2023
Solved

Question About 1095-A

  • February 27, 2023
  • 9 replies
  • 45 views

I am retired.  My income is SS and my healthcare is Medicare. 

My wife is still working (2 days a week).  So she's had to provide her own healthcare benefits (Marketplace - aka Obama Care).  I just entered a 1095-A for my wife. I watched my Federal taxes go from a $1145 refund to a $4,514 PAYMENT to the IRS immediately after entering all the 1095-A data!  I am stunned!  What caused this and how can I prevent it this year (already near the end of Q1!).   Once I saw that, I stopped dead in my tracks.  This is CRAZY!  

 

Any and all help appreciated!

Pete

    Best answer by CatinaT1

    Is your wife on Medicare? You can not have a Marketplace Plan if you have Medicare.

     

    When you enroll in a Marketplace plan, you estimate your household income for the year. This determines the amount of Advanced Premium Tax Credit you are eligible for. When you file your tax return, your Actual Premium Tax Credit is calculated on your Actual household income for the year.

     

    If you underestimated your household income for the year and received too much Advanced Premium Tax Credit, you must pay back any overpayment you received.

     

    That sounds like what happened. Do you know what you estimated your income for the year to be when you applied for coverage compared to what it actually was?

    9 replies

    CatinaT1
    CatinaT1Answer
    Level 15
    February 27, 2023

    Is your wife on Medicare? You can not have a Marketplace Plan if you have Medicare.

     

    When you enroll in a Marketplace plan, you estimate your household income for the year. This determines the amount of Advanced Premium Tax Credit you are eligible for. When you file your tax return, your Actual Premium Tax Credit is calculated on your Actual household income for the year.

     

    If you underestimated your household income for the year and received too much Advanced Premium Tax Credit, you must pay back any overpayment you received.

     

    That sounds like what happened. Do you know what you estimated your income for the year to be when you applied for coverage compared to what it actually was?

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    pferris9
    pferris9Author
    Level 2
    February 27, 2023

    Hi @CatinaT1 ,

     

    I am on Medicare, my wife is not.  I am retired, my wife is not. We usually file jointly.

    I appreciate your answer, I truly do.  Unfortunately my wife isn't home at the moment to ask what she stated when she applied. 

     

    I'm just stunned.  She had very few medical claims, etc.  

     

    Thanks so much for answering.  I'm not sure how to proceed. 

     

    Thanks again, @CatinaT1 

     

    Pete

    JohnB5677
    Level 15
    February 27, 2023

    @pferris9 Please go back and look at what was posted to the 1095-A.  Column C is the Advanced Credit Premiums.  It would have to be at least $600 a month to make that large a difference in your refund.  If column C is that large you would have to check with your wife to see if she included you in the total household income.  If Column C is not that big, I think something different is happening.

     

    If at the end of the year you've taken more premium tax credit in advance than you're due based on your final income, you'll have to pay back the excess when you file your federal tax return. If you've taken less than you qualify for, you'll get the difference back.

     

     

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    pferris9
    pferris9Author
    Level 2
    February 27, 2023

    Correction: The amount TT says I owe is $5465!!  

    Can anyone explain why / how entering ACA data (1095-A) can take you from a >$1K refund to a >$5K deficit owed?!  I'm totally confused.  How do I avoid this for next year? 

    I'm going crazy with this.  I'm retired and don't just have $5K in my pocket. 

    Thanks for all / any help!

    Pete

    Mike9241
    Level 15
    Level 15
    February 27, 2023

    You can get ObamaCare as a secondary insurance, but you can't get tax credits on it. Generally holding more than one comprehensive insurance plan makes no sense. However, there are exceptions to this rule (such as when both spouses have an employer plan, when a person holds Medicaid and Medicare, or when a person holds multiple parts of Medicare).   so basically all those premium tax credits she got have to be repaid

     did her marketplace insurance cover you because it is very easy to err when entering the 1095-A. also if your household income line 3 of 8962 is more than about $70,000 you are not entitled to any credits.  we can't see your return so you'll need to review the form.

     

    Mike9241