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leftyseth
Level 1

Do I need to adjust my SLCSP on 1095a If I had a 1095b for 1 month?

Hello,

I have a question about reconciling my ptc on form 8962.  My wife and I were covered for 12months under a marketplace plan which I paid the premiums for.  If I enter the 3 columns as printed on the 1095a I am due a $300 credit.  

 

My wife was sent a 1095B from Medicaid where she had mec for pregnancy for 1 month in Jan.  We thought it had ended in Dec 2018 but turns out she had it in January of 19.

 

How can I adjust the SLCP to pay back the difference in the credit for the 1 month she had MEC and Market place coverage?

1 Best answer

Accepted Solutions
DavidS127
Expert Alumni

Do I need to adjust my SLCSP on 1095a If I had a 1095b for 1 month?

You will need to report the 1095-A exactly as it is shown on the Form 1095-A you received, unless you receive a corrected one from the marketplace insurer.  In your case, the marketplace insurer provided a policy and received a payment from the government (advance premium credit) for that month.  So, even though one or both of you may have technically been ineligible for coverage that month, coverage was provided by the marketplace in January and it may be difficult or impossible to obtain any kind of refund/corrected 1095-A.

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4 Replies
DavidS127
Expert Alumni

Do I need to adjust my SLCSP on 1095a If I had a 1095b for 1 month?

You will need to report the 1095-A exactly as it is shown on the Form 1095-A you received, unless you receive a corrected one from the marketplace insurer.  In your case, the marketplace insurer provided a policy and received a payment from the government (advance premium credit) for that month.  So, even though one or both of you may have technically been ineligible for coverage that month, coverage was provided by the marketplace in January and it may be difficult or impossible to obtain any kind of refund/corrected 1095-A.

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leftyseth
Level 1

Do I need to adjust my SLCSP on 1095a If I had a 1095b for 1 month?

 
leftyseth
Level 1

Do I need to adjust my SLCSP on 1095a If I had a 1095b for 1 month?

David,

Thank you for the reply. I don't mean to be redundant but for clarification, if I input the 1095a exactly as it is I will get a 300 credit ( I didn't use the full amount per month). 

Shouldn't I have to pay back the month that she wasn't eligible?  Or I just need to be done with it and input as is and they will notify my later to pay it back?

If i use this tool https://www.healthcare.gov/tax-tool/#/premium-tax-credit

it shows what the slcsp should have been and I would owe 600.  Or does this tool not pertain to my situation and i shouldn't edit the information from the 1095a?

 

Thank you for your help!

JohnW222
Expert Alumni

Do I need to adjust my SLCSP on 1095a If I had a 1095b for 1 month?

If you believe that your Form 1095-A should be updated, you should contact the Marketplace Call Center.  Please see HealthCare.gov’s How to use Form 1095-A page for guidance.

But, as DavidS127 notes above, it may be difficult or impossible to get a corrected Form 1095-A. 

The IRS will make its own computation based on Marketplace data.  You’ll receive a notice if the IRS changes your figures.

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