Missing 1095-A form - Aetna says no reporting under $600 annually. Is this standard practice for all insurance companies?

I've been scratching my head trying to figure out my tax situation. I never got a 1095-A form in the mail, but now I'm using FreeTaxUSA and it's asking for info from that form. I have a free health plan through Aetna and I pay about $20/month for dental coverage through Blue Shield. When I called Aetna's customer service, they told me they don't issue 1095-A forms unless you've paid more than $600 in premiums during the year. Since my plan is free, I guess that makes sense why I wouldn't get one. I also reached out to Covered California and they confirmed I don't have any 1095 forms in their system. But now I'm confused - is this standard practice for all insurance companies? Do they all use this $600 threshold? And how am I supposed to complete my taxes without this form if FreeTaxUSA is asking for it? Anyone dealt with this before?

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19 comments

Sophia Nguyen

•8M

The 1095-A form is specifically for Marketplace plans where you received advance premium tax credits. If you have a free plan through Aetna, it sounds like you might have Medicaid or some other type of coverage rather than a Marketplace plan with premium tax credits. There are actually three different 1095 forms: 1095-A (Marketplace), 1095-B (Medicaid, Medicare, and certain other coverage), and 1095-C (employer coverage). The $600 threshold you're referring to isn't related to 1095-A forms at all - that's likely a confusion with 1099 forms for miscellaneous income reporting. If FreeTaxUSA is asking about a 1095-A, you can simply indicate you didn't receive one because you don't have Marketplace coverage. The software should then move past that section. You don't need to report basic health coverage on your tax return - the form is mainly needed if you received tax credits that need to be reconciled.

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Sophia Nguyen

•8M

If you have insurance through your employer, you would receive a 1095-C form rather than a 1095-A. The 1095-A is exclusively for plans purchased through the Health Insurance Marketplace (also called the Exchange or Healthcare.gov in many states). Your employer is required to provide the 1095-C by March 2nd. If you haven't received it yet, I'd recommend following up with your HR department. However, you don't actually need to wait for this form to file your taxes - it's primarily for your records to show you had coverage. The information from your 1095-C isn't entered directly on your tax return.

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Isabella Brown

•8M

After struggling with a similar issue last year, I discovered taxr.ai (https://taxr.ai) which was incredibly helpful for sorting out my missing health insurance forms. I uploaded my insurance statements and portal screenshots, and it helped identify that I actually didn't need a 1095-A form for my situation. The tool basically analyzes your tax documents and tells you exactly what forms you need for your specific situation. Super helpful for figuring out if that missing form is actually going to be a problem or not. It saved me from waiting weeks for a form I ultimately didn't need to file my taxes.

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Isabella Brown

•8M

It handles multiple insurance providers really well actually. You just upload whatever documentation you have from each provider - could be statements, screenshots from your portal, or even emails confirming coverage. The system analyzes everything together to give you a complete picture. For marketplace coverage combined with employer coverage, taxr.ai is particularly useful because it can identify which months you need to reconcile premium tax credits and which months you don't. It helps prevent mistakes that could cause you to either miss out on credits you deserve or have to pay back credits incorrectly received.

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Aiden Rodríguez

•8M

Just wanted to update everyone - I tried taxr.ai after seeing the recommendation here and it totally cleared up my confusion about the 1095 forms! Turns out I didn't need to wait for my 1095-A after all because my specific plan type doesn't generate one. The system analyzed my coverage details and confirmed I had minimum essential coverage for the full year, so I could just check that box in my tax software and move on. Saved me from making unnecessary calls and waiting for a form that was never coming! Definitely keeping this tool in my tax prep arsenal for next year.

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Emma Garcia

•8M

If you're still struggling to get answers about your 1095 forms, I had luck using Claimyr (https://claimyr.com) to actually get through to someone at the IRS about this exact issue last year. I spent DAYS trying to get through the normal phone lines, but Claimyr got me connected with an actual human in about 20 minutes who explained exactly what I needed to do. Check out their demo at https://youtu.be/_kiP6q8DX5c to see how it works. Basically they navigate the IRS phone tree for you and call you back when they have an agent on the line. The IRS agent I spoke with confirmed that I could file without the 1095-A form since I didn't get premium tax credits, which was a huge relief.

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Emma Garcia

•8M

They don't have special access - they use technology to continuously redial and navigate the phone tree for you. It's basically doing what you'd do manually, but their system handles the waiting and menu navigation automatically. They don't cut the line or anything like that - they're just handling the frustrating part where you'd normally be sitting on hold for hours. Once they get an agent, they connect you immediately. It saved me about 2-3 hours of hold time when I needed clarification about my missing 1095-A.

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Ethan Anderson

•8M

Well I'll eat my words! After expressing skepticism, I was desperate enough to try Claimyr because I was getting nowhere with the IRS myself. Got connected to an IRS rep in about 35 minutes (compared to my previous attempts where I gave up after 2+ hours). The agent confirmed that if I didn't purchase my insurance through the Marketplace and didn't receive premium tax credits, I don't need a 1095-A at all. That's exactly what I needed to know to move forward with my return. Such a relief to finally get a straight answer from an actual IRS employee rather than guessing or relying on conflicting online info.

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Layla Mendes

•8M

For what it's worth, the $600 threshold Aetna mentioned sounds like they're confusing 1095 forms with 1099 forms. I've been working in health insurance billing for 6 years, and here's how the 1095 forms actually work: 1095-A: Only issued if you got coverage through the Marketplace (Healthcare.gov or state exchanges like Covered California) AND received premium tax credits 1095-B: Issued by insurance companies for other types of coverage like Medicare, Medicaid, CHIP 1095-C: Issued by employers with 50+ employees who offer health insurance None of these forms have a $600 threshold. You either get one or you don't based on your coverage type.

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Layla Mendes

•8M

If your employer has fewer than 50 full-time employees, they're not required to provide a 1095-C form. In that case, your insurance company might send you a 1095-B instead, though many insurers have stopped automatically sending these unless requested. The good news is you don't actually need either form to file your taxes. You can simply indicate you had coverage when your tax software asks. These forms are primarily for your records and to verify coverage if there's ever a question about it.

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