Form 1095-A with zero monthly advance payments of premium tax credit

[mdaddycpa82]

Hi All!

I have a client on disability who received form 1095-A with zeros in the Column C of Form 1095-A, which evidently means the client was paying the full price of her monthly health insurance premiums through the marketplace, which doesn't make sense of course with her only income being that of disability. But the question here is when inputting form 1095-A showing the reported zeroes in Column C, Form 8962 is not even being generated or calculating any premium tax credit due to the taxpayer. Am I missing something in the rules here??? If I literally put $1 in just one month, then it kicks in the calculation and then shows the taxpayer being owed the credit. Any direction would be appreciated! Thank you!

[Skylane]

I agree it sounds odd. If you don’t get a more definitive answer, I’d go with the $1 and see if accepted or rejected, telling TP you’re going to try to get some of her Obamacare bucks back. No promises. I have seen cases where the 1095a was just wrong. @TaxGuyBill  is pretty good with Obamacare

[TaxGuyBill]

Look at line 5 of the 8962.  Is it under 100%?

On a side note, your client should look into if she qualifies for Medicaid or Medicare.

[10409000]

That can happen where they dont get any advance tax premium credits to reduce the monthly bill when they report something to covered ca and then they have to refer it to medical it kicks them out of receiving any credits till they contact medical. 

[mdaddycpa82]

Yep...it's at 83%. I agree on your comment regarding Medicaid/Medicare! I'm not sure how upon applying on the marketplace it didn't get kicked to the medical assistance program in our state.

Thanks for your response, much appreciated!

[TaxGuyBill]

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@mdaddycpa82 wrote:

Yep...it's at 83%

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The general rule is they don't qualify for the credit if they are under 100%.  So it seems like they don't qualify.

There are a few exceptions to that rule, one of which includes receiving Advance credit because the Marketplace thought they would qualify.  That is why when you enter $1 as Advance credit it triggers the calculation  ... because they meet that exception to the usual rule.  But with no Advance credit, they don't qualify for that exception.

[mdaddycpa82]

Thank you....I'm thinking if I can't get a more definitive answer, I'm going to try the workaround and stick the $1 in for December and see if we can get it through! Can't recall coming across this scenario in the past, where a taxpayer fully qualifies for advanced premium tax credit based on income and gets ZERO of it, and now obviously should be entitled for full reimbursement of premiums paid if you will.

[TaxGuyBill]

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@mdaddycpa82 wrote:

where a taxpayer fully qualifies for advanced premium tax credit based on income and gets ZERO of it, and now obviously should be entitled for full reimbursement of premiums paid if you will.

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I know you were typing this before I responded, but they don't qualify because they are under 100%.

[mdaddycpa82]

Ughh...and that was the rule I was failing to recognize here. Thank you, unfortunately it makes sense now!

[Hillenburg]

I just had a client who had all zero's in column B & C.  (of course column B will always have a value )  Client called the marketplace and the "professional" he talked with said " the 1095A is correct." I convinced him to call back and talk with a different "professional".  He got the numbers over the phone.  Of course issuing a correct 1095A was too much trouble.  12 years and the marketplace is still a joke.

[qbteachmt]

"(of course column B will always have a value )"

Because, if it is 0, you look it up on the marketplace and fill that in manually. SLCSP:

https://www.healthcare.gov/glossary/second-lowest-cost-silver-plan-slcsp/