Do I Need Proof of Health Insurance for Taxes?

For your federal return, you generally do not need proof of health insurance for taxes: the federal penalty for going without coverage has been $0 since the 2019 tax year and remains at zero for 2026.¹ Two situations change that answer. If you got advance premium tax credits through the Health Insurance Marketplace, you need Form 1095-A to reconcile those credits on your return. And if you live in California, Massachusetts, New Jersey, Rhode Island, or the District of Columbia, you need to document coverage on your state return or pay a state-level penalty.

Federal Filing: What Still Matters

You are technically still required by law to maintain minimum essential coverage, but there is no federal dollar consequence for not having it. You do not attach any Form 1095 to your federal return, and the IRS has said taxpayers should not wait for Form 1095-B or 1095-C to file. Insurance cards, explanation of benefits statements, or payroll records showing insurance deductions are enough backup if you ever need to show you were covered.²

The one federal exception is Marketplace coverage with financial help. If any advance premium tax credit was paid on your behalf, you have real filing obligations tied to that coverage, and the penalty for ignoring them is not zero. More on that below.

States That Still Penalize Being Uninsured

Five states and D.C. run their own individual mandates. If you file a state return in any of them, you have to indicate your coverage status, and lacking coverage triggers a penalty unless you qualify for an exemption. Vermont has a mandate on its books but no financial penalty attached. Everywhere else, state law does not penalize you for being uninsured.

California: $950 per uninsured adult and $475 per uninsured child, or 2.5% of household income above the filing threshold, whichever is greater.
New Jersey: $695 per adult and $347.50 per child (capped at $2,085 per family), or 2.5% of household income, whichever is greater.
District of Columbia: $745 per adult and $372.50 per child (capped at $2,235 per family), or 2.5% of household income above the filing threshold.
Rhode Island: Calculated the way the original federal penalty was under Section 5000A of the Internal Revenue Code as it stood on December 15, 2017, but capped using the statewide average bronze-plan premium instead of the national average.
Massachusetts: Tied to the state’s affordability schedule, so the amount depends on your age, income, and the cost of plans available to you.

Every mandate state offers exemptions: affordability (for example, California waives the penalty for 2026 if the cheapest available plan would cost more than 8.05% of household income), a short coverage gap of three consecutive months or less, income below the state filing threshold, hardship categories like eviction or bankruptcy, religious conscience, tribal membership, and incarceration. Some exemptions you claim on the state return itself; others require an application through the state exchange before filing. Check your state’s process well before April, because waiting until you file to discover you needed a pre-approved certificate is a common mistake.

The 1095 Forms and Which One You Need in Hand

Three IRS forms document coverage, and they arrive from different sources.

Form 1095-A (Health Insurance Marketplace Statement) comes from the federal or state exchange if anyone in your household enrolled in Marketplace coverage. It must be furnished by January 31.³ This is the one you actually need to complete your return, because it drives the premium tax credit calculation. If yours has not arrived, log in to your Marketplace account, open the prior year’s application, and download it from the Tax Forms section.⁴

Form 1095-B (Health Coverage) comes from insurance companies, Medicaid, or other coverage providers, confirming you had minimum essential coverage.

Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) comes from employers with 50 or more full-time employees, showing what coverage was offered and whether you enrolled.

You do not need 1095-B or 1095-C in hand to file, and you should not attach any 1095 to your return. The IRS receives copies directly from the issuers.

What to Do If a 1095 Is Wrong

If you spot a mistake on Form 1095-A, such as a wrong Social Security number, incorrect months of coverage, or a misspelled name, contact your Marketplace and request a corrected version. Your Marketplace account may already show a form labeled “Corrected,” which supersedes the earlier one.⁴

For Form 1095-B, your insurance provider files a corrected version with the IRS and sends you an updated copy marked “CORRECTED.”⁵ Contact your insurer or employer directly if coverage dates or personal information look wrong. If you already filed and the corrected form changes your return, you may need to amend.

Reconciling Marketplace Subsidies on Form 8962

This is where the real federal tax consequences live. If the government paid part of your premiums in advance based on your estimated income, you file Form 8962 to compare those advance payments to the credit you actually qualify for based on your final income. Form 1095-A supplies the numbers.⁶

If your income came in lower than estimated, you may get additional credit as part of your refund. If it came in higher, you received more subsidy than you were entitled to and you owe the difference back.

A significant change takes effect for the 2026 tax year: the repayment caps that used to limit how much excess advance credit you had to pay back have been eliminated. In earlier years, taxpayers with income below 400% of the federal poverty line had repayment capped at amounts ranging from $350 to $3,000 depending on income and filing status. Starting in 2026, you repay the full excess regardless of income.⁷ A significant mid-year income increase you didn’t report to the Marketplace can now produce a large bill at tax time.

Two filing rules go with this:

You must file a federal return and attach Form 8962 if advance payments were made on your behalf, even if your income falls below the normal filing threshold.⁸
If you file without Form 8962, the IRS will not process your refund until you provide it, and you lose eligibility for advance premium tax credits and cost-sharing reductions the following year.⁹

With no cap in 2026, the practical way to limit your exposure is to report income changes to the Marketplace when they happen so your advance payments adjust in real time.

Self-Employed Health Insurance Deduction

Self-employment intersects with health insurance in one more way. You can deduct premiums for medical, dental, vision, and qualifying long-term care insurance for yourself, your spouse, your dependents, and your children under age 27, even if those children are not your tax dependents. The deduction goes on Schedule 1 of Form 1040, so you get it whether or not you itemize.¹⁰

To qualify, you need net self-employment income from a Schedule C business, a farm on Schedule F, a partnership reported on Schedule K-1, or wages from an S corporation in which you own more than 2%. The plan must be established under your business. And the deduction is unavailable for any month you were eligible to participate in a subsidized plan through your own employer, your spouse’s employer, or a parent’s employer if you’re a dependent.¹⁰

The deduction cannot exceed your net self-employment income from the business under which the plan is established, and you cannot use the same premiums for both this deduction and the premium tax credit.

How Long to Keep Coverage Records

Keep records supporting items on your return until the statute of limitations expires. For most taxpayers that is three years from the date you filed or two years from the date you paid, whichever is later. If you underreported income by more than 25% of the gross income shown, the IRS has six years to assess additional tax. If you never filed, keep records indefinitely.¹¹

Practically, hold your 1095 forms, Form 8962 worksheets, Marketplace correspondence, and any exemption certificates or hardship documentation for at least three full years after filing. If you claimed the premium tax credit or repaid excess advance payments, those are the records that would support your return in an audit. Digital copies stored with the rest of your tax documents are enough.

1
Internal Revenue Service. Questions and Answers on the Individual Shared Responsibility Provision
2
Internal Revenue Service. Questions and Answers About Health Care Information Forms for Individuals
3
Internal Revenue Service. Instructions for Form 1095-A (2025)
4
Health Insurance Marketplace. How to Find Your Form 1095-A Online
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Internal Revenue Service. Instructions for Forms 1094-B and 1095-B
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Internal Revenue Service. Premium Tax Credit – Claiming the Credit and Reconciling Advance Credit Payments
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IRS.gov. Updates to Questions and Answers About the Premium Tax Credit
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Internal Revenue Service. Premium Tax Credit (PTC) Overview
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Internal Revenue Service. Reconciling Your Advance Payments of the Premium Tax Credit
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Internal Revenue Service. Instructions for Form 7206
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Internal Revenue Service. How Long Should I Keep Records