Go Law

Go Law

Homepage Download IRS 1095-A Form in PDF
Contents

The IRS 1095-A form plays a crucial role in the health insurance landscape, particularly for individuals who have purchased coverage through the Health Insurance Marketplace. This form provides essential information about your health insurance plan, including the months you were covered, the premiums you paid, and any premium tax credits you may have received. Understanding the details on the 1095-A is vital for accurately filing your federal tax return, as it helps determine whether you qualify for premium assistance or if you need to repay any excess credits. Additionally, the form serves as a record of your health coverage, which is important for compliance with the Affordable Care Act. As tax season approaches, knowing how to read and utilize the 1095-A can simplify the process of reporting your health insurance status and ensure that you meet all necessary requirements. Whether you are a first-time filer or someone who has navigated the tax process before, the information contained in this form can significantly impact your tax obligations and potential refunds.

Preview - IRS 1095-A Form

CAUTION: NOT FOR FILING
Form 1095-A is provided here for informational purposes only.
Health Insurance Marketplaces use Form 1095-A to report information on enrollments in a
qualified health plan in the individual market through the Marketplace. As the form is to be
completed by the Marketplaces, individuals cannot complete and use Form 1095-A
available on IRS.gov. Individuals receiving a completed Form 1095-A from the Health
Insurance Marketplace will use the information received on the form and the guidance in the
instructions to assist them in filing an accurate tax return.
Form 1095-A
2025
Health Insurance Marketplace Statement
Department of the Treasury
Internal Revenue Service
Do not attach to your tax return. Keep for your records.
Go to www.irs.gov/Form1095A for instructions and the latest information.
OMB No. 1545-2232
VOID
CORRECTED
Part I
Recipient Information
1 Marketplace identifier 2 Marketplace-assigned policy number 3 Policy issuer’s name
4 Recipient’s name 5 Recipient’s SSN 6 Recipient’s date of birth
7 Recipient’s spouse’s name 8 Recipient’s spouse’s SSN 9 Recipient’s spouse’s date of birth
10 Policy start date 11 Policy termination date 12 Street address (including apartment no.)
13 City or town 14 State or province 15 Country and ZIP or foreign postal code
Part II
Covered Individuals
A. Covered individual name B.
Covered individual SSN
C.
Covered individual
date of birth
D.
Coverage start date
E.
Coverage termination date
16
17
18
19
20
Part III
Coverage Information
Month
A. Monthly enrollment premiums B. Monthly second lowest cost silver
plan (SLCSP) premium
C. Monthly advance payment of
premium tax credit
21 January
22 February
23 March
24 April
25 May
26 June
27 July
28 August
29 September
30 October
31 November
32 December
33 Annual Totals
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 60703Q
Form 1095-A (2025) Created 6/5/25
Form 1095-A (2025)
Page 2
Instructions for Recipient
You received this Form 1095-A because you or a family member
enrolled in health insurance coverage through the Health Insurance
Marketplace. This Form 1095-A provides information you need to
complete Form 8962, Premium Tax Credit (PTC). You must complete
Form 8962 and file it with your tax return (Form 1040, Form
1040-SR, or Form 1040-NR) if any amount other than zero is shown
in Part III, column C, of this Form 1095-A (meaning that you
received premium assistance through advance payments of the
premium tax credit (also called advance credit payments)) or if you
want to take the premium tax credit. The filing requirement applies
whether or not you’re otherwise required to file a tax return. If you are
filing Form 8962, you cannot file Form 1040-NR-EZ, Form
1040-SS, or Form 1040-PR. The Marketplace has also reported the
information on this form to the IRS. If you or your family members
enrolled at the Marketplace in more than one qualified health plan
policy, you will receive a Form 1095-A for each policy. Check the
information on this form carefully. If you think the information is
incorrect, or if you think you should not have received a Form 1095-A
because neither you nor anyone else in your family was enrolled in
Marketplace health insurance, please contact your Marketplace Call
Center. If you purchased insurance through the federally facilitated
Marketplace, you can find your Call Center information at
www.healthcare.gov/contact-us/. If you purchased insurance through a
State-based Marketplace, you can find your Call Center information on
your State-based Marketplace website. You can find a list of State-
based Marketplace websites at www.healthcare.gov/marketplace-in-
your-state/. If you or your family members were enrolled in a
Marketplace catastrophic health plan or separate dental policy, you
aren’t entitled to take a premium tax credit for this coverage when you
file your return, even if you received a Form 1095-A for this coverage.
For additional information related to Form 1095-A, go to www.irs.gov/
Affordable-Care-Act/Individuals-and-Families/Health-Insurance-
Marketplace-Statements.
Additional information. For additional information about the tax
provisions of the Affordable Care Act (ACA), including the premium tax
credit, see www.irs.gov/Affordable-Care-Act/Individuals-and-Families or
call the IRS Healthcare Hotline for ACA questions (800-919-0452).
VOID box. If the “VOID” box is checked at the top of the form, you
previously received a Form 1095-A for the policy described in Part I.
That Form 1095-A was sent in error. You shouldn’t have received a
Form 1095-A for this policy. Don’t use the information on this or the
previously received Form 1095-A to figure your premium tax credit on
Form 8962.
CORRECTED box. If the “CORRECTED” box is checked at the top of
the form, use the information on this Form 1095-A to figure the premium
tax credit and reconcile any advance credit payments on Form 8962.
Don’t use the information on the original Form 1095-A you received for
this policy.
Part I. Recipient Information, lines 1–15. Part I reports information
about you, the insurance company that issued your policy, and the
Marketplace where you enrolled in the coverage.
Line 1. This line identifies the state where you enrolled in coverage
through the Marketplace.
Line 2. This line is the policy number assigned by the Marketplace to
identify the policy in which you enrolled. If you are completing Part IV of
Form 8962, enter this number on line 30, 31, 32, or 33, box a.
Line 3. This is the name of the insurance company that issued your
policy.
Line 4. You are the recipient because you are the person the
Marketplace identified at enrollment who is expected to file a tax return
and who, if qualified, would take the premium tax credit for the year of
coverage.
Line 5. This is your social security number (SSN). For your protection,
this form may show only the last four digits. However, the Marketplace
has reported your complete SSN to the IRS.
Line 6. A date of birth will be entered if there is no SSN on line 5.
Lines 7, 8, and 9. Information about your spouse will be entered only if
advance credit payments were made for your coverage. The date of
birth will be entered on line 9 only if line 8 is blank.
Lines 10 and 11. These are the starting and ending dates of the policy.
Lines 12 through 15. Your address is entered on these lines.
Part II. Covered Individuals, lines 16–20. Part II reports information
about each individual who is covered under your policy. This information
includes the name, SSN, date of birth, and the starting and ending dates
of coverage for each covered individual. For each line, a date of birth is
reported in column C only if an SSN isn’t entered in column B.
If advance credit payments are made, the only individuals listed on
Form 1095-A will be those whom you certified to the Marketplace would
be in your tax family for the year of coverage (yourself, spouse, and
dependents). If you certified to the Marketplace at enrollment that one or
more of the individuals who enrolled in the plan aren’t individuals who
would be in your tax family for the year of coverage, those individuals
won’t be listed on your Form 1095-A. For example, if you indicated to
the Marketplace at enrollment that an individual enrolling in the policy is
your adult child who will not be your dependent for the year of coverage,
that child will receive a separate Form 1095-A and won’t be listed in
Part II on your Form 1095-A.
If advance credit payments are made and you certify that one or more
enrolled individuals aren’t individuals who would be in your tax family for
the year of coverage, your Form 1095-A will include coverage
information in Part III that is applicable solely to the individuals listed on
your Form 1095-A, and separately issued Forms 1095-A will include
coverage information, including dollar amounts, applicable to those
individuals not in your tax family.
If advance credit payments weren’t made and you didn’t identify at
enrollment the individuals who would be in your tax family for the year of
coverage, Form 1095-A will list all enrolled individuals in Part II on your
Form 1095-A.
If there are more than five individuals covered by a policy, you will
receive one or more additional Forms 1095-A that continue Part II.
Part III. Coverage Information, lines 21–33. Part III reports information
about your insurance coverage that you will need to complete Form
8962 to reconcile advance credit payments or to take the premium tax
credit when you file your return.
Column A. This column is the monthly premiums for the plan in which
you or family members were enrolled, including premiums that you paid
and premiums that were paid through advance payments of the
premium tax credit. If you or a family member enrolled in a separate
dental plan with pediatric benefits, this column includes the portion of
the dental plan premiums for the pediatric benefits. If your plan covered
benefits that aren’t essential health benefits, such as adult dental or
vision benefits, the amount in this column will be reduced by the
premiums for the nonessential benefits. See the instructions for Form
8962, Part II, on how to complete Form 8962 if -0- is reported for 1 or
more months.
Column B. This column is the monthly premium for the second lowest
cost silver plan (SLCSP) that the Marketplace has determined applies to
members of your family enrolled in the coverage. The applicable SLCSP
premium is used to compute your monthly advance credit payments
and the premium tax credit you take on your return. See the instructions
for Form 8962, Part II, on how to use the information in this column or
how to complete Form 8962 if there is no information entered, the
information is incorrect, or the information is reported as -0-.
Column C. This column is the monthly amount of advance credit
payments that were made to your insurance company on your behalf to
pay for all or part of the premiums for your coverage. If this is the only
column in Part III that is filled in with an amount other than zero for a
month, it means your policy was terminated by your insurance company
due to nonpayment of premiums, and you aren’t entitled to take the
premium tax credit for that month when you file your tax return. You
must still reconcile the entire advance payment that was paid on your
behalf for that month using Form 8962. No information will be entered in
this column if no advance credit payments were made.
Lines 21–33. The Marketplace will report the amounts in columns A, B,
and C on lines 21–32 for each month and enter the totals on line 33. Use
this information to complete Form 8962, line 11 or lines 12–23.

Document Specifics

Fact Name Description
Purpose The IRS 1095-A form is used to report information about health insurance coverage obtained through the Health Insurance Marketplace.
Who Receives It Individuals who enrolled in a qualified health plan through the Marketplace receive the 1095-A form.
Tax Filing Requirement This form is essential for filing your federal income tax return, particularly for those who are eligible for premium tax credits.
Information Included The form includes details such as the months of coverage, the premiums paid, and any premium tax credits received.
State-Specific Forms Some states have their own forms that serve a similar purpose, governed by state laws such as California's Health and Safety Code.
Deadline The IRS requires that the 1095-A form be provided to individuals by January 31 of the year following the coverage year.

IRS 1095-A: Usage Instruction

After you have received your IRS 1095-A form, it's crucial to fill it out accurately. This form is essential for reporting health insurance coverage on your tax return. Completing it correctly ensures that you can claim any applicable premium tax credits and avoid potential penalties. Follow these steps to fill out the form properly.

  1. Gather necessary information, including your health insurance policy details and the names of all covered individuals.
  2. Locate the first section of the form, which requires you to enter your personal information, such as your name, address, and Social Security number.
  3. In the next section, input the details of your health insurance coverage. This includes the name of the insurance provider and the policy number.
  4. Review the coverage months. Ensure that you indicate the months during which you had health coverage.
  5. Calculate the premium amounts for each month of coverage. This information is typically provided by your insurance company.
  6. Double-check all entries for accuracy. Mistakes can lead to complications when filing your tax return.
  7. Sign and date the form, if required, to validate the information provided.
  8. Keep a copy of the completed form for your records before submitting it with your tax return.

Learn More on IRS 1095-A

What is the IRS 1095-A form?

The IRS 1095-A form is a tax document that provides information about health insurance coverage obtained through the Health Insurance Marketplace. This form is essential for individuals who enrolled in a qualified health plan, as it includes details necessary for filing federal income tax returns. The 1095-A helps determine eligibility for premium tax credits and whether the coverage meets the minimum essential coverage requirement.

Who receives the 1095-A form?

Individuals who purchased health insurance through the Health Insurance Marketplace will receive the 1095-A form. This includes anyone who enrolled in a plan during the open enrollment period or who qualified for a special enrollment period. If you were covered under a Marketplace plan, you should expect to receive this form, typically by the end of January following the tax year.

What information is included on the 1095-A form?

The 1095-A form contains several key pieces of information:

  • The name and Social Security number of the insured individuals.
  • The months during which coverage was active.
  • The premium amounts for the coverage.
  • The amount of any premium tax credits received.

This information is crucial for accurately completing your tax return and determining any potential tax credits or penalties.

How do I use the 1095-A form when filing my taxes?

When filing your taxes, the information on the 1095-A form must be reported on Form 8962, Premium Tax Credit (PTC). This form calculates the premium tax credit you may be eligible for based on your income and family size. If you received advance payments of the premium tax credit, you will need to reconcile those amounts with the actual credit you qualify for, using the information provided on the 1095-A.

What should I do if I don’t receive my 1095-A form?

If you do not receive your 1095-A form by mid-February, it is advisable to contact the Health Insurance Marketplace where you enrolled. They can provide a copy of the form or assist you in resolving any issues. It’s important to have this document before filing your taxes to ensure accurate reporting.

Can I file my taxes without the 1095-A form?

While it is technically possible to file your taxes without the 1095-A form, doing so is not recommended. The information on the form is necessary for accurately determining your premium tax credit and ensuring compliance with tax laws. Filing without it may result in delays or complications, including potential penalties.

What if the information on my 1095-A form is incorrect?

If you notice any discrepancies on your 1095-A form, such as incorrect names, coverage months, or premium amounts, you should contact the Health Insurance Marketplace immediately. They can issue a corrected form, known as a 1095-A correction, which you will need to use when filing your taxes. It’s important to address these issues promptly to avoid complications during tax season.

What happens if I don’t report my 1095-A form on my tax return?

Failing to report the 1095-A form on your tax return can lead to significant consequences. The IRS may assess penalties for not reporting the required information, and you may miss out on any premium tax credits for which you qualify. In some cases, it could result in an audit or additional scrutiny of your tax return. Therefore, it is crucial to include this form when filing your taxes.

Where can I find more information about the 1095-A form?

For more detailed information regarding the 1095-A form, you can visit the official IRS website or the Health Insurance Marketplace website. These resources provide guidance on how to interpret the form, instructions for filing, and answers to additional questions you may have about health coverage and taxes.

Common mistakes

Filling out the IRS 1095-A form can be a daunting task for many individuals. This form is essential for reporting health insurance coverage obtained through the Health Insurance Marketplace. However, mistakes can lead to complications in tax filing. Here are six common errors people often make when completing this form.

One frequent mistake is providing incorrect personal information. This includes errors in names, Social Security numbers, or addresses. Such inaccuracies can cause delays in processing your tax return and may even lead to issues with your health coverage. Always double-check this information to ensure it matches what is on your official documents.

Another common error involves misreporting the coverage dates. The 1095-A form includes specific start and end dates for the coverage period. Failing to accurately reflect these dates can result in discrepancies when reconciling premium tax credits. It is crucial to review your coverage timeline carefully to avoid this mistake.

People often overlook the importance of accurately entering the premium amounts. The form includes information about the monthly premium for each month of coverage. Miscalculating or misreporting these figures can lead to incorrect tax credit calculations. Ensure that you reference the correct amounts as reported on your form.

Many individuals also fail to account for all household members when completing the 1095-A. The form requires information on all individuals covered under the health plan. Omitting anyone can lead to inaccuracies in the reported coverage and tax credits. Make a comprehensive list of all covered individuals to avoid this pitfall.

Confusion can arise when interpreting the information provided in Part III of the form. This section outlines the premium tax credit amounts for each month. If you do not fully understand how to read this section, you may miscalculate your tax credit. Taking the time to understand this part of the form is essential for accurate reporting.

Lastly, some individuals neglect to keep a copy of their completed 1095-A form. This document is vital for your records and may be needed for future reference or audits. Always retain a copy for your files after submitting your tax return. This simple step can save you from potential headaches down the line.

Documents used along the form

The IRS 1095-A form is an important document for those who enrolled in a health plan through the Health Insurance Marketplace. It provides essential information about your health coverage, which you may need when filing your taxes. However, there are several other forms and documents that often accompany the 1095-A, each serving a specific purpose in your tax preparation process.

  • IRS Form 8962: This form is used to calculate the Premium Tax Credit, which can help lower your health insurance costs. You'll need the information from your 1095-A to complete this form accurately.
  • IRS Form 1040: This is the standard individual income tax return form. You will report your income and claim any tax credits, including the Premium Tax Credit, on this form.
  • IRS Form 1095-B: This form is provided by your health insurance provider and indicates whether you had minimum essential coverage. It's useful for confirming that you met the health coverage requirement during the tax year.
  • IRS Form 1095-C: Employers with 50 or more full-time employees provide this form. It details the health insurance coverage offered to employees and helps determine eligibility for the Premium Tax Credit.

Understanding these documents is crucial for a smooth tax filing experience. By gathering and reviewing them alongside your 1095-A, you can ensure that you accurately report your health coverage and take advantage of any available tax credits. Proper preparation can make all the difference in your tax season experience!

Similar forms

The IRS Form 1095-B is similar to the 1095-A as both serve to provide information about health insurance coverage. While the 1095-A is specifically for individuals who obtained coverage through the Health Insurance Marketplace, the 1095-B is used by health insurance providers to report coverage offered to individuals. Both forms are essential for taxpayers to demonstrate compliance with the Affordable Care Act’s individual mandate, although they originate from different sources.

Another related document is the IRS Form 1095-C. Employers with 50 or more full-time employees must use this form to report health coverage offered to their employees. Like the 1095-A, the 1095-C helps individuals understand their health coverage options and ensures compliance with the Affordable Care Act. While the 1095-A focuses on Marketplace coverage, the 1095-C is employer-specific, detailing the health plans offered by large employers.

The IRS Form 1040, the individual income tax return, is also connected to the 1095-A. Taxpayers use the information from the 1095-A to complete their 1040 forms, particularly when claiming premium tax credits. The 1040 requires individuals to report their health coverage status, making the 1095-A a vital document for accurately filing taxes and ensuring they receive any eligible credits.

The IRS Form 8962, Premium Tax Credit, is another document that works in tandem with the 1095-A. Taxpayers use Form 8962 to calculate and claim the premium tax credit based on the information provided in the 1095-A. This form is crucial for individuals who received advance payments of the premium tax credit, as it helps reconcile any differences between the advance payments and the actual credit amount.

Form 1099-H, Health Coverage Tax Credit, shares similarities with the 1095-A in that it also pertains to health coverage but focuses on a specific tax credit for eligible individuals. This form helps taxpayers claim the Health Coverage Tax Credit, which is designed to assist certain individuals, such as those receiving Trade Adjustment Assistance. While both forms address health insurance, their purposes and target audiences differ significantly.

Form 1095-Q, Qualified Health Coverage, is another relevant document. It provides information about qualified health coverage for individuals who are eligible for the Health Coverage Tax Credit. Similar to the 1095-A, it helps taxpayers demonstrate their health coverage status, but it is specifically geared towards those benefiting from tax credits under different circumstances.

The IRS Form 8885, Health Coverage Tax Credit, also aligns with the 1095-A in terms of health coverage reporting. This form is used to claim the Health Coverage Tax Credit for qualified individuals. Both forms help taxpayers navigate the complexities of health insurance credits, but they cater to different eligibility criteria and situations.

The IRS Form 5329, Additional Taxes on Qualified Plans, while not directly about health insurance, can relate to individuals who may have received health-related tax credits. This form is used to report additional taxes on retirement plans, and some taxpayers may find themselves navigating both health coverage and retirement issues simultaneously. Understanding the 1095-A can be helpful for those who are also managing their retirement contributions and tax implications.

Form 8862, Information to Claim Certain Refundable Credits After Disallowance, is another document that, while not directly linked to health insurance, can intersect with tax credits related to health coverage. If a taxpayer's eligibility for certain credits has been disallowed in the past, they may need to file this form when reapplying for credits, including those related to health coverage reported on the 1095-A.

Lastly, Form 4506-T, Request for Transcript of Tax Return, can serve as a supporting document for individuals who need to verify their tax information, including health coverage details. While it does not directly report health coverage, it can provide necessary tax return transcripts that may include relevant information for individuals filing their taxes and claiming credits associated with the 1095-A.

Dos and Don'ts

When filling out the IRS 1095-A form, it’s important to be careful and thorough. This form provides information about your health insurance coverage through the Health Insurance Marketplace. Here’s a list of things you should and shouldn’t do:

  • Do ensure that all personal information is accurate, including your name, address, and Social Security number.
  • Do check that the coverage months are correctly listed for each individual on your policy.
  • Do confirm that the premium amounts and any advance premium tax credits are accurately reported.
  • Do keep a copy of the completed form for your records.
  • Don't leave any sections blank; every part of the form must be filled out completely.
  • Don't forget to include all individuals covered under your plan, even if they are not dependents.
  • Don't submit the form without reviewing it for errors or inconsistencies.

Following these guidelines can help ensure that your 1095-A form is filled out correctly, which is essential for your tax filing process.

Misconceptions

The IRS 1095-A form is an important document for those who have obtained health insurance through the Health Insurance Marketplace. However, there are several misconceptions surrounding this form that can lead to confusion. Here are five common myths debunked:

  1. Myth 1: The 1095-A form is only for people who received premium tax credits.

    This is not true. While the form is essential for those who received premium tax credits, it is also required for anyone who had Marketplace coverage, regardless of whether they received financial assistance.

  2. Myth 2: I don’t need the 1095-A form if I didn’t file taxes last year.

    Even if you did not file a tax return, you should still keep the 1095-A form. It provides important information about your health coverage, which may be relevant for future filings or if your situation changes.

  3. Myth 3: The information on the 1095-A form is optional to report.

    This is a misconception. The information on the 1095-A is crucial for accurately completing your tax return, especially if you received premium tax credits. Failing to report this information can lead to delays or issues with your tax return.

  4. Myth 4: I can ignore the 1095-A if I switched to another insurance plan during the year.

    Not at all! If you had Marketplace coverage at any point during the year, you still need the 1095-A form. It reflects your coverage period and any financial assistance you received, which is necessary for your tax return.

  5. Myth 5: The 1095-A form is the same as the 1095-B or 1095-C forms.

    This is incorrect. While all three forms relate to health coverage, they serve different purposes. The 1095-A is specific to Marketplace coverage, while the 1095-B and 1095-C pertain to other types of health insurance, such as employer-sponsored plans.

Understanding these misconceptions can help you navigate your health insurance and tax obligations more effectively. Always refer to official IRS resources or consult a tax professional if you have questions about your specific situation.

Key takeaways

The IRS 1095-A form is an important document for anyone who has obtained health insurance through the Health Insurance Marketplace. Understanding how to fill it out and use it can help you avoid potential issues with your taxes. Here are some key takeaways:

  • What it is: The 1095-A form provides information about your health coverage, including the months you were covered and any premium tax credits you may have received.
  • Who receives it: If you enrolled in a Marketplace plan, you should receive a 1095-A from the Marketplace, typically by January 31 of the following year.
  • Filling it out: Use the information on the form to complete your tax return accurately, especially when claiming premium tax credits or reconciling any advance payments.
  • Double-check your details: Ensure that the information on your 1095-A matches your records. Any discrepancies could lead to delays in processing your tax return.
  • Multiple forms: If you had coverage for more than one household member or if you switched plans during the year, you may receive more than one 1095-A form.
  • Keep it safe: Store your 1095-A with your tax documents. You’ll need it not just for this year’s taxes, but for future reference if questions arise.

Being informed about the 1095-A form can simplify your tax filing process and help you maximize your benefits. Stay organized and proactive, and you’ll navigate your tax obligations with confidence.