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The IRS 1095-A form plays a crucial role in the health insurance landscape, particularly for those who purchased coverage through the Health Insurance Marketplace. This form provides essential information about your health insurance plan, including details about the coverage you had during the year, the premiums you paid, and any premium tax credits you may have received. If you enrolled in a Marketplace plan, you will receive a 1095-A, which is necessary for completing your tax return. It helps you report your health insurance status and determine if you owe any penalties for not having coverage. Understanding the components of the 1095-A, such as the monthly premium amounts and the coverage start and end dates, is vital for ensuring accurate tax filing and compliance with health care laws. Additionally, this form can assist you in reconciling any advance payments of the premium tax credit you received, making it an important document for both your financial and health insurance records.

Form Sample

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

Department of the Treasury Internal Revenue Service

Health Insurance Marketplace Statement

Do not attach to your tax return. Keep for your records.

Go to www.irs.gov/Form1095A for instructions and the latest information.

VOID

CORRECTED

OMB No. 1545-2232

2025

 

Recipient Information

 

 

 

 

 

 

Part I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

Covered Individuals

 

 

 

 

 

 

 

Part II

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. Covered individual name

B. Covered individual SSN

C. Covered individual

D. Coverage start date

E. Coverage termination date

 

 

 

 

 

 

 

 

date of birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

 

 

 

 

 

 

 

 

 

 

17

 

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

Coverage Information

 

 

 

 

 

 

 

Part III

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Month

A. Monthly enrollment premiums

B. Monthly second lowest cost silver

C. Monthly advance payment of

 

 

 

 

 

plan (SLCSP) premium

 

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 Specifications

Fact Name Description
Purpose The IRS 1095-A form is used to report information about health coverage obtained through the Health Insurance Marketplace.
Who Receives It Individuals who enrolled in a health plan through the Marketplace will receive the 1095-A form.
Reporting Year The form is issued for each calendar year in which coverage was provided.
Required Information The form includes details such as the names of covered individuals, months of coverage, and the premium amounts.
Filing Requirement Taxpayers must include the information from the 1095-A when filing their federal tax returns.
State-Specific Forms Some states, like California and Massachusetts, have their own versions of the form, governed by state laws related to health coverage.
Premium Tax Credit The information on the 1095-A is used to determine eligibility for premium tax credits.
Corrections If there are errors on the 1095-A, individuals should contact the Marketplace for corrections.
Deadline for Issuance The IRS requires that the 1095-A form be sent to recipients by January 31 of the following year.

Steps to Filling Out IRS 1095-A

After receiving the IRS 1095-A form, you will need to fill it out accurately to report information related to your health coverage. This form is essential for filing your taxes and determining eligibility for certain tax credits. Follow these steps to complete the form correctly.

  1. Obtain the form from the issuer, usually your health insurance marketplace.
  2. Fill in your name, address, and Social Security number at the top of the form.
  3. Provide the name, address, and Social Security number of any additional covered individuals, if applicable.
  4. Locate the section that lists the months you had coverage. Mark each month you were covered.
  5. Review the premium amounts listed for each month. Ensure they match your records.
  6. Complete the section for the second lowest cost Silver plan (SLCSP) premium. This information may be provided by your marketplace.
  7. Double-check all entries for accuracy and completeness.
  8. Sign and date the form if required.
  9. Keep a copy of the completed form for your records.

More About IRS 1095-A

What is the IRS 1095-A form?

The IRS 1095-A form is a document that provides information about health insurance coverage obtained through the Health Insurance Marketplace. It includes details about the coverage, including the months you were covered, the premiums paid, and any premium tax credits you may have received. This form is essential for filing your federal tax return accurately.

Who receives the IRS 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 through a special enrollment period. The form is typically sent out by the Marketplace by the end of January each year.

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

When you file your federal tax return, you will need to include information from the 1095-A form. Specifically, it helps you determine if you are eligible for a premium tax credit or if you need to repay any excess credits. You will enter the details from the form on your tax return, usually on Form 8962, which calculates your premium tax credit.

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, you should first check your account on the Health Insurance Marketplace website. If you still cannot find it, contact the Marketplace directly for assistance. It is important to obtain this form before filing your taxes to ensure accuracy.

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

If you notice any discrepancies on your 1095-A form, such as incorrect coverage dates or premium amounts, you should contact the Health Insurance Marketplace immediately. They can issue a corrected form if necessary. It is crucial to resolve any errors before filing your tax return to avoid complications.

Can I access my 1095-A form online?

Yes, you can access your 1095-A form online through your Health Insurance Marketplace account. Log in to your account, and you should find the form available for download. This option allows for quick access and ensures you have the most accurate information at hand.

Is the IRS 1095-A form required for all taxpayers?

No, not all taxpayers need the IRS 1095-A form. It is specifically for those who obtained health insurance through the Health Insurance Marketplace. If you had other types of health coverage, such as employer-sponsored insurance or Medicaid, you would not receive this form. However, you may receive other forms related to your health coverage.

Common mistakes

  1. Incorrect Information About Coverage: One common mistake is entering the wrong details about health coverage. This can include errors in the names of covered individuals, policy numbers, or dates of coverage. Double-checking this information is crucial.

  2. Failing to Report All Covered Individuals: Some people forget to list all individuals covered under their health plan. Each person who was enrolled during the coverage period must be included on the form. Omitting anyone can lead to complications.

  3. Not Using the Correct Tax Year: It's important to ensure that the form corresponds to the right tax year. Using information from a previous year can create confusion and may result in inaccurate tax filings.

  4. Misunderstanding the Premium Tax Credit: Many individuals misinterpret how to report the premium tax credit. This can lead to incorrect calculations, affecting the overall tax return. Familiarizing oneself with the credit can help avoid this pitfall.

Documents used along the form

The IRS 1095-A form is essential for individuals who obtained health insurance coverage through the Health Insurance Marketplace. This form provides necessary information to help taxpayers complete their federal tax returns accurately. Along with the 1095-A, several other documents may be required to ensure compliance with tax regulations and to facilitate the filing process.

  • IRS Form 1040: This is the standard individual income tax return form that taxpayers use to report their annual income and calculate their tax liability.
  • IRS Form 8962: This form is used to calculate the Premium Tax Credit, which helps individuals afford health insurance coverage. It requires information from the 1095-A.
  • IRS Form 1095-B: This form provides information about health coverage from other sources, such as employers or government programs. It verifies that individuals had health insurance during the tax year.
  • IRS Form 1095-C: Employers with 50 or more full-time employees use this form to report health coverage offered to employees. It helps determine compliance with the Affordable Care Act.
  • W-2 Form: This document summarizes an employee's annual wages and the taxes withheld. It is crucial for completing the 1040 form accurately.
  • Schedule A: Taxpayers who itemize deductions will use this form to report various deductible expenses, including medical expenses that exceed a certain percentage of income.
  • Schedule 2: This schedule is used to report additional taxes owed, which may include the individual shared responsibility payment for not having health coverage.
  • Health Insurance Marketplace Coverage Summary: This document provides a detailed overview of the health insurance plan, including coverage dates and premium amounts, which can assist in filling out tax forms.

Gathering these documents along with the IRS 1095-A form will streamline the tax filing process. Ensure that all information is accurate and complete to avoid any potential issues with the IRS.

Similar forms

The IRS 1095-B form is similar to the 1095-A in that both documents provide information about health insurance coverage. The 1095-B is issued by health insurance providers to show that an individual had minimum essential coverage during the year. This form helps taxpayers demonstrate compliance with the Affordable Care Act's individual mandate, just like the 1095-A, which details coverage obtained through the Health Insurance Marketplace.

Another related document is the IRS 1095-C form. Employers with 50 or more full-time employees must provide this form to their employees. The 1095-C outlines the health insurance offered by the employer, including whether it meets the minimum essential coverage requirement. Like the 1095-A, it helps determine if an individual is eligible for premium tax credits or if they owe a penalty for not having coverage.

The IRS Form 8962 is also connected to the 1095-A. This form is used to calculate the Premium Tax Credit, which helps lower the cost of health insurance for eligible individuals. Taxpayers must use information from their 1095-A to complete the 8962. Both forms work together to ensure that individuals receive the correct amount of financial assistance for their health coverage.

The 1099-HC form is another document that shares similarities with the 1095-A. This form is used in Massachusetts to report health insurance coverage. It is provided by health insurance carriers to show that an individual had the required health insurance for state tax purposes. Like the 1095-A, it serves to confirm coverage and assist with tax compliance.

Lastly, the Form 1040, the U.S. Individual Income Tax Return, connects to the 1095-A as well. While the 1040 is the primary form for reporting income and calculating taxes, it includes sections where taxpayers report their health coverage status. Information from the 1095-A is often used when completing the 1040 to ensure that taxpayers accurately report their health insurance and any applicable credits or penalties.

Dos and Don'ts

When filling out the IRS 1095-A form, it's important to be thorough and accurate. This form is crucial for reporting health coverage obtained through the Health Insurance Marketplace. Here are some essential do's and don'ts to keep in mind:

  • Do ensure that all personal information is accurate, including names, addresses, and Social Security numbers.
  • Do check that the coverage months are correctly listed for each individual covered under the plan.
  • Do use the form to report any premium tax credits received, as this information is vital for your tax return.
  • Do keep a copy of the completed form for your records, as you may need it for future reference.
  • Don't leave any sections blank; incomplete forms can lead to delays or issues with your tax return.
  • Don't forget to double-check for any typographical errors that could affect your information.
  • Don't submit the form without reviewing it thoroughly; accuracy is key to avoid complications.

By following these guidelines, you can help ensure that your experience with the IRS 1095-A form is smooth and straightforward.

Misconceptions

The IRS 1095-A form is an important document for individuals who have obtained health insurance through the Health Insurance Marketplace. However, several misconceptions can lead to confusion. Below is a list of common misunderstandings about this form.

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

    This is incorrect. 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. You do not need the 1095-A form to file your taxes.

    This is a misconception. You must have the 1095-A to accurately complete your tax return if you had Marketplace coverage. It provides necessary information about your insurance plan.

  3. The 1095-A form is the same as the W-2 form.

    This is not true. The 1095-A is specifically for health insurance coverage, while the W-2 form reports wages and tax withholdings from your employer.

  4. If you did not receive a 1095-A, you did not have Marketplace coverage.

    This is misleading. Sometimes, the form may not arrive due to mailing issues or errors. If you believe you had coverage, you should check with the Marketplace.

  5. The information on the 1095-A is always correct.

    This is not guaranteed. Mistakes can happen. If you find discrepancies, it is important to contact the Marketplace to correct the information.

  6. You can file your taxes without a 1095-A if you have other health insurance.

    This is incorrect. The 1095-A is only applicable to Marketplace coverage. If you had other types of insurance, different forms would be necessary.

  7. Receiving a 1095-A means you will owe money to the IRS.

    This is a misunderstanding. The form simply reports your coverage. Whether you owe money or receive a refund depends on your overall tax situation.

  8. The 1095-A form is only relevant for the current tax year.

    This is not accurate. While it pertains to the current year’s coverage, it can also affect your tax returns for previous years if you are claiming premium tax credits.

  9. Once you receive your 1095-A, you do not need to keep it.

    This is misleading. It is advisable to keep the form for your records, as it may be needed for future reference or audits.

Understanding the 1095-A form is crucial for ensuring accurate tax filing and compliance with health insurance requirements. Clarifying these misconceptions can help individuals navigate their tax responsibilities more effectively.

Key takeaways

The IRS 1095-A form is an important document for individuals who have health insurance through the Health Insurance Marketplace. Here are key takeaways to consider when filling out and using this form:

  1. The 1095-A form provides information about your health coverage, including who was covered and for what period.
  2. This form is necessary for completing your federal tax return, particularly if you received premium tax credits.
  3. It is essential to ensure that all information on the form is accurate to avoid delays or issues with your tax return.
  4. You will receive the 1095-A form from the Marketplace by January 31 of the year following the coverage year.
  5. If you find errors on your 1095-A, contact the Marketplace to request a corrected form.
  6. Keep a copy of the 1095-A for your records, as you may need it for future reference.
  7. The form includes a section that details the monthly premium amounts and any premium tax credits received.
  8. Use the information from the 1095-A to fill out Form 8962, which is required to reconcile your premium tax credit.
  9. Filing your tax return without the 1095-A can lead to complications, including delays in processing your return.