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What Is Form 1095-A and Why You Might Receive One Form 1095-A is an official tax document that reports information about health insurance coverage purchased...

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What Is Form 1095-A and Why You Might Receive One

Form 1095-A is an official tax document that reports information about health insurance coverage purchased through a Health Insurance Marketplace. The Marketplace is the place where people can shop for and purchase health insurance plans, often referred to as the ACA marketplace or state exchanges. If you bought a health insurance plan through the Marketplace during a given tax year, the insurance company that sold you the plan will send you a Form 1095-A.

This form shows details about the insurance plan you had, the people covered under that plan, and the amount of any advance premium tax credits or cost-sharing reductions you received. A premium tax credit is money the government may have given to your insurance company on your behalf to help pay your monthly premiums. Cost-sharing reductions are reductions in the amounts you have to pay out of pocket for deductibles, copayments, and coinsurance.

The form typically arrives in January or February, after the end of the tax year. For example, if you had Marketplace coverage during 2023, you would receive your 1095-A form in early 2024. The form has multiple copies: one for your records, one for your state tax authority if applicable, and copies for the IRS.

Not everyone receives a 1095-A. You only receive one if you purchased coverage directly through the Marketplace. If you got insurance through an employer, a government program like Medicaid or Medicare, or a private insurance company outside the Marketplace, you would not receive this form. Understanding whether you should have received a 1095-A is the first step in managing your tax documents.

Practical takeaway: Check your mail in January or February for Form 1095-A if you purchased Marketplace coverage. The form shows the names of covered family members, the months of coverage, and the amount of premium tax credits received.

How to Obtain Your Form 1095-A

Your insurance company is required by law to send you Form 1095-A by January 31st of the year following the tax year. This means your 2023 form would arrive by January 31, 2024. The form comes in the mail, usually to the address on file with your Marketplace account. You should receive it without needing to request it, assuming your insurance company has your correct mailing address.

If you do not receive your form by early February, the first step is to verify your mailing address with the Marketplace. You can log into your Marketplace account online to check what address is listed. Many Marketplace accounts are managed through HealthCare.gov if you live in a state that uses the federal Marketplace, or through your state's Marketplace website if your state runs its own exchange.

You can contact your insurance company directly to request a replacement copy. Have your policy number and personal information ready. Most insurance companies have customer service phone numbers on their websites or on previous correspondence they sent you. When you call, explain that you need a replacement 1095-A form for the previous tax year.

Many insurance companies also allow you to view or print your Form 1095-A online through your customer account portal. Log into your insurance company's website and look for options such as "tax documents," "forms," or "1095-A." Some companies make the form available online before sending it by mail. The online version is often available in January and may be printed immediately.

If you had coverage through multiple insurance companies during the same year (for example, if you switched plans mid-year), you will receive a separate Form 1095-A from each company. Make sure to save all of them for your tax records.

Practical takeaway: You should receive Form 1095-A automatically by January 31st. If you do not receive it, check your Marketplace account for the correct address on file, or contact your insurance company's customer service to request a replacement copy or view it online.

Understanding the Information on Your Form 1095-A

Form 1095-A contains specific sections, each with important information. The top section of the form shows the insurance company's name and contact information. Below that, you will see your name, address, and tax identification number (usually your Social Security number). This section also includes your policy number or contract number, which identifies the specific coverage you had.

Part II of the form lists the individuals covered under your insurance plan. For each person covered, the form shows their name, date of birth, and relationship to you (such as spouse or child). There are 12 columns, one for each month of the year. For each person listed, an "X" is marked in the columns for the months they had coverage. If someone was covered for only part of a month, the form may show a specific date rather than an "X."

Part III shows the monthly premium, or the amount you were charged each month for your coverage. This is broken into two parts: the amount you paid and the amount the government paid on your behalf through a premium tax credit. For example, if your monthly premium was $500 and the government paid $350 of that through a tax credit, you would pay $150 out of pocket. The form shows all three numbers for each month.

Part IV lists any cost-sharing reductions you received. These reductions apply only to people who enrolled in a Silver-level plan and had a household income between 100 percent and 400 percent of the federal poverty line. Cost-sharing reductions lower the amounts you pay for deductibles, copayments, and coinsurance when you use medical services.

The back of the form contains instructions and explanations. It also includes contact information for the insurance company in case you have questions about the information shown.

Practical takeaway: Review each section of your 1095-A carefully. Check that your name and address are correct, that all covered family members are listed, and that the months of coverage match your records. Verify that the premium amounts and tax credit amounts shown match what you paid and what the government paid.

Why Your 1095-A Matters for Your Taxes

Your Form 1095-A is directly connected to your income tax return. If you received advance premium tax credits during the year (meaning the government paid part of your premium monthly), the IRS needs to know how much was paid so they can reconcile it with what you actually owed. This process is called reconciliation of advance premium tax credits.

When you file your taxes, you will need to report the information from your 1095-A on IRS Form 8962, also called the "Premium Tax Credit (PTC) Reconciliation Statement." This form compares the advance credits you received throughout the year to the amount of credit you were actually allowed based on your final income for the year. If you received more than you were allowed, you may owe money back. If you received less than you were allowed, you may receive a refund as part of your tax return.

For example, imagine you estimated your 2023 income would be $35,000 when you enrolled in a Marketplace plan in November 2022, and you received a monthly tax credit of $200 based on that estimate. However, your actual 2023 income ended up being $45,000. At tax time, the IRS recalculates and determines you only qualified for a $150 monthly credit. This means you received $50 too much per month for 12 months, totaling $600 that you owe back to the IRS. Your 1095-A provides the proof of what you actually received.

If you did not receive any advance premium tax credits—meaning you paid your full premium yourself each month—Form 1095-A still documents your coverage. However, you may not need to file Form 8962 unless you also claimed the Health Coverage Tax Credit (HCTC), which is a different program for certain individuals.

Keeping your 1095-A with your tax documents is important. The IRS may request to see it if your return is audited. It serves as proof of what you actually reported regarding your Marketplace coverage and premium tax credits.

Practical takeaway: If you received advance premium tax credits, you must use Form 1095-A to complete IRS Form 8962 when filing your taxes. Save your 1095-A with your tax documents for at least three years. Even if you did not owe taxes, keeping the form shows you reported accurate coverage information.

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