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Your Free Guide to Understanding Form 1095-A

What Is Form 1095-A and Why You Received It Form 1095-A is an official document sent by the Health Insurance Marketplace that shows information about your he...

GuideKiwi Editorial Team·

What Is Form 1095-A and Why You Received It

Form 1095-A is an official document sent by the Health Insurance Marketplace that shows information about your health insurance coverage during a specific year. The Internal Revenue Service (IRS) requires this form to be issued to anyone who obtained health insurance through the federal marketplace (Healthcare.gov) or a state marketplace during the tax year. If you purchased a plan and received any financial assistance to help pay your premiums, you will definitely receive this form.

The form serves as a record of your coverage and any subsidies (also called premium tax credits) that were provided to help reduce your monthly insurance payments. The IRS needs this information to verify that you were covered during the year and that any subsidies you received matched what you were actually supposed to get based on your income and household size.

You typically receive Form 1095-A by mail in January or early February of the year following the coverage year. For example, if you had coverage in 2023, you would receive the form in early 2024. The form comes from the Marketplace, not from your insurance company. Your insurance company sends Form 1095-B instead, which simply shows that you had coverage.

Form 1095-A contains several key pieces of information: your name and address, the names and Social Security numbers of everyone on your plan, each month of the coverage year, the monthly premium amounts, the monthly advance payments of the premium tax credit (the subsidies), and the policy number for your health plan. The form has multiple copies—one for you, one for your records, and one for the IRS.

Practical Takeaway: If you bought a Marketplace plan in 2024 with financial help, expect to receive Form 1095-A in early 2025. Keep all copies safe and have them available when you file your taxes, even if you do not use the information on the form to reduce your taxes.

Understanding the Different Sections and Line Items

Form 1095-A has multiple parts that may seem confusing at first glance, but each section provides specific information the IRS needs. The top section contains identifying information: your name, address, Social Security number, and the policy number assigned to your plan by the Marketplace. This identifies which Marketplace plan you had during the year. Make sure this information is correct. If your name or Social Security number is wrong, contact the Marketplace to request a corrected form.

The main body of the form is organized by month. For each month from January through December, there are columns showing whether you had coverage, the monthly premium amount, and the amount of advance premium tax credit (APTC) that was paid on your behalf. The premium amount is what your plan costs before any subsidies. The advance premium tax credit amount is the money the government sent directly to your insurance company each month to help pay that premium.

For example, if your monthly premium was $400 and you received an advance premium tax credit of $300, you would have paid $100 out of pocket each month. These columns show this information for each calendar month. Some people may have had coverage for only part of the year (such as if they enrolled in March), so the form will show blank months at the beginning or end of the year.

The form also includes spaces for information about dependents covered under your plan. If you had a spouse or children on your plan, their names, dates of birth, and Social Security numbers are listed. This is important because the tax credit can change based on how many people are on your plan and their ages.

Another important section shows the enrollment period when you purchased or changed your plan. This indicates whether you enrolled during the open enrollment period or during a special enrollment period due to a qualifying life event like losing other coverage or having a baby. This timing can affect how your subsidies are calculated.

Practical Takeaway: Review each month on Form 1095-A to make sure the premium amounts and advance tax credit amounts match your records. If you remember paying a different amount or if your coverage started or ended in the middle of a month, note these discrepancies so you can understand them when preparing your taxes.

How Advance Premium Tax Credits Work and Appear on the Form

When you enroll in a Marketplace plan, you may be offered financial assistance in the form of an advance premium tax credit (APTC). This is money that the Marketplace estimates you will be eligible to receive based on your expected household income for the year. Rather than waiting until you file your taxes to receive this money, the government sends the credit directly to your insurance company each month, reducing what you have to pay out of your pocket.

The amount of credit you receive depends on your household income, the size of your household, and the cost of the second-lowest-cost silver plan available in your area. The formula used by the IRS sets a target amount you would be expected to pay (usually based on a percentage of your income), and the rest of the premium up to the second-lowest silver plan cost is covered by the credit. This means if you choose a cheaper plan, the credit amount stays the same and you save money. If you choose a more expensive plan, you pay the difference.

On Form 1095-A, the advance premium tax credit appears in a column for each month. This represents the actual amount sent to your insurance company that month. The form shows this month by month because the amount can change. For example, if you reported a change in income to the Marketplace, or if your household size changed due to birth or adoption, the credit amount might increase or decrease starting the next month.

When you file your taxes, the IRS compares the advance credits you received throughout the year (shown on Form 1095-A) to the total premium tax credit you are actually entitled to receive based on your final, actual household income for the year. If you received more credit than you should have, you may owe money back when you file your taxes. If you received less credit than you were entitled to, you may receive a refund. This comparison is called "reconciliation."

It is important to understand that the advance credit is an estimate. Your actual income during the year may be different from what you predicted when you enrolled. If your income turns out to be higher than expected, some of the credit money you received during the year may need to be repaid. If your income was lower than expected, you may be entitled to receive additional money at tax time.

Practical Takeaway: Keep Form 1095-A to compare with your actual income when you file taxes. If you had major changes in income during the year (job loss, raise, marriage, divorce), gather documentation showing your actual income so you can accurately reconcile the credits you received with what you were supposed to get.

Checking Your Form 1095-A for Errors and What to Do About Them

Before you use Form 1095-A to file your taxes, you should carefully review it for errors. Mistakes on this form can affect your tax return and potentially delay your refund or create additional tax liability. Start by checking all personal identifying information: your name, address, and Social Security number should match your tax records exactly. If any of this information is wrong, contact the Marketplace immediately.

Next, verify the coverage months listed on the form. The form should show coverage for each month you actually had insurance. If there are blank months when you had coverage, or if the form shows months when you did not have coverage, this is an error that needs correction. Also check the names and Social Security numbers of any dependents listed on the form. These must be accurate because they affect your tax situation.

Compare the monthly premium amounts shown on the form with your insurance bills or statements from your plan. The premium is the full cost of your plan before any subsidies are applied. This amount should be consistent month to month unless you changed plans during the year. If the premium amounts on the form do not match your records, document the discrepancy.

Look at the advance premium tax credit amounts for each month. If you remember making changes to your income or household size during the year, these amounts may have changed accordingly. For example, if you reported an income increase in June, the credit amount starting in July should reflect this change. If the credits shown do not match what you remember, investigate further.

If you find errors on your Form 1095-A, contact the Marketplace in the state where you enrolled. You can find contact information by visiting Healthcare.gov or your state Marketplace website. Explain the error clearly and provide documentation if you have it (such as copies of your insurance bills or Marketplace notices showing the

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