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The IRS 1095-A form plays a crucial role in understanding health insurance coverage, especially for those who have purchased insurance through the Health Insurance Marketplace. This form provides essential information about the coverage you had during the year, including details about the premiums you paid and any premium tax credits you may have received. It serves as a key document for filing your federal income tax return, helping to determine whether you met the Affordable Care Act's requirement for health coverage. Additionally, the 1095-A form includes information about the individuals covered under the plan, making it easier for taxpayers to report their health insurance status accurately. Understanding this form is vital, as it not only impacts your tax obligations but also ensures compliance with healthcare laws. With the deadline for filing taxes approaching, being informed about the 1095-A can help you navigate the complexities of tax season more smoothly.

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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.

Form Specifications

Fact Name Description
Purpose The IRS 1095-A form provides 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.
Reporting Year The form is issued for the previous tax year, reflecting coverage from January 1 to December 31.
Filing Requirement Taxpayers must use the information on the 1095-A form to complete their tax returns accurately.
State-Specific Forms Some states have their own forms similar to the 1095-A, governed by state laws such as California's AB 133 and Massachusetts' Chapter 111M.
Premium Tax Credit The form helps taxpayers determine their eligibility for the Premium Tax Credit, which can lower monthly premiums.
Correcting Errors If there are mistakes on the 1095-A, individuals should contact the Marketplace for corrections.
Multiple Coverage Taxpayers with multiple plans will receive separate 1095-A forms for each coverage.
Deadline for Issuance The IRS requires the 1095-A forms to be sent out by January 31 of the following year.
Not Required for All Individuals who did not have coverage through the Marketplace will not receive a 1095-A form.

IRS 1095-A: Usage Guidelines

After receiving your IRS 1095-A form, you will need to ensure that all information is accurate before proceeding with your tax return. This form provides essential details about your health insurance coverage, which may impact your tax obligations. Follow these steps to complete the form correctly.

  1. Obtain the IRS 1095-A form from your insurance provider or download it from the official IRS website.
  2. Locate the section labeled "Part I: Recipient Information." Fill in your name, address, and Social Security number accurately.
  3. In "Part II: Coverage Information," enter the details of the coverage you received. This includes the start and end dates of your coverage period.
  4. Identify the "Monthly Premium Amount" for each month of coverage. Record this information in the corresponding boxes for each month.
  5. Check the "Second Lowest Cost Silver Plan" (SLCSP) premium amount. This amount is necessary for calculating any premium tax credits you may be eligible for.
  6. Review all entries for accuracy. Ensure that names, dates, and amounts are correct and match your insurance records.
  7. Sign and date the form if required, and make a copy for your records before submitting it with your tax return.

Your Questions, Answered

What is the IRS 1095-A form?

The IRS 1095-A form is a tax document that provides information about your health insurance coverage obtained through the Health Insurance Marketplace. It includes details such as the coverage period, the premium amounts, and the individuals covered under the policy. This form is essential for taxpayers who wish to claim the Premium Tax Credit or reconcile their advance premium tax credits when filing their federal tax returns.

Who receives the 1095-A form?

Individuals who enrolled in a health insurance plan through the Health Insurance Marketplace will receive the 1095-A form. This includes those who purchased coverage for themselves or their family members during the open enrollment period or through a special enrollment period due to qualifying life events.

When will I receive my 1095-A form?

The Health Insurance Marketplace is required to send the 1095-A form to you by January 31 of the year following the coverage year. If you do not receive it by this date, you should contact the Marketplace directly to obtain a copy.

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

When preparing your tax return, you will use the information from the 1095-A form to complete IRS Form 8962, which is used to calculate the Premium Tax Credit. This credit can help lower your tax bill or increase your refund. Ensure that the details on the 1095-A form match your tax return to avoid discrepancies.

What should I do if there is an error on my 1095-A form?

If you notice any errors on your 1095-A form, such as incorrect coverage dates or premium amounts, you should contact the Health Insurance Marketplace immediately. They can provide a corrected form, which is crucial for accurate tax filing.

Can I access my 1095-A form online?

Yes, you can access your 1095-A form online through your account on the Health Insurance Marketplace website. Log in to your account, and you should find the form available for download. This option can be convenient if you need to retrieve the form quickly.

What if I didn’t have health insurance for the entire year?

If you did not have health insurance for the entire year, you may still receive a 1095-A form if you had coverage for part of the year. You will need to report the months you were covered when filing your taxes. If you did not have any qualifying health coverage, you may be subject to a penalty unless you qualify for an exemption.

Common mistakes

  1. Incorrect Personal Information: One of the most common mistakes is entering incorrect names or Social Security Numbers. Ensure that your name matches exactly as it appears on your Social Security card. A simple typo can lead to delays in processing your tax return.

  2. Missing Coverage Dates: Failing to accurately report the months you had health coverage can cause issues. Make sure to indicate all months you were enrolled in a qualified health plan during the year.

  3. Inaccurate Premium Amounts: Reporting the wrong premium amounts can lead to discrepancies. Double-check the amounts listed on your Form 1095-A against your health insurance statements to avoid errors.

  4. Not Including All Household Members: Some people forget to include all members of their household who were covered under the same plan. Each person who had coverage should be listed to ensure accurate reporting.

  5. Ignoring the Instructions: Skipping the instructions can lead to mistakes. Take the time to read the guidelines provided with the form. Understanding how to fill it out correctly can save you from future complications.

  6. Submitting Without Verification: Many submit the form without double-checking for accuracy. Always review your completed form before sending it off. A thorough review can catch errors that might otherwise go unnoticed.

Documents used along the form

The IRS 1095-A form is essential for individuals who have health insurance coverage through the Health Insurance Marketplace. However, several other documents are often used in conjunction with it to provide a complete picture of your health coverage and tax obligations. Here are six important forms and documents you may encounter:

  • IRS Form 1040: This is the standard individual income tax return form. You will use it to report your income, calculate your tax liability, and claim any tax credits or deductions.
  • IRS Form 8962: This form is necessary for reconciling your premium tax credit. If you received advance payments of the premium tax credit, you must complete this form to determine your actual credit amount.
  • IRS Form 1095-B: This form provides information about your health coverage. It is issued by insurance providers and shows whether you had minimum essential coverage for each month of the year.
  • IRS Form 1095-C: Employers provide this form to employees who are eligible for employer-sponsored health coverage. It details the coverage offered and whether you were enrolled in it.
  • Marketplace Enrollment Confirmation: This document confirms your enrollment in a health plan through the Marketplace. It includes details about your plan and coverage period.
  • Health Insurance Marketplace Statement: This statement summarizes your health coverage and any premium tax credits you received during the year. It helps you ensure that the information on your tax forms is accurate.

Understanding these documents will help you navigate your tax filing process smoothly. Always keep them organized and accessible, as they are vital for accurate reporting and ensuring compliance with tax regulations.

Similar forms

The IRS Form 1095-A is an important document for taxpayers who have health insurance coverage through the Health Insurance Marketplace. It provides essential information about the coverage you had during the year, including details necessary for filing your taxes. There are several other forms that serve similar purposes in terms of reporting health insurance coverage and related tax information. Here are five documents that are comparable to the 1095-A form:

  • IRS Form 1095-B: This form is used by health insurance providers to report information about individuals who are covered by minimum essential coverage. Like the 1095-A, it confirms that you had health insurance during the tax year, but it does not provide information about premium tax credits.
  • IRS Form 1095-C: Employers with 50 or more full-time employees use this form to report health coverage offered to their employees. Similar to the 1095-A, it helps to demonstrate compliance with the Affordable Care Act, but it focuses on employer-sponsored plans rather than Marketplace plans.
  • IRS Form 8962: This form is used to calculate the Premium Tax Credit that you may be eligible for based on your income and the coverage you had. It relies on the information provided in the 1095-A to determine your eligibility, making it closely related.
  • IRS Form 1040: While this is the standard individual income tax return form, it incorporates information from the 1095-A and other health coverage forms to ensure that taxpayers report their health insurance status correctly. It is essential for completing your tax return accurately.
  • IRS Form 1094-A: This is a transmittal form that accompanies the 1095-A. It summarizes the information reported on the 1095-A forms for a given year, similar to how the 1095-A provides a detailed account of your health coverage.

Each of these forms plays a critical role in ensuring that individuals comply with health insurance requirements and accurately report their coverage when filing taxes. Understanding the similarities can help you navigate your tax obligations with greater ease.

Dos and Don'ts

When filling out the IRS 1095-A form, it’s important to be careful and accurate. Here’s a list of things you should and shouldn’t do to ensure the process goes smoothly.

  • Do check your personal information for accuracy. Make sure your name, address, and Social Security number are correct.
  • Do confirm the coverage details. Verify that the information about your health insurance coverage is complete and correct.
  • Do keep a copy of the form for your records. It’s always a good idea to have a backup in case you need it later.
  • Do reach out for help if needed. If you have questions, don’t hesitate to contact the Marketplace or a tax professional.
  • Don’t ignore deadlines. Submit your form on time to avoid penalties or issues with your tax return.
  • Don’t leave any sections blank. Fill out all required fields to ensure the form is complete.

Following these tips can help you navigate the process of filling out the IRS 1095-A form with confidence.

Misconceptions

The IRS 1095-A form can be confusing for many people. Here are some common misconceptions about this important document:

  • It's only for people who received health insurance through the marketplace. Many believe that the 1095-A is only relevant for those who purchased their health insurance through the Health Insurance Marketplace. However, it is essential for anyone who received a premium tax credit or cost-sharing reductions, regardless of how they obtained their insurance.
  • Receiving a 1095-A means you owe taxes. Some people think that simply receiving this form means they will owe taxes. In reality, the 1095-A is used to report information about health coverage and may help you determine if you qualify for a premium tax credit.
  • You can ignore the 1095-A if you didn't use it. It's a common belief that if you didn't use the premium tax credit, you can ignore the form. However, you still need to keep it for your records, as it provides important information about your health coverage.
  • The 1095-A is the same as the 1095-B or 1095-C. Many confuse the 1095-A with the 1095-B or 1095-C forms. Each serves a different purpose. The 1095-B is for health coverage provided by insurers, while the 1095-C is for employers who offer health insurance to employees.
  • You don't need the 1095-A to file your taxes. Some believe they can file their taxes without the 1095-A. While it is not mandatory to submit it with your return, you will need the information it contains to accurately complete your tax forms.
  • The information on the 1095-A is always accurate. It's a misconception that the information on the 1095-A is flawless. Mistakes can happen, so it's crucial to review the form carefully and report any discrepancies to the marketplace.
  • Only one 1095-A is issued per household. People often think that only one form is issued for the entire household. In reality, each individual who enrolled in a plan may receive their own 1095-A, especially if they were covered under different plans.
  • You can't amend your tax return after using the 1095-A. Some individuals believe that once they file their taxes using the 1095-A, they cannot make changes. If you discover an error or need to amend your return, you can do so, but it may require additional steps.
  • The 1095-A is only relevant for the current tax year. Many think that the 1095-A is only useful for the current year’s taxes. However, it’s a good idea to keep it for future reference, especially if you need to prove health coverage for other reasons.

Understanding these misconceptions can help you navigate your tax obligations more effectively and ensure you are using the 1095-A form correctly.

Key takeaways

The IRS 1095-A form is an important document for individuals who have purchased health insurance through the Health Insurance Marketplace. Understanding how to fill it out and use it correctly can help ensure that you receive the appropriate tax credits and avoid potential penalties. Here are some key takeaways:

  • Purpose of the Form: The 1095-A provides information about your health coverage, including the months you were covered and any premium tax credits you received.
  • Who Receives It: If you enrolled in a health plan through the Marketplace, you should receive a 1095-A by January 31 of the following year.
  • Filling It Out: Ensure that the information on the form is accurate, including the names of covered individuals and the amounts of premiums paid.
  • Using the Form: You will need the 1095-A when completing your federal tax return to reconcile any premium tax credits you received.
  • Correcting Errors: If you notice any mistakes on your 1095-A, contact the Marketplace as soon as possible to request a corrected form.
  • Record Keeping: Keep a copy of the 1095-A for your records, as you may need it for future reference or if you are audited by the IRS.

By being aware of these key points, you can navigate the process of using the IRS 1095-A form more effectively and ensure compliance with tax regulations.