What is a Form 1095-A, and What Does It Mean For Your Taxes - GoodRx (2024)

The Affordable Care Act helps more people receive affordable health insurance through tax subsidies such as the premium tax credit (PTC). This credit allows eligible individuals and family members to receive financial assistance during the year to reduce the cost of monthly insurance premiums.

You can also wait until tax time to receive your benefits. The PTC is a refundable credit that can reduce your tax bill or increase your tax refund. In order to receive this credit, you must gain access to your Form 1095-A. This form will provide you with all the information needed to complete Form 8962 and claim your tax credit.

Below, we review how Form 1095-A works and how you can use it to claim the premium tax credit.

What is Form 1095-A used for?

You will receive Form 1095-A if you or a member of your household purchased health insurance through a state or federal healthcare exchange. This is also known as the health insurance marketplace. You should be on the lookout for Form 1095-A if you received marketplace coverage at any time during the previous year.

You will need Form 1095-A to get the benefits of the premium tax credit using Form 8962, Premium Tax Credit (PTC). You’ll also need Form 1095-A if you received advance payments of the premium tax credit during the previous year. The advance payments reduce your out-of-pocket costs for insurance every month.

You do not need to submit Form 1095-A to the IRS when you file your taxes. The health insurance marketplace will send copies of the form to you and the IRS. Form 1095-A is only an informational form needed to help you submit an accurate tax return.

What Form 1095-A information is on a health insurance marketplace statement?

Form 1095-A contains three parts. Each part of the form will provide you with information needed to successfully fill out Form 8962 and claim your premium tax credit.

The first part of your statement contains information about you and your insurance coverage. Here is the information you’ll find in Part I:

• Basic household information

• Information about the insurance company that provided you with coverage

• Health insurance policy start date

• Health insurance policy termination date

• Marketplace policy number

Part II will provide you with a list of individuals in your household who are covered under a health insurance marketplace plan. Here is the information you’ll find in Part II:

• Covered individual’s name and Social Security number

• Covered individual’s date of birth

• Coverage start date

• Coverage termination date

Part III will provide more details about your coverage during the year. You will find the following information:

• Monthly premiums: This includes total insurance premiums paid by you and any advance payments that were paid on your behalf.

• Dates of insurance coverage: You will see the coverage amount for every month you were enrolled in a health insurance marketplace plan.

• Second-lowest-cost Silver plan premium (SLCSP): You can use the HealthCare.gov tax tool to find your SLCSP. This number is used to compute your premium tax credit.

• Advance payments of premium tax credit (APTC): This column will show the amount of advance payments that were submitted on your behalf to cover the cost of monthly insurance premiums.

Who issues your Form 1095-A?

You will not receive Form 1095-A from the IRS. The health insurance marketplace will provide you with this form if you had a marketplace plan in the prior year. You’ll also receive the form if a member of your household was covered under a marketplace insurance plan.

You should have received Form 1095-A by mid-February so you’ll have time to file your taxes before the deadline.

How do you obtain your Form 1095-A?

If you misplaced your Form 1095-A or don’t receive it in the mail, you may be able to access it by logging into your HealthCare.gov account. Your form may be available as early as January if you retrieve it online.

What do you do with a Form 1095-A?

When you receive your health insurance marketplace statement, make sure all the information is correct. If anything is inaccurate, contact the Marketplace Call Center at 1-800-318-2596 to obtain an updated Form 1095-A.

After you’ve reviewed and confirmed all information, you can then use your Form 1095-A to fill out Form 8962. This will help you claim your premium tax credit. Your Form 1095-A will allow you to compare the actual amount of premium tax credit you received in the previous year with the amount you were qualified to receive.

Your Form 1095-A is yours to keep. You do not need to submit it with your tax return.

What happens if you don't file your Form 1095-A?

The purpose of Form 1095-A is to reconcile any advance premium tax credits you received during the year with the amount of credits you were eligible to receive. If you fail to file a tax return reconciling those payments, you will not be eligible for premium tax subsidies in the next year. You also won’t be eligible for cost-sharing reductions and will be responsible for paying 100% of your monthly premiums and all covered services in the future.

Therefore, you will not be able to file your taxes without Form 1095-A. You can wait for your form to arrive in the mail or log into your HealthCare.gov account to find it.

If you filed your taxes before reviewing Form 1095-A, you may need to submit an amended tax return to ensure you are submitting an accurate tax return. If there are any discrepancies on your tax return, you may have to pay back some or all of the advance payments of the premium tax credit you received during the year.

Remember, Form 1095-A is an informational return used to complete Form 8962. You do not need to submit Form 1095-A with your tax return.

How long do you need to keep your Form 1095-A?

Although you do not need to submit Form 1095-A to the IRS, you should still keep it with your tax records for at least 3 years. This will provide you with proof in case the IRS decides to audit your return.

Can you get your Form 1095-A online?

Yes. You may be able to access your Form 1095-A by logging into your HealthCare.gov account.

Here’s how to get a Form 1095-A online through HealthCare.gov:

• Log in to your account. If you don’t remember your health insurance marketplace login information, click “Forgot your username?” or “Forgot your password?” Your username may be your email address.

• Click on the 2023 application if you are trying to find the relevant information for your 2023 tax return.

• Select “tax forms,” located on the left side of the screen.

• Click on “Form 1095-A” for tax filing.

• Save and print the PDF form.

You may notice multiple 1095-A forms listed under your account. This may be the case if your household enrolled in more than one health insurance plan from the marketplace. This will also happen if you reported any changes during the year, such as a switch in health insurance plans or updates to your household information.

If you need additional assistance finding your 1095-A form online, you can review the screen-by-screen directions and pictures on the healthcare.gov website. You can also call the Marketplace Call Center at 1-800-318-2596.

What’s the difference between a Form 1095-A and a Form 1095-B?

Form 1095-A is the health insurance marketplace statement. This form shows you details about health coverage that you or a family member may have received from the marketplace. Form 1095-A will help you complete Form 8962. This will help you claim your premium tax credit benefits on your tax return. You should not file your tax return before you receive and verify the information shown on your Form 1095-A.

Form 1095-B is used to report and confirm that you had the minimum required insurance coverage during the year. Health insurance providers will send this form to covered individuals by early February. This coverage can include information about the following:

• Employer-sponsored health plans

• Medicaid

• Medicare Part A

• Children’s Health Insurance Program (CHIP)

• Individual market plans

You may get multiple 1095-B forms if you switched jobs or changed coverage during the year. You do not need to wait for your forms to file your tax return. Form 1095-B is typically not needed for your federal income taxes.