What Is Form 1095-A and What Do I Do With It?
Learn how your Health Insurance Marketplace statement, Form 1095-A, is used to calculate your final premium tax credit for your federal tax return.
Form 1095-A, the Health Insurance Marketplace Statement, is a tax document for individuals who have obtained health coverage through a government-run marketplace. This form provides a detailed record of your health insurance policy for the year, including the premiums paid and any financial assistance received to help cover those costs. The Internal Revenue Service (IRS) receives a copy of this form from the Marketplace to verify health coverage and calculate tax credits.
Who Receives Form 1095-A
Individuals or families who enrolled in a health plan through the federal Health Insurance Marketplace or a state-specific exchange will receive Form 1095-A. The Marketplace must send this form by January 31 of the year following the coverage year, and it is often available in your online account by mid-January. You will not receive a Form 1095-A if your coverage was through an employer, Medicaid, or Medicare.
You may receive more than one Form 1095-A if household members were on different plans, you changed plans, or you reported new family information during the year. You should wait to file your taxes until you have a correct form for each policy.
Understanding the Information on Form 1095-A
Form 1095-A is divided into three parts. Part I identifies the policyholder and policy details, while Part II lists all individuals covered by the plan. Part III contains the financial information needed for your tax return, broken down by month into three columns.
Column A shows the total monthly premium for your health plan. Column B lists the premium for the “second-lowest cost Silver plan” (SLCSP), which is a benchmark plan in your area that the IRS uses to calculate your premium tax credit. This figure is based on your location, age, and family size.
Column C details the advance premium tax credit (APTC) you received each month. This is the amount the government sent to your insurance company to lower your monthly payments. If you did not receive this assistance, this column will be blank or show a zero.
Required Information for Reconciling Your Credit
You must use the information from Form 1095-A to complete and submit Form 8962, Premium Tax Credit (PTC). This process is called “reconciliation,” where you compare the advance payments you received (APTC) with the actual premium tax credit you qualify for based on your final income for the year. This determines whether you will receive an additional credit or have to repay some of the assistance you received.
To complete Form 8962, you will need your Form 1095-A, your final household income figures, and your tax filing status. For each month of coverage, you will transfer the monthly premium from Column A, the SLCSP premium from Column B, and the APTC from Column C of your 1095-A. If Column B on your Form 1095-A is blank, you must use the Health Coverage Tax Tool on HealthCare.gov to find the correct SLCSP amount.
Filing Your Tax Return with Form 8962
Once completed, Form 8962 must be attached to your Form 1040 when you file your federal income tax return. Filing Form 8962 is mandatory if you received any advance premium tax credits during the year. It is also required if you did not receive advance payments but wish to claim the premium tax credit on your return.
The final calculations on Form 8962 determine your net premium tax credit. If the total premium tax credit you are eligible for is more than the advance credit payments you received, the difference is your net premium tax credit. This amount is then carried over to your tax return to increase your refund or lower the tax you owe.
If you received more in advance payments than the credit you ultimately qualify for, you will have an excess advance premium tax credit repayment. This repayment amount is calculated on Form 8962 and entered on your tax return, which will decrease your refund or increase your tax liability.
Correcting an Inaccurate Form 1095-A
Before using Form 1095-A to file your taxes, you should review it for any errors. Check that your name, coverage dates, and the premium amounts are all correct. If you find a mistake in the coverage information or the financial figures, you must get it corrected before you file your tax return. Do not file with an incorrect form, as the information has also been reported to the IRS.
To get an error fixed, you must contact the Health Insurance Marketplace call center directly, not the IRS. You will need to explain the error and request that they research the issue and send you a new, corrected Form 1095-A. The Marketplace will mail the corrected form and may also upload it to your online account.
Some minor demographic errors, such as a misspelled name or an incorrect address, do not require a formal correction from the Marketplace. You can correct this type of information when you file your tax return. However, for any inaccuracies related to premiums, tax credits, or coverage periods, obtaining a corrected Form 1095-A is required. If you have already filed your return and then receive a corrected form, you may need to file an amended return using Form 1040-X.