Form 1095-A : What it is & How to get it ?

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Form 1095-A, Health Insurance Marketplace Statement, is the IRS tax form that reports the premium tax credit that members received in advance from the health insurance marketplace.

The Affordable Care Act introduced premium tax credits to help lower the cost of health insurance purchased through Healthcare.gov and the 14 states (and the District of Columbia) that run their own health insurance marketplaces.

Rather than wait until you file your income-tax return to benefit from the tax break, you can receive the credit in advance — using it to reduce your health insurance premiums throughout the year.

How do you determine the premium tax credit?

The size of the premium tax credit is based on your income. When you apply for health insurance on Healthcare.gov or your state marketplace, you estimate your household income for the current year to determine how large a credit you can receive. The website then calculates how much you can save via subsidies.

You can request that the government send all or part of your credit directly to the health insurance company to reduce your bills during the year. In that case, you just pay the remaining portion of the premium each month.

Depending on your income and family size, the advance premium tax credit (also known as a premium subsidy) could reduce your premiums by hundreds of dollars every month.

The size of the credit you receive during the year is based on your estimated household income. But you may qualify for a larger or smaller credit based on your actual income for the full year.

When you file your income-tax return, you reconcile the amount you received in advance credits with the amount you should have received based on your annual income:

If your income ended up being lower than expected, you may get back more money in an extra tax credit when you file your income tax return.
If your income wound up being larger than expected, you may have to pay back money you received from the advance credit when you file your return.

However, repayments of excess premium tax credits were temporarily suspended for 2020.

“Due to the challenges Americans faced with fluctuating income in 2020, the American Rescue Plan temporarily waived the requirement for taxpayers to pay back excess advance premium tax credits on their 2020 taxes since taxpayers may have received more income than projected when applying for a subsidy to help pay for marketplace insurance,” says Lisa Greene-Lewis, CPA and tax expert from TurboTax.

The repayment of excess credits hasn’t been suspended for 2021.

You need to use the information in IRS Form 1905-A to perform this calculation. You’ll receive this form from your health insurance marketplace each January reporting how much you received from the credit to reduce your premiums each month during the year.

Anyone who bought insurance from Healthcare.gov or their state marketplace and received a premium tax credit should receive Form 1095-A and use the information when completing Form 8962. You must file Form 8962 with your income-tax return, reconciling the credit you qualify for with the amount you received in advance.

“Since your advanced premium tax credit is based on an estimate of household income, you need the advanced premium tax credit information from Form 1095-A to determine the amount you should have received based on your actual income when you file your taxes,” says Greene-Lewis.

Key Takeaways

The health insurance marketplace offers premium tax credits to members to help reduce the cost of coverage.
You can choose to have advance payments sent to your health insurance company to cut premium costs.
Members must estimate their household income for the next year when getting a marketplace plan. Form 1095-A later helps you figure out whether you owe money or are owed money the following year based on your actual household income.
You also use that information to complete Form 8962, Premium Tax Credit, which is filed with your federal tax return.
You can receive Form 1095-A online or have the marketplace mail you a copy.

What is a 1095-A Form?

Form 1095-A, Health Insurance Marketplace Statement, is the IRS tax form that reports the amount of the premium tax credit you received in advance from your health insurance marketplace.

When you file your income tax return, you need to use this information to determine whether you should receive additional money from the tax credit or if you need to pay back any of the advance credit you received.

The actual amount of the credit you qualify for may be different than what you received if your household income for the full year ended up being more or less than you estimated when you applied for health insurance on the marketplace.

You don’t file Form 1095-A with your tax return — just keep it in your tax records. However, you need to use the information on it to complete Form 8962, Premium Tax Credit, which you will file with your income tax return.

“Form 8962 determines how much tax credit someone qualified for based on their actual income and household size shown on their federal income tax return,” says Monica Caballeros of Connect for Health Colorado, the state’s health insurance marketplace. “Based on the difference between the reported and actual income, customers may collect more premium tax credit or they may need to repay some of the tax credit they received.”

You need to file Form 8962 if you received a premium tax credit or were eligible for the credit.

“The IRS requires you to file a federal income tax return with Form 8962 if you or any other member of your household received or wants to claim the premium tax credit,” says Caballeros.

The marketplace sends a copy of Form 1095-A to the IRS, too.

How do you receive a Form 1095-A?

The state insurance marketplace where you purchased your health insurance should send you Form 1095-A by Jan. 31, reporting the advance premium tax credit you received for the previous year.

Connect for Health Colorado, for example, mails Form 1095-A to the primary tax filer in the household. You can also get an electronic version by logging into your account at the marketplace website.

How to get a 1095-A form online

Most insurance marketplaces also make the form available online. In Colorado, for example, you can get an electronic version of Form 1095-A in the “My Documents” section of your Connect for Health Colorado online account.

See the Marketplace in Your State list at Healthcare.gov for links to the websites for the 14 states (and District of Columbia) that run their own health insurance marketplaces. The rest of the states use Healthcare.gov.

If you purchased your health insurance through Healthcare.gov, you usually should receive Form 1095-A in the mail in January (or mid-February for 2020 forms). To get a copy online, log into your Healthcare.gov account, select the tax year, and then choose “tax forms” from the menu on the left. Healthcare.gov has step-by-step guidance to help you find the form online.

What does a 1095-A form look like?

Form 1095-A is broken down into three sections:

The first section lists the marketplace information and the name and Social Security number of the recipient (the person expected to file the tax return and claim the credit) and spouse. It also shows the policy start and end date and the recipient’s address.
The second section lists the name, covered start and end date, Social Security number and birthdate for each individual covered under your policy.
The third section shows the monthly premiums, the monthly second-lowest cost silver plan premium (which is used to determine the size of the credit in your area) and the monthly advance payment of premium tax credit.

There is a separate line for each month and also an annual total. The yearly totals determine the size of your credit, but the information is also shown for each month because you can change the amount of the credit monthly by reporting changes in your estimated income to the marketplace.

“It is a record of how much tax credit was received by month and will show any changes to the advance payment of tax credit based on the income and other information reported by the customer during the year,” says Caballeros. Here’s a copy of 1095-A for 2020 on the IRS website.

You then use information from that form when filling out Form 8962, which you must submit when you file your income-tax return for the year. Here’s a copy of Form 8962 for 2020.

Frequently Asked Questions

What is a 1095-B form?

Form 1095-B reports that you and your family members had “minimum essential” health coverage, according to the standards of the Affordable Care Act.

Keep this form in your tax records to show that you don’t have to pay a penalty for not having health insurance if your state mandates health insurance. You will receive this form from your health insurance company, employer, or from a government entity that provides your coverage (if you have Medicaid, for example).

Even though the individual mandate penalty requiring health insurance was reduced to $0 starting in 2019, employers, insurance companies and government entities that provide coverage must still send this form (and several states still have an individual health insurance mandate).

What is a 1095-C form?

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is similar to Form 1095-B, but it reports employer-provided health insurance from companies with 50 or more employees. Here is a copy of the form and IRS instructions.

How do I find my 1095-A form on Healthcare.gov?

If you purchased your health insurance through Healthcare.gov, you should receive a copy of the form in the mail and you can also access the form online.

Log into your Healthcare.gov account, select the tax year, and then choose “tax forms” from the menu on the left.

What is the marketplace identifier on Form 1095-A?

This line at the top of Form 1095-A identifies the state where you enrolled in coverage through the marketplace.

How to get Form 1095-A from Covered California?

If you chose mail as your communication preference on your account, you will receive your tax forms in the mail and an e-mail notification when they become available in your Covered California account.

If you chose e-mail as your communication preference, you will receive an e-mail letting you know when the forms are available to access through your account. Sign in to your account to download and print the forms.

How to get Form 1095-A from New York State of Health?

Everyone enrolled in a qualified health plan receives a Form 1095-A by Jan. 31 the year following their enrollment, says Abigail Barker of the New York State of Health, New York’s health insurance marketplace.

“While a hard copy is mailed, members can also log into their NY State of Health account to access their 1095-A form there,” Barker says.

How to print 1095-A form?

You should be able to print the 1095-A form by logging into your account at the marketplace and downloading an electronic copy of the form.

Kimberly Lankford

Contributing Researcher

Kimberly Lankford has been a financial journalist for more than 20 years. She received the personal finance Best in Business Award from the Society of American Business Editors and Writers. She also has written three books: “The Insurance Maze: How You Can Save Money on Insurance – and Still Get the Coverage You Need” “Rescue Your Financial Life,” and “Ask Kim for Money Smart Solutions.”