Your Guide to Form 1095-A

You’ll receive this tax form if you bought coverage from the health insurance marketplace.

Elissa

Elissa Suh

Published August 28, 2019

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KEY TAKEAWAYS

  • Form 1095-A details how much you paid in monthly premiums and how much you received from the advance premium tax credit (APTC)

  • Everyone who purchased health insurance on the marketplace will receive a 1095-A

  • You do not fill out Form 1095-A yourself; you just use it to file your taxes

Form 1095-A details how much you paid in monthly premiums and any premium tax credits you claimed. Everyone who bought a health plan on the health insurance marketplace will receive a copy of Form 1095-A, which is officially called the Health Insurance Marketplace Statement.

The information on your 1095-A may be important when you file your federal income tax return, especially if you received the advance premium tax credit (APTC). You do not fill out 1095-A yourself; the marketplace will fill it out and send you a copy, usually by the end of January.

There are two other versions of the 1095 form and they’re all used under the Affordable Care Act (Obamacare) to show whether or not you met the law’s requirement for minimum health insurance coverage. People without that minimum coverage used to have to pay the individual mandate, a tax penalty, but that was repealed starting in 2019. You’ll still receive a 1095 as long as you had health insurance, but most people won’t actually need it when filing their taxes. It’s a good form to keep for reference, though, and some states do have their own individual mandate penalties.

Get health insurance with the help of our state-by-state guide to Obamacare enrollment.

What is Form 1095-A?

Form 1095-A is a tax form that you receive if you purchased a qualifying health plan — anything other than a stand-alone dental plan, short-term health plan, or catastrophic coverage — through the Obamacare marketplace. Individuals do not file this form. You will receive it from the marketplace to use for tax filing purposes.

When you get a qualified health plan through the Obamacare marketplace — healthcare.gov or your state’s exchange if it has its own — the marketplace is required to report the details of your coverage to the Internal Revenue Service (IRS). The IRS needs to know how much you paid in premiums and any tax credit payments you took. Form 1095-A includes all the necessary information.

Your 1095-A details coverage you had during the calendar year, regardless of whether you enrolled during the Open Enrollment period or through a Special Enrollment Period. You may receive multiple 1095 forms if you change insurance coverage during the year, like if you leave your employer’s coverage and get a marketplace plan.

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What is on my 1095-A form?

Form 1095-A includes the following information:

  • Personal details: Your basic information, including Social Security number, address and birth date.
  • Covered individuals: Other people who get health insurance through your plan, like family members. If you and your spouse are covered by one plan, you will only receive one 1095-A form.
  • Policy details: Your insurance provider, coverage start date, and end date if applicable.
  • Monthly premiums: How much you paid in premiums each month, or the cost to have access to your insurance.
  • Second lowest cost silver plan (SLCSP): This is the monthly premium cost for the SLCSP in your area. The SLCSP determines the amount of premium tax credit you’re eligible for. If you didn’t qualify for a tax credit, then these figures might not apply to you.
  • Advance premium tax credit: If you qualified for and claimed the advance premium tax credit during the tax year, your 1095-A will list exactly how much you received from the credit.

Related: Where Obamacare plans cost the most, even after subsidies.

How do I get Form 1095-A?

You should receive either a physical copy of the 1095-A in the mail or an electronic version. The marketplace should send the form by January 31. If that is on a weekend or holiday, they have until the following business day. For an electronic form, log into your marketplace account online. If you opted for a physical copy, it could take a couple of weeks after January 31 for the form to arrive.

If you don’t get your 1095-A within three weeks of the January 31 deadline, contact healthcare.gov (or your state marketplace) to check its status or request another copy. If you need a second copy of your 1095-A, you can either download it through your online marketplace account, or you can reach out to the marketplace for a physical copy.

Form 1095-A & tax credits

If your household income is below a certain amount, you may qualify for a health insurance subsidy to lower your monthly premiums. The most common example is the premium tax credit, or PTC. You can receive this tax credit in one of two ways: either by claiming it at the end of the year on your federal tax return, or by claiming it throughout the year and having the government make advance payments directly to your insurance company. This advance option is called the advance premium tax credit or APTC.

If you claimed the APTC during the year, you need to file a tax return at the end of the year. You also need to file Form 8962, which will require some of the information on your 1095-A.

Learn more in our complete guide to filing taxes.

Form 1095-A vs 1095-B vs 1095-C

A 1095 form shows whether an individual meets the Affordable Care Act’s requirement for minimum health insurance coverage. There are three versions of the 1095 and they all show basically the same information, but which version you get depends on the type of coverage you had:

  • You receive a 1095-A from the marketplace if you had a marketplace plan.
  • You receive a 1095-B from your insurance company if you had coverage that wasn’t through the marketplace or a large employer, like if you had COBRA or Medicare.
  • You receive a 1095-C from your employer if you had employer-sponsored coverage.

Before 2019, if someone didn’t have qualifying health coverage, they would have to pay the individual mandate penalty. The individual mandate has been repealed, so most people won’t actually need a 1095 to help fill out their tax return. However, a handful of states still levy their own tax penalty for going without health insurance. Regardless of where you live, you will receive a 1095 if you had health insurance.

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Personal Finance Editor

Elissa Suh

Personal Finance Editor

Elissa is a personal finance editor at Policygenius in New York City. She writes about estate planning, mortgages, and occasionally health insurance. In the past she has written about film and music.

Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.

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