Form 1095-A is the Health Insurance Marketplace Statement that Health Insurance Marketplaces report to the Internal Revenue Service (IRS) and furnish to people who enrolled in a qualified health plan through the Marketplace. If you or a family member enrolled, the figures on it feed Form 8962, Premium Tax Credit (PTC). The IRS marks its posted PDF "NOT FOR FILING": Marketplaces complete the form, and you do not attach it to your return. On FillingPDF you can fill out the form online and download or print the completed PDF; the original and the instructions are published by the IRS.
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What is 1095-A?
Form 1095-A, Health Insurance Marketplace Statement, is the IRS form that Health Insurance Marketplaces use to report enrollments in a qualified health plan in the individual market, and to give each enrollee the figures needed to complete Form 8962, Premium Tax Credit (PTC).
The Marketplace sends the information to the IRS and furnishes a statement to the recipient. A separate Form 1095-A is furnished for each policy, and it relates only to that policy. The form has three parts:
- Part I, Recipient Information (lines 1-15): the Marketplace state, the policy number, the issuer, the recipient, the spouse when advance credit payments were made, the policy dates and the address.
- Part II, Covered Individuals (lines 16-20): name, SSN or date of birth, and coverage dates for each covered person.
- Part III, Coverage Information (lines 21-33): for each month, the enrollment premiums, the second lowest cost silver plan (SLCSP) premium and the advance payment of the premium tax credit, with annual totals on line 33.
Three boxes at the top matter: VOID means the statement was sent in error, and CORRECTED means you use this version instead of the original. The form is not for catastrophic health plans or stand-alone dental plans. The IRS posts its PDF for information only, because the Marketplaces complete it.
Who needs to file 1095-A?
Health Insurance Marketplaces must file Form 1095-A with the IRS for all enrollments in qualified health plans in the individual market through the Marketplace, and furnish a statement to each recipient.
The recipient is the person the Marketplace identified at enrollment as the tax filer: the one expected to file a tax return, claim other family members as dependents and, if qualified, take the premium tax credit. If no tax filer can be identified, it is the primary applicant. You receive the form because you or a family member enrolled through the Marketplace.
- If you received premium assistance through advance payments of the premium tax credit (any amount other than zero in Part III, column C), you must complete Form 8962 and file it with your return, whether or not you are otherwise required to file.
- If you want to take the premium tax credit, you also use the information on this form for Form 8962.
- If you were in more than one policy, you receive a Form 1095-A for each.
Do not expect a premium tax credit for a catastrophic health plan or a separate dental policy, even if you received a Form 1095-A for it. Individuals cannot complete and use the Form 1095-A posted on IRS.gov.
When to file 1095-A
Marketplaces must file the annual report with the IRS and furnish statements to individuals on or before January 31, 2026, for coverage in calendar year 2025. The duty to furnish is met if the form is properly addressed and mailed, or furnished electronically to a recipient who has consented, by the due date. If January 31 falls on a Saturday, Sunday or legal holiday, the statement is due the next business day.
Errors are handled as soon as they are found. A Marketplace that discovers incorrect information reports the correction to the IRS and the recipient as soon as possible with the CORRECTED box checked. A statement sent in error is voided with the VOID box.
As a recipient, you use the form when you prepare your tax return, because Form 8962 is filed with that return.
How to fill out 1095-A
Check the VOID and CORRECTED boxes
At the top, mark VOID only for a statement sent in error, such as one for a stand-alone dental or catastrophic plan. Mark CORRECTED when you are reporting corrected information.
Enter the Marketplace and policy
Line 1: the Marketplace state name or abbreviation. Line 2: the Marketplace-assigned policy number, using only the last 15 characters if it is longer. Line 3: the name of the policy issuer.
Identify the recipient
Line 4: the person identified at enrollment as the tax filer, or the primary applicant if no tax filer can be identified. Line 5: the recipient's SSN. Line 6: date of birth only if line 5 is blank.
Add the spouse when required
Lines 7, 8 and 9: enter the recipient's spouse only if advance credit payments were made for the coverage, even if they were not made for the spouse. Enter the date of birth on line 9 only if line 8 is blank.
Enter policy dates and address
Line 10: the coverage start date, 1/1/2025 if the policy was in effect at the start of the year. Line 11: the termination date, or 12/31/2025 if still in effect at year end. Lines 12-15: the recipient's address.
List each covered individual
Lines 16-20: columns A-E give name, SSN, date of birth, coverage start and coverage end for each person. Enter a date of birth in column C only if column B is blank. If advance credit payments were made, list only people certified as part of the tax family.
Continue Part II if needed
If more than five individuals are covered, complete one or more additional Forms 1095-A, Part II. Individuals in the policy who are not in the tax family go on a separate Form 1095-A.
Enter monthly premiums in column A
Lines 21-32: enter the total monthly enrollment premiums, only those for essential health benefits plus pediatric dental where it applies. Enter -0- for months where premiums were not fully paid, except in the grace-period situations the instructions list.
Enter the SLCSP premium in column B
Lines 21-32, column B: the premium for the applicable second lowest cost silver plan used as the benchmark for advance credit payments. Enter -0- if everyone enrolled after the first of the month, unless the instructions' birth, adoption, foster care or court-order exception applies.
Enter advance payments in column C
Lines 21-32, column C: the advance credit payments for each month, allocated only to the policy on this form if more than one Form 1095-A applies. Leave it empty if none were made.
Total the year on line 33
Add the amounts on lines 21 through 32 and enter the annual totals for columns A, B and C on line 33.
Review and download the PDF
Check each line against the instructions, then download or print the completed PDF from FillingPDF. The IRS notes that the form posted on IRS.gov is for information only and is completed by the Marketplace.
How to submit 1095-A
Form 1095-A is submitted by the Marketplace, not by you: Marketplaces file electronically with the IRS and furnish statements to recipients by mail or, with consent, electronically.
- To the IRS: the Marketplace must submit the information electronically. Truncated SSNs are not allowed on forms filed with the IRS.
- To you: the statement is mailed to your last known permanent address (or temporary address if no permanent one is known), unless you consented to receive it electronically, for example by email or through your Marketplace account. Statements to recipients may show only the last four digits of an SSN.
- With your return: do not attach Form 1095-A to your tax return; keep it for your records. File Form 8962 with Form 1040, 1040-SR or 1040-NR when it applies.
- If something looks wrong: contact your Marketplace Call Center. For the federally facilitated Marketplace, see https://www.healthcare.gov/contact-us/. For a State-based Marketplace, use its website.
FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Attaching Form 1095-A to your tax return; the form says not to attach it and to keep it for your records.
- Using the original Form 1095-A to figure the premium tax credit when the CORRECTED box is checked on a newer one; use the corrected form instead.
- Using a Form 1095-A with the VOID box checked on Form 8962; it was sent in error and should not be used.
- Expecting a premium tax credit for a catastrophic health plan or separate dental policy because a Form 1095-A arrived for it.
- Entering a date of birth in column C (Part II) or on line 6 when an SSN is already entered; the date applies only if the SSN is blank.
- Entering a policy number longer than 15 characters in full on line 2; only the last 15 characters go there.
- Including refunded premiums in a month's column A amount when coverage ended before the last day of the month.
- Filing Form 1095-A with the IRS with a truncated SSN; truncation is not allowed on forms filed with the IRS.
Frequently asked questions
What is Form 1095-A used for?
Form 1095-A is the Health Insurance Marketplace Statement. Marketplaces use it to report to the IRS who enrolled in a qualified health plan, and to give enrollees the information they need to take the premium tax credit and reconcile advance credit payments on Form 8962.
Do I attach Form 1095-A to my tax return?
No. The form says not to attach it to your tax return and to keep it for your records. Use its figures to complete Form 8962, which you file with Form 1040, 1040-SR or 1040-NR when it applies to you.
Who has to file Form 8962 with a 1095-A?
You must file Form 8962 with your return if any amount other than zero appears in Part III, column C, meaning advance credit payments were made for you. The requirement applies whether or not you are otherwise required to file. You also use it to take the premium tax credit.
Can I fill out Form 1095-A online myself?
You can fill out the PDF online on FillingPDF and download it, but the IRS says Marketplaces complete this form and individuals cannot complete and use the version on IRS.gov. FillingPDF does not file anything with the IRS or a Marketplace.
When do I get my Form 1095-A?
Marketplaces must furnish statements on or before January 31, 2026, for 2025 coverage, or the next business day if that date is a weekend or legal holiday. Statements are mailed unless you consented to receive them electronically.
What if my Form 1095-A has wrong information?
Contact your Marketplace Call Center. If you bought through the federally facilitated Marketplace, see healthcare.gov/contact-us/; for a State-based Marketplace, use its website. A corrected statement has the CORRECTED box checked, and you use it instead of the original.
What does the VOID box on Form 1095-A mean?
VOID means you previously received a Form 1095-A for that policy and it was sent in error. Do not use the information on the voided form or the earlier one to figure your premium tax credit on Form 8962.
Why did I get more than one Form 1095-A?
You receive one for each policy you enrolled in through the Marketplace. You may also get an additional form if more than five people were covered, or a separate one if someone in the policy is not in your tax family, such as an adult child who is not your dependent.
What are columns A, B and C in Part III?
Column A is the monthly enrollment premium, column B is the monthly premium for the second lowest cost silver plan (SLCSP), and column C is the monthly advance payment of the premium tax credit. Lines 21-32 cover each month and line 33 gives the annual totals.
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