Each year, millions of Americans purchase insurance coverage through the Health Insurance Marketplace and take advantage of federal tax credits. The credits are designed to lower the cost of health insurance for those who meet income criteria. Credits can be applied directly to lower your monthly insurance premiums (advance payments of the premium tax credit), or you can wait to claim them all at once when you file your annual tax return.
If you or a member of your household purchased health insurance coverage through the Health Insurance Marketplace during the past year, you can expect to receive a Form 1095-A, also known as the Health Insurance Marketplace Statement. This form contains critical information needed to accurately complete your tax return. Here’s what you need to know.
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What is Form 1095-A?
Form 1095-A is issued by the Health Insurance Marketplace. It is sent to those who enrolled in a Marketplace health plan during the previous tax year, and a copy is also sent to the Internal Revenue Service (IRS). Form 1095-A contains important information, including:
- Total Marketplace health insurance premiums paid
- Advance payments of the premium tax credit (APTC)
- Information regarding the “Second-Lowest-Cost Silver Plan” (SLCSP)
If you received APTC, the information contained on Form 1095-A is used to determine whether you received too much or too little of the premium tax credit. If you did not receive APTC, you can use this form to claim the premium tax credit on your tax return.
When and Where to Get Your Form 1095-A
The Marketplace mails 1095-A forms by mid-February each year, so keeping an eye on your mailbox is important. If you have not received your form, you can also download it from your online Marketplace account by following these steps:
- Log in to your account on the official Health Insurance Marketplace website.
- Navigate to the “Your Existing Applications” section and select the application for the year in question — for example, your 2023 application if you’re filing taxes for the 2023 tax year.
- Look for a section labeled “Tax Forms” and select it. Your Form 1095-A should be listed among any other tax-related documents here.
- Download the form for your records and to use when preparing your taxes.
For assistance, contact the Health Insurance Marketplace Call Center at 1-800-318-2596 (TYY: 1-855-889-4325).
It’s critical not to file your tax return until you receive your 1095-A Form. This is not only necessary to ensure you comply with tax laws, but it also allows you to maximize tax benefits related to your health insurance coverage.
Using Form 1095-A to Complete Your Tax Return
To best follow along, have your 1095-A in hand as we guide you through this process. Looking at the form, confirm each of the following:
- Your personal information
- Months of coverage
- Details of other household members covered by the plan
- Monthly premium amounts
- Amount of APTC received
If you find a mistake, contact the Marketplace Call Center to report it. If the information is correct, move on to the following steps.
1. Confirm the Second Lowest Cost Silver Plan
The Second Lowest Cost Silver Plan (SLCSP) is a benchmark plan used to calculate how much you can receive for your premium tax credit. Make sure the SLCSP premium amount listed on your Form 1095-A accurately reflects the cost of the second lowest-priced Silver health plan in your area, based on your household size and income.
The SLCSP may be different if there were changes in your household, like if you welcomed a child or if your spouse passed away. It may also change if you moved to a different area. If the SLCSP premium seems incorrect or you experienced significant life changes that you did not report to the Marketplace, use the Tax Tool available through the Marketplace website to find your correct SLCSP premium.
2. Reconcile Premium Tax Credits
Next, reconcile your premium tax credits by comparing the APTC you received throughout the year with the amount you were eligible for based on your actual income.
Use the information on Form 1095-A to complete Part II of Form 8962:
- Enrollment Premiums: Find on Part III, Column A of 1095-A, enter on Part II, Column A of Form 8962.
- SLCSP Premium: Find on Part III, Column B of 1095-A, enter on Part II, Column B of Form 8962.
- APTC: Find on Part III, Column C of 1095-A, enter on Part III, Column F of Form 8962.
Complete the remaining sections of Form 8926, then check line 26 to determine if you used more or less of the amount you qualified for.
If you received more APTC than you qualify for, you might need to repay the extra amount with your tax return. If you received less, the IRS may refund or apply the difference against taxes due. Once you’ve completed the Form 8962, file it with your tax return.
The Bottom Line
If you or a household member has health insurance from the Marketplace, it’s critical to handle Form 1095-A correctly. Make sure to check the information thoroughly and contact the Marketplace Call Center if you notice a discrepancy. Confirm the SLCSP, particularly if you’ve had significant household changes during the tax year.
Once you’ve confirmed the details, use the information to complete Form 8962 and file it with your tax return. If you have additional questions, find help from a tax professional who can guide you through the process in greater detail.