This form provides detailed information about your Marketplace health insurance plan.

You should receive Form 1095-A if you:

• Enrolled in a health plan through the Health Insurance Marketplace
• Received advance payments of the premium tax credit
• Had coverage through Healthcare.gov or a state-based exchange

The Marketplace sends this form by mail or makes it available through your online account by January 31 each year.

You must use Form 1095-A to:

1. Reconcile your advance premium tax credits on Form 8962
2. Calculate your final premium tax credit amount
3. Determine if you owe repayment or get additional credit

Even if you only had Marketplace coverage for one month, you must complete this reconciliation.

What if my form has errors?
Contact the Marketplace immediately for a corrected form. Do not use incorrect information.

What if I didn't receive my form?
Check your Marketplace account online or call the Marketplace at 1-800-318-2596.

Do I file Form 1095-A with my return?
No, but keep it with your records and use it to complete Form 8962.

When preparing your taxes, have these ready:

• Form 1095-A from the Marketplace
• Records of any premium payments you made directly
• Documentation of life changes (marriage, income changes, etc.)
• Last year's tax return for reference