Fill IRS Form 1095-A Online
The 1095-A Health Insurance Marketplace Statement — complete or annotate it in your browser, then download. Nothing leaves your device.
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About 1095-A
Form 1095-A, the "Health Insurance Marketplace Statement," is sent to anyone who bought health coverage through the federal or a state Marketplace (Healthcare.gov or a state exchange). You use it at tax time to reconcile the Advance Premium Tax Credit — the subsidy that lowered your monthly premiums — against the credit you actually qualified for, by completing Form 8962. The 1095-A reports, month by month, your enrollment premiums, the cost of the benchmark Second Lowest Cost Silver Plan, and the advance credit that was paid on your behalf.
The form has three parts: Part I identifies the recipient, the policy, and the Marketplace; Part II lists the covered individuals; and Part III is the monthly grid — columns A (monthly premium), B (benchmark SLCSP premium), and C (advance payment of the premium tax credit) for each month of coverage. Those three columns are exactly what flow into Form 8962, so accuracy in the grid matters most. The Marketplace normally issues your 1095-A by mid-February; this filler is handy for completing a corrected copy, filling a blank for record-keeping, or annotating one before handing it to your tax preparer.
FormatFuse opens the official IRS 1095-A and lets you fill every field in your browser — coverage and premium details never leave your device. Download the completed PDF for your records or your preparer. Note that the Marketplace, not the taxpayer, is the official issuer of the 1095-A you file from; use this tool to work with the form privately rather than as a substitute for the Marketplace's authoritative statement.
How to fill 1095-A
- 1
Part I — Recipient + policy
Enter the Marketplace ID, policy number, recipient name, SSN, and the policy start/end dates.
- 2
Part II — Covered individuals
List each person covered under the policy with their SSN and coverage dates.
- 3
Part III — Monthly grid
For each month, fill Column A (premium), Column B (benchmark SLCSP), and Column C (advance premium tax credit).
- 4
Review against 8962
Columns A, B, and C feed directly into Form 8962 to reconcile your premium tax credit — double-check the monthly figures.
- 5
Download
Download the completed PDF for your records or to hand to your tax preparer.
Privacy reminder. Your inputs — including your SSN, EIN, or PAN — never leave your browser. We do not log or transmit form values.
This tool fills the form, it does not give advice. It puts the information you enter onto the official PDF. It does not calculate your taxes, check your answers, or tell you if something is wrong. Compare everything to the official instructions, and if your situation is anything beyond simple, have a professional review it before you file or submit.
FormatFuse provides a privacy-first form-filling tool. We are not affiliated with the Internal Revenue Service and do not provide tax advice. The Marketplace is the official issuer of the 1095-A used to file your return.
Frequently asked questions
What do I do with Form 1095-A?
Use it to complete Form 8962 (Premium Tax Credit) with your tax return. The monthly figures in Part III — your premium, the benchmark plan premium, and the advance credit paid — reconcile the subsidy you received against what you actually qualified for. If too much was advanced, you may repay some; if too little, you get the difference as a credit.
Who issues the 1095-A — me or the Marketplace?
The Health Insurance Marketplace issues it, usually by mid-February, and posts it to your Healthcare.gov (or state exchange) account. This filler is for completing a corrected copy, a blank for your records, or annotating before sharing with a preparer — not a replacement for the Marketplace's official statement.
What's the difference between 1095-A, 1095-B, and 1095-C?
1095-A is for Marketplace coverage (and is the one you need to reconcile a premium tax credit on Form 8962). 1095-B is for other minimum essential coverage (often from insurers or government programs). 1095-C is from large employers about employer-sponsored coverage. Only the 1095-A drives the premium tax credit reconciliation.
Is filling the 1095-A here private?
Yes. The PDF and the coverage, SSN, and premium details you enter all stay in your browser. Nothing is uploaded or logged. Download the finished form and share it only with your tax preparer through a secure channel.
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