What Is a 1095-A Form—and Why It’s So Important for Your Health Insurance

Every year around tax time, we start getting the same questions from clients:

“What is a 1095-A?”

“Do I really need it?”

“What happens if I don’t file it?”

If you had a health insurance plan through the Health Insurance Marketplace at any point in 2025, this form is extremely important. Here’s what you need to know—and what to do next.

What Is a 1095-A Form?

Form 1095-A is a tax document sent by the Health Insurance Marketplace to anyone who had a Marketplace health plan. It shows:

• The months you had coverage

• The full cost of your health insurance plan

• The subsidy (premium tax credit) that was paid on your behalf each month

This form is required to reconcile the subsidies you received with your federal tax return. The subsidies is the amount of help you received each month on your health plan based on your birthdays, zip code, household size and income. To reconcile those subsidies means that you match up what household size, zip code, and income you estimated on your Marketplace health insurance application with what your actual household size, zip code and income are. As long as everything matches, then nothing more is needed. If these do not match you'll either get a refund or owe the extra subsidies you got towards your health plan with your tax return.

When Will You Get Your 1095-A?

1095-A forms are sent by the end of January.

✔️ Check your mail

Please wait until January 31st before reaching out—this gives the Marketplace enough time to send forms to everyone. 👉 If you don’t receive your 1095-A by January 31st, contact us and we’ll help you get a copy as long as you had a Marketplace plan in 2025.

Why You Must File and Reconcile Your 1095-A

If you received subsidies on your Marketplace health plan, the IRS requires that you reconcile those subsidies when you file your taxes.

This means comparing:

• The income you estimated on your Marketplace application comparted to your actual Adjusted Gross Income (AGI) on your tax return

• Your estimated household size on your Marketplace application comparted to your actual household size.

If you don’t reconcile your 2025 subsidies:

• The Marketplace can remove your subsidies at any time on your current health insurance plan.

• You may lose help paying for or not be able to apply for financial assistance towards your health insurance in the 2027 open enrollment year

• If you don’t file your 2025 taxes, you will NOT qualify for subsidies in 2027

⚠️ The Marketplace now runs audits throughout the year and during Open Enrollment. If your taxes aren’t filed, subsidies can be denied for the following year. If you are filing an extension on your tax return, please let your agent know so they can watch your application each month and submit documentation about your extension so you don't lose your subsidies on your health plan this year.

What Happens After You File?

Once you file your 2025 taxes:

• If you estimated your income too high👉 Your AGI is lower than expected✔️ You may get a refund for premiums you overpaid

• If you estimated your income too low👉 Your AGI is higher than expected✔️ You may need to pay back some of the subsidy on your tax return

As long as your estimated income and your actual AGI are reasonably close, everything works exactly as it should.

Why AGI Matters More Than Ever Right Now

With major changes to subsidy amounts for 2026 Marketplace plans, it’s especially important to pay attention to your Adjusted Gross Income (AGI).

Now is a great time to:

• Look at your 2025 AGI

• Decide if your income will stay about the same or change for 2026

• Review what you estimated on your 2026 Marketplace application

📌 Your local agent can update your income at any time during the year. If your estimate is too high or too low, we can fix it—helping you avoid big refunds or surprise tax bills later.

We’re Here to Help—Anytime

If you:

• Don’t receive your 1095-A by the end of January

• Have questions about reconciling your subsidies

• Want to review or update your income estimate

• Need help understanding your AGI

📞 Contact us anytime. We’re a local agency, and helping you avoid problems with taxes and health insurance is exactly what we do best.

Utah Avenue Insurance Local, trusted help with Marketplace health insurance📱 Call or text us to get support from a real local agent

Better coverage starts here.