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This version of the form is not currently in use and is provided for reference only. Download this version of
IRS Form 1095-A
for the current year.
IRS Form 1095-A Health Insurance Marketplace Statement
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What Is IRS Form 1095-A?
This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury. Check the official IRS-issued instructions before completing and submitting the form.
Form Details:
- A 3-page form available for download in PDF;
- This form cannot be used to file taxes for the current year. Choose a more recent version to file for the current tax year;
- Additional instructions and information can be found on page 3 of the document;
- Editable, printable, and free;
- Fill out the form in our online filing application.
Download a printable version of IRS Form 1095-A through the link below or browse more documents in our library of IRS Forms.
Download IRS Form 1095-A Health Insurance Marketplace Statement
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