​​​​​​​​​Form 1095-B Frequently Asked Questions

NOTE: Your Form 1095-B is proof of healthcare insurance for the IRS and does not require completion or submission to DHCS. Please keep this form for your records.

Back to Form 1095-B Returns

The Form 1095-B is an Internal Revenue Service (IRS) document that many, but not all, people who have Medi-Cal will receive. The Department of Health Care Services (DHCS) only sends Form 1095-B to people who had Medi-Cal benefits that met certain requirements, known as “minimum essential coverage (MEC),” at least one month during the tax year.
 
MEC refers to a level of health benefits that the IRS requires all individuals to have. The person or their tax preparer will use the information from Form 1095-B as proof of health coverage for that tax year.
 
​If you only had health coverage for part of the year or no health coverage at all, the tax penalty no longer applies. However, the ACA still requires most people to report to the IRS that they had MEC health coverage for th​e tax year. Although, you are not required to have Form 1095-B to file your taxes, please save this form for your record.
 
DHCS will mail Form 1095-B to people who had Medi-Cal that met the health coverage requirement by January 31. A cover letter explaining the purpose of the form will be included with Form 1095-B. DHCS will also send an electronic copy of Form 1095-B to the IRS by March 30. 

IRS Resources

Go here to find a list of  frequently asked questions by topic from the Internal Revenue Services . 

Affordable Care Act and California’s Health Mandate

  1.  What is the Individual Mandate or California's Health Mandate?
    The Affordable Care Act (ACA) requires most people to have health coverage that meets certain minimum standards, also called minimum essential coverage (MEC). California Senate Bill 78, chaptered into law in 2019, also requires most California residents to have MEC or pay a penalty to the state beginning in 2020, if they do not qualify for an exemption from the requirement to have coverage. These laws requiring health care coverage are also referred as the “Individual Mandate" or the “Health Care Mandate". 
     

  2. What is the exemption from the requirements to have coverage?
    Individuals may qualify for an exemption and not have to pay a penalty for not having qualifying health insurance coverage under California's Health Mandate. Some exemptions can be applied for through Covered California and other exemptions can be  claimed when filing your state tax return. 

    For more information about the specific exemptions and how to apply for them, visit the Franchise Tax Board (FTB) website: https://www.ftb.ca.gov/about-ftb/newsroom/health-care-mandate/personal.html. 

  3. The federal tax penalty was eliminated from the ACA, how does that affect me?
    In 2019, the federal tax penalty associated with the ACA was reduced to zero. However under the California Health Mandate, beginning in 2020, if you did not have Medi-Cal or other qualifying health care coverage for all twelve months of the previous calendar year, and you do not qualify for an exemption from the required coverage, you may be penalized by the FTB when you file your state income taxes. Although there is no federal penalty, the ACA still requires most people to report to the IRS if they had MEC for the prior tax year.

  4. Where can I get additional information about the Individual Mandates and the potential penalty under California's Health Mandate?
    Additional information about the ACA, California's Health Mandate, and state or federal tax filings can be found at the following webpages: 

Form 1095-B Basics

  1. What is the Form 1095-B?

    Form 1095-B is an Internal Revenue Service (IRS) document that may be used as proof that a person had qualifying health care coverage that counts as Minimum Essential Coverage (MEC) during a tax year. Pursuant to the Affordable Care Act and the California Health Mandate, most people are required to maintain health insurance coverage that meets MEC requirements every year. Most Medi Cal coverage is considered MEC. 

    Your Form 1095-B shows your Medi-Cal coverage and can be used to verify that you had MEC during the previous calendar year. You can use this information to complete your state and/or federal income tax returns. If you are required to file state or federal taxes, you may self-attest your coverage as well. You are not required to submit a copy of the Form 1095-B with your tax return, but you should still keep it for your records.

  2. What information will be included on Form 1095-B?
     The Form 1095-B will include the insured person's:

      • Name
      • Address
      • Social Security number (last four digits only)
      • Date of birth (only if the Social Security number is not available)
      • Months of Medi-Cal coverage that meet minimum essential coverage requirements or an indicator that the minimum essential coverage was met for the entire tax year

  3. Why did I received another form that looks like the Form 1095-B?
    IRS has different 1095 tax forms, similar to Form 1095-B, used for reporting health coverage:
      • Form 1095-A –Individuals who enroll in health insurance through Covered California or the Federal Marketplace will get this form.
      • Form 1095-B –Individuals who enroll in health insurance through Medi-Cal, Medicare, and other insurance companies or coverage providers will receive this form.
      • Form 1095-C –Individuals who enroll in health insurance through their employers will receive this form.

        If you got any of the forms identified above, do not throw them away. The 1095 Forms serve as proof of qualifying health coverage during the tax year reported. 

Who Gets a Form 1095-B

  1. Who will get his or her own Form 1095-B?
    Starting with tax year 2015, the Department of Health Care Services (DHCS) will mail every person, adult or child, who is or was enrolled in a Medi-Cal program that met the requirement for minimum essential coverage (MEC), his or her own Form 1095-B.

    Starting with tax year 2020, Form 1095-B will also serve as proof of MEC for California's Health Mandate.

  2. Are there people who have Medi-Cal but will not get Form 1095-B?
    Yes. People who are enrolled in a Medi-Cal program that does not meet the requirement for MEC will not get a Form 1095-B.

    Please see the next question below for examples of Medi-Cal programs that do not meet the requirement for MEC.

  3. How do I know if the Medi-Cal program I am or was enrolled in counts as MEC?
    Most Medi-Cal coverage meets the MEC requirements. Nearly all people enrolled in the Medi-Cal program have full coverage, including those in pregnancy programs, which qualifies as MEC. The list below provides a few examples of Medi-Cal or state funded programs that do not meet the MEC requirement:

      • Medi-Cal with an unmet Share of Cost
      • Restricted Medi-Cal, (sometimes called “emergency" Medi-Cal)
      • Family Planning, Access, Care, and Treatment (FPACT)
      • Special treatment programs such as treatment for tuberculosis, dialysis, and parenteral hyper-alimentation

        For more information on your Medi-Cal coverage, contact your county eligibility worker. To find an office near you please go to the county human services agencies listing.

  4. If I am a non-citizen or an immigrant, but lawfully present in the United States and enrolled in Medi-Cal, will I get a Form 1095-B?
    All people who receive Medi-Cal coverage that meets the requirement for MEC will receive a Form 1095-B.

  5. How will I get a Form 1095-B?
    A Form 1095-B will be mailed to you by DHCS during the tax season following the reported tax year. A cover letter will be included to explain what the form means to you and give you extra resources.

    If you would like your mail to go to a new address or if you need to update your address because you moved, please contact your county human services agency to update your contact information.

    SSI/SSP recipients:
    If your Medi-Cal is provided through Supplemental Security Income (SSI) or State Supplementary Payment (SSP), you or the member of your household who gets SSI/SSP must contact the Social Security Administration (SSA) to verify or update your eligibility status or personal information used by Medi-Cal.

    To find contact information for your local SSA office, please visit SSA's Office Locator webpage: https://secure.ssa.gov/ICON/main.jsp. You can also contact SSA by phone: 1-800-772-1213.

  6. What if I only had Medi-Cal for part of the year, will I still get a Form 1095- B?
    Yes, DHCS is responsible for reporting any month(s) of Medi-Cal coverage that meet the requirement for MEC to the IRS and Franchise Tax Board (FTB). DHCS must also provide a Form 1095-B to all people whose coverage was reported to the IRS and FTB. The form you will get will show which months you had MEC.

  7. What will happen if I had Medi-Cal for part of the year and then I purchased a Covered California health insurance plan?
    You will get a Form 1095-B for your Medi-Cal coverage from DHCS and you will also get a Form 1095‑A from Covered California. Each form will show the months of coverage that met the requirement for MEC for any months of coverage you got from either Medi‑Cal or Covered California.

  8. Some people in my home have Covered California and others have Medi-Cal. Will Form 1095-B show members of my household who are not enrolled in any Medi-Cal program?
    No. DHCS will only report a person's coverage to the IRS and FTB if that person receives coverage from Medi-Cal. Every person in the home enrolled in Medi-Cal will get their own Form 1095-B. If you have family members enrolled in Covered California, they should receive Form 1095-A.

  9. If I have an authorized representative noted on my Medi-Cal record, can they receive or request Form 1095-B on my behalf?
    Currently, authorized representatives are not allowed to request your Form 1095-B. If you would like someone else to receive your tax information, you can either provide them your Form 1095-B information directly or you may request to have a reprint of your Form 1095-B mailed to a different address. Please contact your county human services agency and speak to an eligibility worker to make this request.

  10. Can I have my Form 1095-B sent to my tax preparer?
    Yes! Simply contact your county human service agency and they will be able to help you. SSI/SSP recipients can also request their Form 1095-B be sent to their named tax preparer through their local county human service agency. Please contact your county human services agency and speak to an eligibility worker to make this request.

Making Sure Your 1095-B Is Correct

  1. How do I update my information to ensure I receive my Form 1095-B?
    Contact your county human services agency county eligibility worker (CEW) to verify or update your contact information for Medi-Cal. The CEW may discuss your personal information and they can make necessary changes. In some cases, your CEW may need you to give them additional information to verify your identity.

    SSI/SSP recipients:
    If your Medi-Cal is provided through Supplemental Security Income (SSI) or State Supplementary Payment (SSP), you or the member of your household who gets SSI/SSP must contact the Social Security Administration (SSA) to verify or update your eligibility status or personal information used by Medi-Cal.

    To find contact information for your local SSA office, please visit SSA's Office Locator webpage: https://secure.ssa.gov/ICON/main.jsp. You can also contact SSA by phone: 1-800-772-1213.
  2. What changes do I need to report to make sure my information is up-to-date?
    You must report changes to your home or mailing address, income, household size, employment, or other health insurance coverage. These changes must be reported to the county human services agency within 10 calendar days from the date the change occurred.

     SSI/SSP recipients:
    If your Medi-Cal is provided through SSI or SSP, you or the member of your household who gets SSI/SSP must contact the SSA to verify or update your eligibility status or personal information used by Medi-Cal.

    To find contact information for your local SSA office, please visit SSA's Office Locator webpage: https://secure.ssa.gov/ICON/main.jsp. You can also contact SSA by phone: 1-800-772-1213.

  3. How do I locate my county human services agency?
    You can locate your county human services agency from the Department Health Care Services' County listing. Agencies are listed by county and may include street addresses, telephone numbers, and webpages.

What to Do with Your Form 1095-B

  1. What do I need to do with my Form 1095-B?
    Keep your Form 1095-B for your records. The Form 1095-B is used as proof of Minimum Essential Coverage (MEC) when filing your state and/or federal taxes. It should be kept with your other tax information in the event the Internal Revenue Service (IRS) or Franchise Tax Board (FTB) require you to provide it as proof of your health care coverage.

    Please remember, the Form 1095-B is not required to file your state or federal taxes and you may self‑attest your health coverage without it.
  2. Why does Medi-Cal/Department Health Care Services send Form 1095-B information to the IRS and FTB?
     The Department of Health Care Services (DHCS) is required by the state and federal law to send Form 1095-B information to the IRS and FTB for the purpose of validating months of health coverage reported by the person filing their state and/or federal taxes.
  3. Why did I get more than one Form 1095-B from Medi-Cal and what should I do with all of them?
    DHCS will mail a Form 1095-B to every person enrolled in a Medi-Cal program that meets the requirement for MEC.

    If you received another copy of your Form 1095-B, it could be a corrected Form 1095-B. A corrected Form 1095-B will have a box checked “Corrected" at the top of the form. If it is a corrected form, then this new form is the most current version of your Form 1095-B. The Form 1095-B will include a print date to assist with distinguishing which form is the most current. Please keep all Form 1095-Bs for your records.

What If You Have Problems with Form 1095-B

  1. Who can I contact if I need additional help with Form 1095-B?
    If you need support in another language, please call the Medi-Cal 1095-B Helpdesk at 1‑844‑253‑0883 (for TTY call 1-844-357-5709) for live support. Our helpdesk service can provide assistance in English and other languages.  This is a free service that is available Monday through Friday from 8 am to 5 pm PTS, except for major holidays.  

  2. What do I do if my personal information is incorrect or some of the months that I had Medi-Cal are not on the form?
    Contact your county human services agency county eligibility worker (CEW) to verify your months of coverage or to update your contact information for Medi-Cal. The CEW may discuss your personal information and they can make necessary changes. In some cases, your CEW may need you to give them additional information to verify your identity.

    SSI/SSP recipients:
    If your Medi-Cal is provided through Supplemental Security Income (SSI) or State Supplementary Payment (SSP), you or the member of your household who gets SSI/SSP must contact the Social Security Administration (SSA) to verify or update your eligibility status or personal information used by Medi-Cal. 

    To find contact information for your local SSA office, please visit SSA's Office Locator webpage: https://secure.ssa.gov/ICON/main.jsp. You can also contact SSA by phone: 1-800-772-1213.

  3. Why did I not get a Form 1095-B?
    There may be one of two reasons why you did not get a Form 1095-B. The mailing address we have on record may be incorrect or you were enrolled in a Medi-Cal program that does not meet the requirement for Minimum Essential Coverage (MEC). Please contact your county human services agency to find out why you did not receive a Form 1095-B. You may have to update some of your information with the county. Also, you can request a new copy of any Form 1095-B previously mailed.

    SSI/SSP recipients:
    If your Medi-Cal is provided through Supplemental Security Income (SSI) or State Supplementary Payment (SSP), you or the member of your household who gets SSI/SSP must contact the Social Security Administration (SSA) to verify or update your eligibility status or personal information used by Medi-Cal.  

    To find contact information for your local SSA office, please visit SSA's Office Locator webpage: https://secure.ssa.gov/ICON/main.jsp. You can also contact SSA by phone: 1-800-772-1213.

  4. I normally get my mail through my P.O. Box. I received my Form 1095-B but I did not get my child's Form 1095-B. How can I get my child's Form 1095-B?
    Department Health Care Services will send all Form 1095-B letters to the mailing address on record. If you use a P.O. Box and your child is not listed on your P.O. Box through the post office, your child's Form 1095-B will not be delivered. Please add your child or children to your P.O. Box at your local post office or update your mailing address with Medi-Cal by contacting your county human services agency. 

    If you would like a reprint of your Form 1095-B for any previous tax year, just ask your county eligibility worker and they will assist.

  5. I claim an adult dependent on my taxes. How can I get their Form 1095-B for tax filing purposes?
    If you claim an adult as a dependent on your taxes and you are responsible for reporting their health coverage, you may need access to their Form 1095-B. If you do, the adult tax dependent must provide you with their own Form 1095-B. The adult tax dependent may also have their Form 1095-B mailed to another person of their choice. They will need to contact their county human services agency and speak to an eligibility worker to make this request.

  6. What if I received Medicaid coverage for part of the year while living in another state?
     California's Medicaid program is known as Medi-Cal. If you got Medicaid coverage in another state, the human services agency from that state will send a Form 1095-B to your most recent address they have on record.

    If you moved to a different county in California, it is important that you report your current address to the California county human services agency you lived in so that they can send Form 1095-B for your months of eligible Medi-Cal coverage to your current address.

    To find contact information for each Medicaid agency by state please go visit the Medicaid webpage.

  7. What if I received Qualified Health Plan coverage while living in another state for part of the year through that state's marketplace or through the Federally Facilitated Marketplace?
    If you lived in another state and received Qualified Health Plan coverage through that state's marketplace or through the Federally Facilitated Marketplace (also known as healthcare.gov), you will receive a Form 1095-A from that marketplace. It is important that you report your current address to that marketplace and the health plan that covered you so they can send the Form 1095-A to your current address.

      • Click here to update your contact information with the federal marketplace
      • Click here to update your contact information with a state marketplace that does not take enrollments through healthcare.gov

Tax Filing Help

  1. Is there someone who can help me file my state and/or federal taxes?
    The Department of Health Care Services does not provide tax advice.  Here are some resources to help you file your taxes:
      • You can get help from your local Taxpayer Assistance Center Office. To find an office near you, visit the http://apps.irs.gov/app/officeLocator/index.jsp or call 1-800-829-1040.
      • You can get free tax assistance from your local Volunteer Income Tax Assistance office or Tax Counseling for the Elderly Program. This service is for people who generally make $56,000 or less per year, persons with disabilities, the elderly, and limited English speaking taxpayers. To find the nearest center, visit their locator website at: http://irs.treasury.gov/freetaxprep/. 
         
  2. The Form 1095-B I received has incorrect information, but I already filed my state and/or federal taxes. Do I have to amend my state and/or federal tax return when I get the corrected Form 1095-B?
    Depending on how the information was changed, you may need to amend your taxes. You also may want to consult with your tax preparer to determine if you would benefit from amending.

    If you notice any incorrect information on your Form 1095-B, Department Health Care Services (DHCS) highly recommends that you contact your county human services agency and work with your county eligibility worker to fix the wrong information and have a corrected Form 1095-B.

    SSI/SSP recipients:
    If your Medi-Cal is provided through Supplemental Security Income (SSI) or State Supplementary Payment (SSP), you or the member of your household who gets SSI/SSP must contact the Social Security Administration (SSA) to verify or update your eligibility status or personal information used by Medi-Cal.  

    To find contact information for your local SSA office, please visit SSA's Office Locator webpage: https://secure.ssa.gov/ICON/main.jsp. You can also contact SSA by phone: 1-800-772-1213. 
     
  3. Can I file my state and/or federal taxes and report that I got health coverage before I receive my Form 1095-B from DHCS?
    Yes, you may self-attest your coverage while filing you state and/or federal taxes before getting your Form 1095-B. Please note that the Internal Revenue Service (IRS) or Franchise Tax Board (FTB) may require proof of your coverage by requesting a copy of your Form 1095-B. DHCS strongly suggests you keep your Form 1095-B for your records.

     
  4. What if I did not get a Form 1095-B but I filed my state and/or federal income taxes without the information from the form?
    Form 1095-B is not required to file your state or federal taxes and you may self‑attest to your health coverage without it. You should get a Form 1095-B in the mail by January 31 following the reported tax year.  

    If the information reported on the Form 1095-B was different than what was reported on your state and/or federal taxes, you may need to amend your taxes. You also may want to consult with your tax preparer to determine if you would benefit from amending. 

    If you do not receive a Form 1095-B and you would like a Form 1095-B for your records, you should contact your eligibility worker at your county human services agency to determine why and request a reprint.

     
  5. If I do not regularly file taxes, is there a benefit to filing taxes this year?
    Even if you are not required to file taxes, you may be able to claim federal or state tax credits available for low to moderate income level households. One of these incentives is called the Earned Income Tax Credit (EITC) and is now available for both federal and California state taxes. You should consult with your tax preparer to determine if you qualify for available tax credits.

    Also, if you or someone in your household receives a premium tax credit through Covered California (or through healthcare.gov or another state marketplace if you lived outside of California for any part of the tax year) you are required to file taxes. When someone receives a premium tax credit and does not file taxes, Covered California will not continue to provide financial assistance in paying for their coverage.

  6. What do I do regarding the Form 1095-B if a member of my family has passed away?
    DHCS does not mail a Form 1095-B for individuals who are deceased. However, a Form 1095-B can be obtained by a family member with the appropriate documentation. The family member can contact the responsible county for the deceased's Medi-Cal coverage information and request a reprint of their Form 1095-B. A forwarding address should be given if the Form 1095-B needs to be sent to a different address.

    To find an office near you please go to the county human services agency .

  7. Are there any special considerations for my foster or adopted child(ren) in regards to the Form 1095-B?
    Yes. If you are a foster parent, adoptive parent, or legal guardian that claims the child as a dependent on your tax return for the given tax year, you are responsible for obtaining qualifying health coverage, that counts as minimum essential coverage (MEC) during a tax year, for that foster child. If the adoption or placement of the child occurs during the given tax year, you are only responsible for the month following the adoption or placement through the end of the tax year. Parents who cannot claim the child as a dependent are not liable for obtaining MEC for the child for the months they were responsible for the child.

    Foster care or adoptive parents and children fall under the same rules regarding MEC. If a foster parent, adoptive parent, or legal guardian has not received a Form 1095-B for their child, they may request a reprint through an eligibility worker at their county human services agency.

    Please remember that all former foster youth, up to the age of 26, are eligible for Medi-Cal coverage that qualifies as MEC.

  8. Are there any special considerations regarding Form 1095-B if I am a parent of a child(ren) who has entered foster care?
    Parents who had their child(ren) enter foster care may have not received a Form 1095-B for their child or children. Until further guidance is received from the Centers for Medicare & Medicaid Services, DHCS will not issue or provide reprints of Form 1095-B to these parents.

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Last modified date: 11/25/2020 11:56 AM