Medicaid 1095-B Form

If you, or members of your family, had health coverage through Medicaid during the past year, you will receive a 1095-B tax form during tax season. This form includes information about the Medicaid health coverage that you, or members of your family, had during each month in 2015.

Why am I receiving this form?
You are receiving this form because you, your spouse, or one or more of your dependents were enrolled in Medicaid for at least part of 2015. The health care law requires the state Medicaid agency to provide this information to you and to the IRS.

What do I need to do with this form?
Check to make sure the information is correct, paying special attention to Part I and Part IV of the form. You should also keep the form for your records.

I received a 1095-B form that incorrectly lists my child as having Medicaid health coverage. What should I do?
1095-B forms were sent in error to some families whose children were referred for Early Intervention services. This error is being corrected, and will not negatively affect your family. If you were sent a form by mistake, you will receive a letter with more information.

For other families, check your records to see what kind of health coverage your child has. It is possible for parents and children to be enrolled in different health plans. For example, your child could be enrolled in Medicaid even if you purchased coverage for yourself or other family members through HealthSource RI. (If you or a family member has Medicaid coverage, you received an “anchor card” in addition to your health plan card from Neighborhood Health Plan  or United Healthcare.) If you believe your child is listed on the 1095-B form by mistake, call the Department of Human Services at 401-462-5300.

I’m confused – I received more than one 1095 form
If you or your family have other kinds of health coverage, you may receive other health care tax documents.

  • If you purchased health coverage through HealthSource RI, you may receive Form 1095-A.
  • If you had health coverage through Medicaid, Medicare, or through your job, you may receive Form 1095-B.
  • If you had health coverage through a large employer, you may receive Form 1095-C.

For example, if you purchased coverage through HealthSource RI, but you have children who were covered by RIte Care (Medicaid) you will receive both a Form 1095-A and a Form 1095-B. Read the instructions that come with every form you receive. Each form may have different instructions.

Do I have to file a federal tax return?
Not necessarily. Receiving this form does not mean you have to file a tax return if you are not otherwise required to. Please check and the Form 1040 instructions to see if you are required to file a federal income tax return. (Some people who have a low annual income don’t have to file a federal income tax return.)

I’m required to file a federal tax return. Can I do that now?
If you purchased coverage through HealthSource RI and have not yet received a 1095-A form, you must wait to file until you get that form. You will need the information on Form 1095-A to complete your return.

Do I need to file Form 1095-B with my tax return?
No, but you should save it with your records. You should read the instructions that come with this form and any other tax forms that you receive for more information.

What if my Form 1095-B has incorrect or missing information?
If you believe any of the information on the form is wrong, call the Department of Human Services at 401-462-5300. For example, you may want to check your form to make sure:

  • Your name and address are correct.
  • All of the months that you had Medicaid coverage in 2015 are correctly listed.
  • All family members and dependents, including children, who had Medicaid coverage during 2015 are listed.

If the information on your Form 1095-B is incorrect, the Department of Human Services will work with you to issue a corrected form. (Please note that the “corrected” box might not be checked on the corrected form if you receive it in the mail before March 31.)



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