Form 1095-B Frequently Asked Questions Guide
This guide provides essential information about Form 1095-B from the NYS Department of Health. It outlines how to obtain the form and its significance for Medicaid, Child Health Plus, and Essential Plan consumers. Understand your rights and obligations regarding this important health coverage documentation.
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How do I fill this out?
To fill out Form 1095-B, start by gathering your information regarding health coverage and enrollment details. Ensure that you have the relevant health plan information at hand for accurate completion. Follow the instructions provided on the form carefully to ensure all sections are filled correctly.

How to fill out the Form 1095-B Frequently Asked Questions Guide?
1
Gather your health coverage and enrollment details.
2
Review the form's instructions thoroughly.
3
Fill out each section accurately.
4
Double-check your entries for completeness.
5
Submit the form by the specified deadline.
Who needs the Form 1095-B Frequently Asked Questions Guide?
1
Consumers enrolled in Medicaid who need proof of health coverage.
2
Families using Child Health Plus to verify their children's health insurance.
3
Individuals in the Essential Plan looking to establish insurance coverage.
4
Tax filers needing to report their health coverage on their returns.
5
Anyone wishing to correct discrepancies in their health coverage records.
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What are the instructions for submitting this form?
To submit Form 1095-B, contact NY State of Health via phone at 1-800-541-2831 or email 1095B@health.ny.gov. You may also send the completed form by mail to NY State of Health, P.O. Box 11774, Albany, NY 12211. Ensure that your submission is completed accurately to facilitate prompt processing.
What are the important dates for this form in 2024 and 2025?
Key dates for Form 1095-B include the reporting deadline in early March 2024 for consumers and ensuring all required requests are made promptly for tax filing purposes.

What is the purpose of this form?
Form 1095-B serves as proof of health coverage to verify enrollment in Medicaid, Child Health Plus, or the Essential Plan. This documentation is essential for taxpayers to ensure compliance with health coverage mandates. Consumers must be aware of its significance in their annual tax responsibilities.

Tell me about this form and its components and fields line-by-line.

- 1. Subscriber Information: The name and details of the primary insured individual.
- 2. Coverage Period: Duration of the health coverage provided.
- 3. Employer Information: Details about the employer providing the health plan, if applicable.
- 4. Dependent Coverage: Information on any dependents covered under the plan.
- 5. Health Plan Details: Identification of the health plan and insurer.
What happens if I fail to submit this form?
Failing to submit Form 1095-B may lead to complications in verifying your health coverage. This can result in issues with tax filings, including potential penalties for non-compliance with healthcare mandates.
- Tax Filing Delays: Inability to verify health coverage may delay your tax return processing.
- Penalties: Potential penalties for not meeting healthcare coverage reporting requirements.
- Inaccurate Records: Failure to submit could lead to inaccuracies in health coverage documentation.
How do I know when to use this form?

- 1. Tax Reporting: For reporting health coverage during tax season.
- 2. Coverage Verification: To verify your coverage for any appeals or inquiries.
- 3. Proof of Enrollment: To provide proof of enrollment in health coverage for other purposes.
Frequently Asked Questions
How can I request Form 1095-B?
You can request Form 1095-B by contacting NY State of Health via phone at 1-800-541-2831 or emailing 1095B@health.ny.gov.
Is there a deadline for obtaining Form 1095-B?
There is no set deadline, but it is advisable to request it as soon as you need it for tax filing.
Do I need to attach Form 1095-B to my tax return?
No, you do not need to attach Form 1095-B to your federal income tax return.
What should I do if my Form 1095-B has errors?
Contact NY State of Health at 1-855-766-7860 for assistance in correcting any inaccuracies.
Can I edit Form 1095-B once downloaded?
Yes, you can edit the downloaded PDF using PrintFriendly's editing tools.
How do I share my Form 1095-B with others?
You can share your document via email or social media by using the share function on PrintFriendly.
What information is included in Form 1095-B?
Form 1095-B contains information about your health coverage under Medicaid, Child Health Plus, or Essential Plan.
When will I receive Form 1095-B after request?
The NYS Department of Health will send Form 1095-B by mail upon your request.
Who should I contact for more help?
For more assistance, contact your tax advisor or reach out to the IRS for guidance.
How does Form 1095-B impact my tax filing?
Form 1095-B provides necessary proof of health coverage for your tax records.
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