Per the Internal Revenue Service (IRS) guidelines, Missouri Medicaid and CHIP Responsible Individuals may receive a copy of their 2019 IRS Form 1095-B upon request. This form will no longer be automatically mailed to participants. To request a copy of your IRS Form 1095-B, you can:

  • Call our 1095-B Call Center at 1-800-407-9890; or
  • Email your request to 1095B@mydssquestions.mo.gov; or
  • Mail your request to:
    MO HealthNet Division
    PO Box 2700
    Jefferson City, MO 65109

About the 1095-B Form

IRS Form 1095-B is a tax document that includes information about the health coverage provided for one or more months during the year to Missouri Medicaid participants and anyone they may include on their taxes (yourself, a spouse, or dependents). This form relates only to coverage provided by Missouri Medicaid and CHIP agencies. Individuals may use this information when filing their federal tax returns, provided they have a federal tax return filing requirement.

The Affordable Care Act (ACA) requires providers of minimum essential coverage, including Missouri Medicaid and CHIP providers, to report certain information to the IRS. These providers must submit information for the 2019 tax year to the IRS in early 2020, and they must also furnish a statement (IRS Form 1095-B) that includes the same information for each covered individual which is required to be provided to the IRS.

Questions?

If you have questions about current or past IRS 1095-B Forms, please contact our call center at 1-800-407-9890. If you have any questions about filing your Income Taxes, you will need to check with the IRS or your tax preparer. Visit the IRS website to find contact information, tax forms, and instructions.