1095-B Tax Form | Department of Human Services | Commonwealth of Pennsylvania

1095-B Tax Form | Department of Human Services | Commonwealth of Pennsylvania
1095-B Tax Form
Upon request, the Department of Human Services will mail 1095-B tax forms to households who have a member receiving Medical Assistance (MA) coverage.
Why are you receiving this form?
The Internal Revenue Service (IRS) requires all health insurance providers send this form upon request to all enrollees who have health insurance and meet the "minimum essential coverage" requirements of the Affordable Care Act (ACA) and requested the form. The ACA requires nearly all Americans who meet health care reform standards to have health insurance. The 1095-B form informs the IRS who had coverage and for how long.
What information is on the 1095-B tax form?
For each person covered on your policy, the 1095-B lists:
Name
Address
Date of birth
Taxpayer identification number
Months of coverage
If you need a copy of your 1095-B tax form, you can:
Print the form
or go to your
myCOMPASS account
to obtain the form.
You can also request the form by:
Calling 877-617-9906
Sending an email to
RA-PWPA1095-B@pa.gov
Mailing a written request to your local
county assistance office
Additional Information
Have more questions?
Read the
1095-B Tax Form FAQ
— English & Spanish