If my child had Medical Assistance for a portion of the year and CHIP for a portion of the year, will I
receive two forms?
Yes – you will receive a 1095-B form for each type of insurance that you received. So, if your child had
Medical Assistance and CHIP in the same year, you will receive a form from the Department of Human
Services showing the Medical Assistance coverage and a separate form from CHIP showing the CHIP
What if my children had insurance with CHIP for a portion of the year and they had private health
insurance for a portion of the tax year?
The 1095-B form that CHIP will send you shows only the months that your child had CHIP coverage. If
your children had other insurance coverage for a portion of the year, it is important that you reach out
to that insurance provider with any questions or if you need to replace the 1095-B form from that
insurance provider. Your CHIP insurance provider will not have access to other health insurance
information or be able to answer questions about their information.
What if there are changes in my CHIP coverage?
Sometimes, your CHIP coverage that you had in the previous year may change. For example, you
applied for CHIP coverage and the coverage began in January. After your coverage begins, you find that
you had a medical bill in December of the previous year that you would like covered. In some instances,
the CHIP health insurance provider will go back and authorize CHIP coverage for December. If this
occurs after you receive your 1095-B form in January, you will then receive a corrected 1095-B form to
show the additional coverage. This corrected form will also be sent to the IRS.
I lost my 1095-B form. How can I get a copy?
You can go to
to obtain a copy of the
most current 1095-B form. Or, you can call 1-800-986-KIDS (5437) to obtain a copy. Your CHIP health
insurance provider cannot get a copy of the form.
What if I have questions that are not answered here?
The best source for information regarding the 1095-B form and information about the Affordable Care
Act is your tax advisor or the IRS website at:
“Individuals & Families” for help as an individual). For additional information regarding the 1095-B form,
you may also refer to the IRS publication found at this site: