1095-B FAQ

This tax season, Medical Assistance members (including Foster Care) will receive Form 1095-B Members who receive their Medical Assistance through a CMO (Amerigroup, Peachstate, Wellcare, or CareSource) will also receive this form from Georgia Medical Assistance. This form is required by the IRS as a result of the Affordable Care Act.

The 1095-B is an information form. Just like a W-2 form, it contains information that is required for completing your taxes. Also, like a W-2 form, the 1095-B form will be provided to the IRS to show the months you had Medical Assistance.

In order to avoid possible delays with filing your taxes or with receiving your refund, it is extremely important for each member to make sure that DFCS has the latest address on file. The forms will be sent to your address on file as of December 15, 2020. If the information is not correct, you may be unable to file your taxes on time, which could delay your tax refund if one is due.

WHAT IS THE 1095-B AND WHY DOES IT MATTER TO MEDICAID MEMBERS? 

  • The 1095-B is an informational form that lets each Medical Assistance member know which months during the previous calendar year (2020) he/she had health coverage. Individuals who show that they had the required coverage are not liable for the penalty imposed on those without such coverage. Starting with the 2020 plan year (for which you’ll file taxes in April 2021), the penalty no longer applies. This information is also provided to the IRS. 
  • Georgia Medical Assistance will need this form to file their taxes beginning in 2016. 

WHEN WILL GEORGIA MEDICAID MEMBERS RECEIVE THEIR 1095-B? 

  • The forms will be mailed out during the month of January 2021. The last forms will be mailed no later than January 31, 2021.
  • The forms can be downloaded via the GAMMIS Web Portal or from the CMO’s website.
  • It is very important for members to update their address as soon as possible.  Members who need to update their address with DFCS can call 1-877-423-4746 or Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

WHO WILL RECEIVE FORM 1095-B? 

  • Each person who has received certain types of Medical Assistance in 2020.
  • This includes persons who received their Medical Assistance through a CMO and also individuals who receive Supplemental Security Income (SSI).

Certain member categories will not receive a 1095-B. Those categories are:

  • Medically Needy Spenddown
  • Qualified Medicare Beneficiaries (QMB)
  • Specified Low Income Medicare Beneficiaries (SLMB)
  • Qualifying Individuals (QI1)
  • Planning for Healthy Babies (P4HB)
  • Presumptive Pregnant Woman
  • Emergency Medical Assistance (EMA)
  • Other Presumptively eligible categories

IS THERE ANYTHING THAT I CAN DO TO ASSIST MY GEORGIA MEDICAID MEMBERS? 

  • Refer members to the FAQs that are available.                   
  • Direct Members to the correct resources.

Contact information you may need: