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IRS Form 1095-B for 2021

The information on this page is about the Internal Revenue Service (IRS) Form 1095-B, Health Coverage, for 2021. For tax year 2021, you do not need the form 1095-B to complete an income tax return.

IRS form 1095-B for 2021 is available upon request.
DHS will mail the form only when requested by Medical Assistance and MinnesotaCare enrollees. We will not automatically send the form. Follow the instructions on this page to request your 1095-B. 

How to request a copy of your 2021 form 1095-B

If you or members of your family were enrolled in Medical Assistance or MinnesotaCare in 2021, you may request a printed copy of your 2021 form 1095-B in these ways:

  1. Enrollees with eligibility in MNsure who have an online account, can view and print their form from their online account.

  2. Any enrollee may request their form by:

Email disclaimer: Unsecured emails may have a small privacy risk, and if this is a concern to you, use one of the other options instead.

You must include the following information when making a request. If you do not have all the required information, DHS may not be able to mail the form to you. If you need help, call 651-297-3862 or toll free 800-657-3672 to make the request and a representative will assist you.

  • Requester’s first name and last name
  • Address to mail the form
  • Telephone number
  • Date of birth
  • Case number
  • Name(s) of family member(s) requesting a form 1095-B
  • Form 1095-B tax year(s) requested

Forms will be available after February 1, 2022, and DHS will mail it to you within 30 days of your request. If you have any questions, contact the DHS Health Care Consumer Support at 651-297-3862 or toll free at 800-657-3672.

Answers to questions about form 1095-B

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