Fillable Online narbha PM Form ADHS AE-01 AHCCCS Elig 2026

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By Jan. 31 of each year, Covered California sends the federal IRS form 1095-A Health Insurance Marketplace statement to members. This form is used to: Provide information for your federal taxes.
A: No. You do not need to include Form 1095-B with your federal or state tax return. But, the IRS and the California State Franchise Tax Board suggest that you save it with your tax records.
Form 1095C: This Affordable Care Act document is mailed to your home address on file the first week of February. If you do not receive it, you may request a reprint after March 1. Form 1099: To access your statement for your Optum Health Savings Account (HSA), visit optumbank.com/arizona or view it on your Optum app.
If a member believes their contact information is not correct, they can sign into their Health-e-Arizona Plus account at .healthearizonaplus.gov, create a new HEAplus account, or call 1-855-HEA-PLUS (1-855-432-7587) to ensure their contact information is up to date.
Form 1095-B is being sent to you because you, someone in your household, or your tax dependents received AHCCCS Medical Assistance for at least one day in the prior tax year. If you are required to file income taxes, you must include this information on your tax return.

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Duplicate Forms 1095-C can now be requested by completing a Request for Duplicate IRS Tax form (OSUP/F037) Refer to the Request a Duplicate IRS Tax Form Procedure on the OSUP Procedures page of the OSUP Website for more information on obtaining a duplicate form.