What Is Form 1099-HC and How Do You Use It?

Form 1099-HC is a Massachusetts tax document your health insurance carrier sends you each January to prove you had coverage meeting the state’s minimum standard during the prior year. You use it to complete Schedule HC, which you file with your Massachusetts income tax return to show the state you satisfied its individual health insurance mandate and to avoid a penalty on your tax bill.¹

What’s on the Form and Who Sends It

Your insurance carrier issues Form 1099-HC, not the state. It identifies you as the policyholder, lists the months you were covered during the tax year, and shows whether the plan met the state’s Minimum Creditable Coverage (MCC) standard.¹²

Insurers must send you the form by January 31. They also file the same information directly with the Massachusetts Department of Revenue (DOR), so the state already has a copy of what your carrier reported before your return arrives. If you switched carriers during the year, you’ll get a separate 1099-HC from each one, and you need all of them to account for a full twelve months on your return.

The MCC Box Is the One That Matters

Massachusetts sets a coverage floor called Minimum Creditable Coverage. Your insurer decides whether the policy it sold you clears that floor and checks the appropriate box on your 1099-HC. If the box says the plan met MCC, the state treats you as insured for those months. If it says the plan did not, the state treats those months the same as if you had no coverage at all, even though you were paying premiums.²

MCC requires a broad set of benefits, including doctor visits and preventive care without a deductible, hospital and surgical care, emergency services, mental health and substance abuse treatment, prescription drugs, maternity and newborn care, and diagnostic services. Deductibles are capped at annual limits published by the Health Connector, and plans can’t impose lifetime or annual caps on total benefits for an illness. Fixed-dollar-per-day hospital plans don’t qualify. Student Health Insurance Plans offered through Massachusetts universities automatically meet MCC.²³

How to Use It on Schedule HC

Schedule HC is where the 1099-HC actually gets applied. You attach Schedule HC to Form 1 as a full-year resident or Form 1-NR/PY as a part-year resident.⁴

Look at your 1099-HC to see which months you had MCC-compliant coverage, then fill in the corresponding ovals on Schedule HC. If you had qualifying coverage every month, you finish the first page of Schedule HC and move on. If any months are blank, you work through the penalty calculation section on the following pages.⁴

Don’t claim months you can’t document. The DOR matches Schedule HC against the data insurers file directly, and a mismatch can trigger a review or an automatic adjustment.

When You Don’t Receive a 1099-HC

MassHealth members get a 1099-HC the same as anyone with private coverage. If you need a copy, call MassHealth Customer Service at 1-800-841-2900. Medicare and TRICARE enrollees usually receive federal forms such as a 1095-B from those programs instead of a Massachusetts 1099-HC.⁵

Out-of-state and some employer plans don’t issue a 1099-HC at all. In that case, contact your insurer or benefits department and ask whether the plan met MCC. If they can’t tell you, the Schedule HC instructions include a checklist of required MCC benefits you can walk through yourself. If the plan meets every item, you can self-certify on line 3 of Schedule HC that your coverage qualified, even without a 1099-HC. Count any month with 15 or more days of qualifying coverage as covered; leave months with 14 days or fewer blank.⁴

Part-Year Residents

If you moved into Massachusetts during the year, the mandate applies starting on the first day of the third full month after you became a resident. Someone who moves to Boston on March 15 becomes subject to it on June 1. If you moved out, the mandate applies through the last day of the last full month you were a resident. If you lived outside Massachusetts the entire year, the mandate doesn’t apply at all, even if Massachusetts-source income required you to file a non-resident return.²

What a Coverage Gap Costs

A gap of 63 consecutive days or fewer carries no penalty. The Health Connector reads 63 days as roughly three calendar months, so short gaps generally cost nothing.⁶

Longer gaps trigger a penalty that scales with income, measured against the federal poverty level (FPL) for your family size. For the 2026 tax year, the monthly amounts are:⁶

At or below 150% FPL: no penalty.
150.1–200% FPL: $26 per month ($312 per year).
200.1–250% FPL: $51 per month ($612 per year).
250.1–300% FPL: $76 per month ($912 per year).
300.1–400% FPL: $117 per month ($1,404 per year).
Above 400% FPL: $211 per month ($2,532 per year).

When both spouses in a married couple lack coverage, each spouse’s penalty is calculated separately and added. No individual’s penalty can exceed 50% of the cheapest monthly premium they could have bought through the Health Connector. The amount either increases what you owe or reduces your refund.⁶

Appealing a Penalty

Massachusetts allows exemptions for religious beliefs that conflict with insurance and for financial hardship severe enough that paying for coverage would leave you without basic necessities. The Health Connector, not the DOR, decides these appeals.⁷

The appeal starts on Schedule HC. Fill in the appeal oval for yourself and your spouse if applicable, which lets the DOR share your return with the Health Connector. Calculate the penalty on Schedule HC but leave the penalty lines on your income tax return blank. File all three pages of Schedule HC. Don’t attach hardship documentation yet.⁸

After the DOR processes your return, the Health Connector sends a letter asking for your written grounds and supporting documents. Respond by the deadline in that letter or the appeal is automatically dismissed and the full penalty applies. A hearing may be scheduled before a decision. There is only one appeal; if it fails, there’s no second review.⁸

1
Mass.gov. 1095-B and 1099-HC Tax Form
2
Mass.gov. Health Care Reform for Individuals
3
Massachusetts Health Connector. Minimum Creditable Coverage
4
Mass.gov. 2025 Massachusetts Schedule Health Care Instructions
5
Massachusetts Health Connector. Get Your Health Coverage Tax Forms Together
6
Mass.gov. TIR 26-1 Individual Mandate Penalties for Tax Year 2026
7
Mass.gov. 830 CMR 111M.2.1 – Health Insurance Individual Mandate Personal Income Tax Return Requirements
8
Mass.gov. Learn How to Appeal the Health Care Penalty