Massachusetts requires full-year and certain part-year residents age 18 and over to complete the Schedule HC.
Schedule HC must also be completed if you turned 18 during the year. Beginning the first day of the third month following your birthday month, you are required to obtain and maintain health insurance.
Minimum Creditable Coverage is the minimum level of insurance an adult tax filer needs to maintain to be considered insured in Massachusetts. If you have insurance through a Massachusetts licensed health insurance company, the health plan must indicate if it meets MCC requirements. Your form 1099-HC will also indicate if your insurance met MCC requirements.
According to the Massachusetts instructions the Minimum Creditable Coverage standards include:
- "Coverage for a comprehensive set of services (doctor visits, hospital admissions, day surgery, emergency services, mental health and substance abuse, and prescription drug coverage);
- Doctor visits for preventive care, without a deductible;
- A cap on annual deductibles of $2,000 for an individual and $4,000 for a family;
- For plans with up-front deductibles or co-insurance on core services, an annual maximum on out-of-pocket spending of no more than $7,900 for an individual and $15,800 for a family;
- No caps on total benefits for a particular illness or for a single year;
- No policy that covers only a fixed dollar amount per day or stay in the hospital, with the patient responsible for all other charges;
- For policies that have a separate prescription drug deductible, it cannot exceed $250 for an individual or $500 for a family;
- All services must be provided to all of those covered (for example, a plan that covers dependents must extend maternity services to them); and
- No cap on prescription drug benefits.
You automatically meet MCC if you are enrolled in:
- Medicare Part A or B
- Any Qualified Health Plan purchased through the Massachusetts Health Connector or directly through a carrier, including ConnectorCare plans and catastrophic plans;
- A Student Health Insurance Plan (SHIP) offered in Massachusetts or another state;
- Eligibility for services through a tribal organization or the Indian Health Service;
- The U.S. Veterans Administration Health System;
- A health insurance plan offered by the federal government to federal employees or retirees;
- Peace Corps, VISTA or AmeriCorps or National Civilian Community Corps coverage; or
- A Pre-Existing Condition Insurance Plan (PCIP)."
Private Health Insurance is insurance provided by your employer or purchased on your own. If you were not provided with a 1099-HC, you must still provide the name, Identification Number and Subscriber Number for your insurance provider.
For additional information pertaining to the Massachusetts Schedule HC, please click here.