California Health Coverage Tax Return: No 1095 Form?

For your California health coverage tax return, you do not need a Form 1095: if you had qualifying coverage for all twelve months, check the full-year health care coverage box, and use Form FTB 3853 only if you had a gap, a partial year, or an exemption.

California still enforces its own health coverage requirement even though the federal penalty is zero. This guide to your California health coverage tax return explains who has to report, what to do without a 1095, how the penalty works, and what Health Share members need to know before they check any box. It is general information, so confirm your own situation with the Franchise Tax Board (FTB) or a tax professional.

Who needs to complete a California health coverage tax return section?

California residents who had minimum essential coverage (MEC) or a Health Share membership during the year and did not receive a Form 1095. MEC is the health coverage that satisfies the requirement. According to the FTB, it includes employer-sponsored plans, individual market plans, and certain government programs. A Health Share is not insurance, so it is handled differently, as explained below.

Why does California care about my health coverage?

California requires residents to have coverage, qualify for an exemption, or pay a penalty. The FTB’s health care mandate page says coverage must be MEC for each month, for you, your spouse or domestic partner, and your dependents. The California Department of Health Care Services (DHCS) states that the federal ACA penalty was reduced to zero, but that you may be penalized by the FTB when you file your state taxes if you did not have coverage for all twelve months and do not qualify for an exemption.

What does the California penalty cost?

The latest figures published by the FTB are for tax year 2025. The penalty is the higher of a flat amount or a percentage of income:

Flat amount: $950 per adult and $475 per dependent child.
Percentage: 2.5% of gross income above the filing threshold.
Cap: The penalty cannot exceed the statewide average cost of a bronze plan for your household size, which is $4,524 for one person for 2025 per the FTB’s Form 3853 instructions.

The FTB gives two examples: an individual earning under $57,580 may pay $950, and a married couple earning under $115,146 may pay $1,900. Amounts can change each year, so check the FTB for the figures that apply to the year you are filing.

Do I need a Form 1095 for my California health coverage tax return?

No. DHCS states that Form 1095-B “is not required to file your state or federal taxes” and that you may self-attest your coverage when you file. A DHCS letter says the same thing: individuals may self-attest their MEC at the time they file.

Two cautions apply:

The coverage provider is still responsible for reporting your coverage to the IRS and the FTB, so a missing form can mean the provider did not file correctly. Ask them.
The IRS or FTB may still ask for the form as proof later, so keep your own records (see below).

How do I report a full year of coverage on my California health coverage tax return? (Path A)

Check the full-year health care coverage box on your California return. According to the FTB’s instructions, that box appears on Form 540, Form 540NR, and Form 540 2EZ. You do not need to file Form FTB 3853 if everyone on your return had MEC for all twelve months and you are not claiming an exemption.

How do I report partial-year coverage or an exemption on my California health coverage tax return? (Path B)

Use Form FTB 3853, Health Coverage Exemptions and Individual Shared Responsibility Penalty. It is for anyone who had MEC or an exemption for some months but not qualifying coverage for the entire year. The form lists these exemptions:

Income below the filing threshold
Coverage considered unaffordable (over 7.28% of household income for 2025, per the FTB)
A short coverage gap of three consecutive months or less
Nonresident or part-year resident
Members of a health care sharing ministry
Members of Indian tribes or those eligible for Indian health services
Incarceration
A household member who was born, adopted, or died during the year

Covered California handles other exemptions, such as religious conscience and hardship exemptions. If you owe a penalty, the FTB instructions direct you to report it on your return using the penalty worksheet.

What if I am a Health Share member filing a California health coverage tax return? (Path C)

Do not simply check the full-year coverage box. A Health Share is not insurance, and Health Share membership is generally not MEC, so it does not support that box on its own.

The exemption that may apply is the health care sharing ministry exemption, code F on Form FTB 3853. It applies to any month you were a member of an organization that meets the legal definition of a health care sharing ministry in federal law, which the FTB’s instructions follow. Not every Health Sharing organization meets that definition, so the exemption does not apply to every Health Share.

Before you claim it, ask your organization for a written statement saying whether it meets the criteria for the months you were a member. If it does not, you may owe the penalty unless another exemption applies, such as unaffordable coverage or income below the filing threshold. Compare how Health Shares differ from insurance in ACA vs. Health Share for individuals and how cost sharing works in a Health Share.

What records should I keep for my California health coverage tax return?

Keep these for at least as long as your return can be reviewed:

Enrollment confirmation or membership agreement showing your effective dates
Insurance ID card or membership card
Proof of premium or contribution payments for each month
Any written statement from the plan or Health Share about coverage, MEC status, or exemption eligibility
Any 1095 form you later receive

When should I talk to a tax professional?

Get help if any of these apply:

You had mixed coverage during the year, such as insurance for some months and a Health Share for others
Household members were on different plans
You are unsure whether your coverage counts as MEC
You are unsure whether you qualify for an exemption
You moved to or from California during the year

Do other states have the same rule?

Yes, a few do. As of 2026, the jurisdictions actively enforcing a mandate with a financial penalty are California, Massachusetts, New Jersey, Rhode Island, and Washington, D.C., according to Free Market Healthcare Blog. Vermont has a mandate but does not attach a financial penalty. The filing steps differ by state, so watch for our state-by-state guides.

Frequently asked questions

Can I file my California health coverage tax return without a Form 1095? Yes. DHCS says the form is not required to file state or federal taxes and that you can self-attest your coverage.

Where do I check the box for health coverage? On your California return (Form 540, 540NR, or 540 2EZ), the full-year health care coverage box, if everyone had MEC for all twelve months.

When do I need Form FTB 3853? When you did not have qualifying coverage for the full year, need to claim an exemption, or need to calculate the penalty.

Does a Health Share count as minimum essential coverage? Generally no. Health Share members may qualify for the health care sharing ministry exemption if their organization meets the legal definition, so ask for written confirmation.

What is the penalty for not having coverage in California? For tax year 2025, the higher of $950 per adult and $475 per child, or 2.5% of income above the filing threshold, capped at the statewide average bronze premium for your household size.

This article is for general informational purposes only and is not insurance, legal, tax, or financial advice. Information comes from the California Franchise Tax Board, the California Department of Health Care Services, the Internal Revenue Code, and Free Market Healthcare Blog. Penalty amounts and exemption rules are for tax year 2025 and may change. Eligibility for any exemption depends on your individual facts, and Health Sharing arrangements are not insurance. Always confirm your filing requirements and exemption eligibility with the FTB or a licensed tax professional before filing.

By the Modern Healthcare Works team