Documents you may need when applying for health insurance

Are you shopping for a new health insurance plan? Whether you apply during an Open or Special Enrollment Period, you may need to confirm some of your information with additional documentation. Your enrollment won’t be completed until you provide any necessary documents, so it’s a great idea to have these available and ready to submit.

Confirming Your Identity, Date of Birth, Citizenship, or Immigration Status

One of the following documents can be used as proof of your identity, date of birth, citizenship, or immigration status.

Proof of Identity, Date of Birth, and Citizenship/Immigration Status

U.S. passport Certificate of Naturalization (DHS Forms N-550 or N-570) Certificate of U.S. Citizenship (DHS Forms N-560 or N-561) Enhanced Driver’s License (available in Michigan, New York, Vermont, and Washington) Native American Tribal Document A tribal enrollment card A Certificate of Degree of Indian Blood A tribal census document Documents on tribal letterhead signed by a tribal official

If you do not have one of the documents listed above, two of the documents listed below (one from each column) can be used as proof of your citizenship and/or identity.

Proof of Citizenship or Identity (requires one from each column)

U.S. Birth Certificate Consular Report of Birth Abroad (FS-240, CRBA) Certification of Report of Birth (DS-1350) Certification of Birth Abroad (FS-545) U.S. Citizen ID card (Form I-197 or I-179) Northern Mariana Card (I-873) Final adoption decree (showing the person’s name and U.S. place of birth) U.S. Civil Service Employment Record showing employment before June 1, 1976 Military record of service showing U.S. place of birth U.S. medical record from a clinic, hospital, physician, midwife, or institution showing a U.S. place of birth U.S. life, health, or other insurance record showing U.S. place of birth Religious record showing U.S. place of birth recorded in the U.S. School record showing the child’s name and U.S. place of birth Federal or state census record showing U.S. citizenship or U.S. place of birth Documentation of a foreign-born adopted child who received automatic U.S. citizenship (IR3 or IH3)

Driver’s license issued by a state or territory or ID card issued by the federal, state, or local government  School identification card U.S. military card or draft record or military dependent’s identification card U.S. Coast Guard Merchant Mariner card Voter Registration Card A clinic, doctor, hospital, or school record, including preschool or daycare records (for children under 19 years old) 2 documents containing consistent information that proves your identity, like employer IDs, high school and college diplomas, marriage certificates, divorce decrees, property deeds, or titles

For those who are not citizens, there are some common forms you can use to prove your immigration status. One of the following documents can be used to prove your immigration status.

Proof of Immigration Status and Identity

Permanent Resident Card, “Green Card” (I-551) Reentry Permit (I-327) Refugee Travel Document (I-571) Employment Authorization Card (I-766) Machine Readable Immigrant Visa (with temporary I-551 language) Temporary I-551 Stamp (on Passport or I-94/I-94A) Foreign passport Arrival/Departure Record (I-94/I-94A) Arrival/Departure Record in foreign passport (I-94) Certificate of Eligibility for Nonimmigrant Student Status (I-20) Certificate of Eligibility for Exchange Visitor Status (DS-2019) Notice of Action (I-797) Document indicating a member of a federally recognized Indian tribe or American Indian born in Canada Certification from U.S. Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR) Document indicating withholding of removal (or withholding of deportation) Office of Refugee Resettlement (ORR) eligibility letter (if under 18) Resident of American Samoa Card

One of the following documents can be used as proof of your Social Security Number (SSN). The document must include your first name, last name, and SSN.

Proof of Social Security Number

Social Security card 1040 Tax Return (federal or state versions acceptable) W2 and/or 1099s (includes 1099 MISC, 1099G, 1099R, 1099SSA, 1099DIV, 1099S, 1099INT) W4 Withholding Allowance Certificate (federal or state versions acceptable) 1095 (includes 1095A, 1095B, 1095C) Pay stub documentation Social Security Administration documentation (includes 4029) Military record U.S. Military ID card Military dependent’s ID card Unemployment Benefits (Unemployment Benefits Letter) Court Order Granting a Name Change (including your original first and last name, new first and last name, and SSN) Divorce decree

Confirming Your Home Address

One of the following documents can be used as proof of your home address. The address must match what you submitted during your health insurance application. Additionally, the proof you use must be dated within 6 months from when you signed the application.

Proof of Home Address

Lease/letter/rent receipt with your home address from landlord Utility bill (gas, electric, phone, cable, fuel, or water) Property tax records or mortgage statement Driver’s license (if issued in the past 6 months) Government ID card with address Postmarked envelope or postcard (cannot use if sent to a P.O. Box)

Confirming Your Current or Future Income

One document for each type of income you receive will be needed when providing proof of income. This includes your current income, as well as future income you may get from unemployment benefits or upcoming lawsuits. It will also include the income of anyone living with you.

A letter, written statement, or copy of a check or pay stub from your employer (or whoever is providing payment) should be provided. Additionally, documents should be dated, include the name of the payor, and show your gross income for the pay period. Please use the most recent document as proof of income before any taxes or other deductions. Documents must be for the last 4 weeks, regardless of your frequency of pay.

Proof of Wages and Salary

1040 federal or state tax return Wages and tax statement (W-2 and/ or 1099, including 1099 MISC, 1099G, 1099R, 1099SSA, 1099DIV, 1099SS, 1099INT) Paycheck stubs Letter from employer on company letterhead, signed and dated Current signed and dated income tax return and all Schedules Business/payroll records

Proof of Self-Employment

1040 SE with Schedule C, F, or SE tax documents 1065 Schedule K1 with Schedule E tax documents Tax return Records of earnings and expenses/bookkeeping records Receipts for all allowable expenses Signed timesheets and receipt of payroll, if you have employees Most recent quarterly or year-to-date profit and loss statement

Proof of Unemployment Benefits

Award letter/certificate Monthly benefit statement from Department of Labor Printout of recipient’s account information from the Department of Labor’s website Copy of Direct Payment Card with printout Correspondence from the Department of Labor

Proof of Private Pensions/Annuities

Statement from pension/annuity

Proof of Social Security Benefits

Award letter/certificate Annual benefit statement Correspondence from Social Security Administration

Proof of Workers’ Compensation

Award letter Check stub

Proof of Child Support/Alimony

Letter from person providing support Letter from court Child support/alimony check stub Copy of EPPICard with printout Copy of child support account information Copy of bank statement showing direct deposit

Proof of Veterans’ Benefits

Award letter Benefit check stub Correspondence from Veterans Affairs

Proof of Military Pay

Award letter Check stub

Proof of Income from Rent or Room/Board

Letter from roomer, boarder, tenant Check stub

Proof of Interest/Dividends/Royalties

Recent statement from bank, credit union, or financial institution Letter from broker or agent 1099 or tax return (if no other documentation is available)

Proof of Support from Other Family Members

Signed statement or letter from family member

Confirming Child or Paternal Care

One of the following documents can be used as proof if you pay for child or parental care while you work.

Proof of Child or Parental Care

Written statement from daycare center or other child/adult care provider Canceled checks or receipts that show your payments

Confirming Your Insurance Status

Any of the following documents that apply should be used when explaining proof of insurance.

Proof of Insurance

Current Insurance Policy document, Certificate of Insurance, or Insurance Card Health Insurance Termination Letter (including Medicaid or CHIP) Medicare Card Letter or statement from a Medicaid or CHIP agency that shows that you or your family members aren’t enrolled in or eligible for Medicaid or CHIP Letter or statement from a Medicaid agency showing that you or a family member are enrolled in a Medicaid program that’s not considered qualifying health coverage Denial letter from your state Medicaid or CHIP agency Letter stating your Medicaid or CHIP coverage ended that shows you used to have Medicaid or CHIP coverage and the date it ended Letter from the Marketplace that says your state Medicaid or CHIP agency sent your application to the Marketplace Screenshot of your eligibility results from your state’s online application Letter or statement from TRICARE that shows the expiration or un-enrollment date of previous health coverage Letter or statement from TRICARE that confirms ineligibility for health coverage Letter, statement, or other document indicating a life change event (like divorce) that would make you or a family member ineligible for TRICARE coverage Letter or statement from TRICARE or other government agency showing that you or a family member are enrolled in a TRICARE program that’s not considered qualifying health coverage Letter from the VA that shows the expiration date of previous health coverage Letter from the Peace Corps with the expiration date for any previous health coverage or a letter showing that you never had this type of coverage

One of the following documents can be used as proof that your employer does not provide minimal essential (qualifying health) coverage.

Proof that Employer Doesn’t Provide Minimum Essential Coverage

Completed Employer Coverage Tool form and a cover letter signed by the employer Letter or other documentation from an employer or other documentation with this information: Statement that the employer doesn’t currently offer you (or your family member) coverage Statement that the employer doesn’t provide coverage that is qualifying health coverage Statement showing the cost of your share of the premium for the lowest-cost self-only plan that meets the minimum value standard (factoring in wellness incentives), if offered Health insurance letter that contains confirmation of health coverage and expiration dates for coverage received outside of the Marketplace

Documents for Proof  Pregnancy and Adoption/Placement

One of the following documents can be used as proof that you are pregnant. This documentation is for pregnant women only.

Proof of Pregnancy

Presumptive Eligibility Screening Worksheet for pregnant women completed by a qualified provider that includes expected date of delivery Statement from medical professional (such as a doctor or nurse practitioner) with the expected date of delivery WIC Medical Referral Form that includes expected date of delivery

One of the following documents can be used as proof of an adoption, foster placement, or court-ordered dependency. The documents must have the name of the dependent and the date the person became a dependent.

Proof of Adoption or Placement

Adoption letter or record (needs to be signed by a government or court official) Foster care papers (needs to be signed by a government or court official) Child support or other court order (needs to be signed by a court official) Document for legal guardianship (needs to be a government-issued or legal document) Medical support order U.S. Department of Homeland Security (DHS) immigration document

Confirming Eligible Medical Expenses

To receive a determination for eligible medical expenses from the past 3 months, all the following documents should be provided.

Proof for Determination of Eligible Medical Expenses

Proof of income for the month(s) in which the expense was incurred Proof of residency/home address for the month(s) in which the expense was incurred Medical bills for last three months, whether or not you paid them

Confirming Your Incarceration Status

One of following documents can be used as proof that you are not currently incarcerated.

Proof of Incarceration Status

Official release papers from the institution or Department of Corrections Parole papers Unexpired state ID, driver’s license, work ID, or passport Pay stubs Federal, state, or local benefit letter Clinic, doctor, or hospital records for services provided Medical claim explanation of benefits provided School record/schedule showing enrollment (like for college students) Bank or credit card statement showing transaction history (showing only your name, but not a joint account) Military records Cell phone bill (showing only your name) Lease (must be an active lease where you’re currently residing) Signed notarized statement from the individual with alleged false incarceration inconsistency showing that you’re living in the community and includes your name, date of birth, and address Written statement from someone within the community which shows your name, date of birth, address, phone number, your relationship with the person with alleged false incarceration inconsistency (if it’s not you), and that you’re present and participating within the community Rent receipts (showing only your name)

Do I Need These Documents to Apply for a Plan?

If you aren’t sure what documentation you will need, don’t worry. You will be asked for the type of proof needed. You can still shop and apply for a plan without these documents. However, your enrollment in a plan won’t be complete until you provide any required documents.

This is not an exhaustive list of documents that can be provided for health insurance enrollment.