It’s Not Too Early to Determine Whether You Have Qualifying Health Care Coverage

IRS Health Care Tax Tip 2016-66, August 24, 2016                                              

The individual shared responsibility provision requires you and each member of your family to have basic health coverage – also known as minimum essential coverage – qualify for a health coverage exemption, or make an individual shared responsibility payment for months without coverage or an exemption when you file your federal income tax return.

Many people already have minimum essential coverage. If you do, you'll simply report your coverage when you file your 2016 tax return in 2017. If you and your family members all had minimum essential coverage for each month of the tax year, you will indicate this on your tax return by checking a box on Form 1040, 1040-A or 1040-EZ. No further action is required.

If you do have health coverage, you’ll receive one or more forms early next year about the health care coverage that you had or were offered during 2016. You should not attach any of these forms to your tax return but should keep them with your tax records.

Here are some examples of coverage that qualify as minimum essential coverage:

Employer-sponsored coverage

• Group health insurance coverage for employees under
  • a governmental plan such as the Federal Employees Health Benefit program
  • a plan or coverage offered in the small or large group market within a state
  • a grandfathered health plan offered in a group market
• Self-insured group health plan for employees
• COBRA coverage
• Retiree coverage

Individual health coverage:

• Health insurance you purchase directly from an insurance company
• Health insurance you purchase through the Health Insurance Marketplace
• Health insurance provided through a student health plan

Coverage under government-sponsored programs:

• Medicare Part A coverage
• Medicare Advantage plans
• Most Medicaid coverage
• Children’s Health Insurance Program, also known as CHIP
• Most types of TRICARE coverage
• Comprehensive health care programs offered by the Department of Veterans Affairs
• Department of Defense Nonappropriated Fund Health Benefits Program
• Refugee Medical Assistance

U.S. citizens, who are residents of a foreign country for an entire year, and residents of U.S. territories, are considered to have minimum essential coverage for the year.

For a a list of the types of coverage that qualify as minimum essential coverage and information on those that do not qualify – as well as information on certain coverage that may provide limited benefits – visit the MEC page on IRS.gov/aca.

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