Most people with health coverage today have a plan that will count as minimum essential coverage. The following types of health coverage count as minimum essential coverage:
Employer-sponsored group health plans
Union plans
COBRA coverage
Retiree health plans
Non-group health insurance that you buy on your own, for example, through the health insurance Marketplace
Student health insurance plans
Grandfathered health plans
Medicare
Medicaid
The Children’s Health Insurance Program (CHIP)
TRICARE (military health coverage)
Veterans’ health care programs
Peace Corps Volunteer plans
Be aware that outside of the Marketplace, other policies be for sale that may look like health insurance (such as short term individual policies, or policies that only cover cancer.) These kinds of products are sometimes referred to as “excepted benefits.” They do not count as Minimum Essential Coverage.
Starting in 2019, there is no tax penalty for people who are not covered by Minimum Essential Coverage.
There is an exemption for people who are incarcerated but it does not apply to people who were in jail awaiting trial.
However, for 2018, you could also claim a hardship exemption because you experienced circumstances that prevented you from obtaining coverage. You can claim this exemption directly on your 2018 tax return, by checking the box on Form 1040, when you file next spring.
No, you can apply to the Marketplace for a hardship exemption at any time during the year. Most hardship exemptions will be granted for the month before the hardship, the months of the hardship, and the month after the hardship. You will need to document the timing of the hardship in your application.
In addition, for the 2018 tax year, you can claim a hardship exemption directly on your tax return, by checking the box on Form 1040, without having to apply to the Marketplace. You won’t be required to submit documentation of the hardship with your tax return, though you should retain any documents for your own records.
For the 2018 tax year, anyone can apply for a hardship exemption if they experienced circumstances that prevented them from having health insurance. You can claim the hardship exemption directly on your 2018 federal income tax return, by checking the box on Form 1040, when you file. You will not be required to submit documentation of the hardship with the return, though you should keep any documentation for your records.
Federal law provides other types of exemptions. For some of these, you must apply through the health insurance Marketplace; for other types, you must apply when you file your taxes; some types of exemptions can be claimed either way.
The religious conscience exemption is available only by going to a health insurance Marketplace and applying for an exemption certificate. In the federal Marketplace, you cannot apply for an exemption online. Instead, you can download a paper application for an exemption from healthcare.gov, fill it out and mail it in. You will receive a response by mail and, if the exemption is approved, it will include an exemption certificate number. Save this document, you will need to include the exemption certificate number on IRS Form 8965, which you will need to submit with your tax return when you file your federal income taxes. If you need help applying for an exemption, you can contact the Marketplace call center or a Navigator or other in-person assister. Your Marketplace website has a list of Navigators and other assisters.
The hardship exemption and other exemptions for unaffordable coverage, members of Indian tribes, members of health care sharing ministries, and individuals who are incarcerated are available either by going to a Marketplace and applying for an exemption certificate or by claiming the exemption as part of filing a federal income tax return.
The exemptions for short coverage gaps, certain hardships and individuals who are not lawfully present in the United States can be claimed only as part of filing a federal income tax return. You will need to file a return and include with it Form 8965. If you already received an exemption from the Marketplace, you will include the Marketplace exemption certificate number on this form. Otherwise, instructions for this form will explain the steps you must take and information you must enter on your federal tax return so that you won’t owe a tax penalty.
The exemption for having income under the federal income tax return filing threshold is available automatically. No special action is needed. However, if you are filing a tax return anyway (for example, to have refunded taxes that were withheld during the year), you should include Form 8965 with your tax return and check the special box indicating that your income is below the tax filing threshold.
If you did not maintain minimum essential coverage every month of this year and you don’t qualify for an exemption you will need to pay a “shared responsibility payment” to the IRS on your federal income tax return . If you are like most people, you will need to file your tax return by April 15 next year.
However, for 2018, the IRS has made it easier for people to claim a hardship exemption directly on your tax return by checking the box on Form 1040. You can claim the hardship exemption if you experienced circumstances that made it hard for you to obtain coverage in 2018. You will not be asked to provide documentation of the hardship when you file, though you should keep any documentation for your records.
Health insurance companies, employer-sponsored health plans, and public health programs such as Medicaid are required to provide you with documentation of coverage. In January, you should receive a form 1095-B from your health plan or insurance company indicating the months during the prior year when you were covered under the plan. If you were enrolled in family coverage, Form 1095-B will indicate the names of all family members who were covered with you under the plan. (If you worked for a large employer, with more than 50 employees, you might receive a Form 1095-C instead of Form 1095-B. Form 1095-C documents an offer of coverage by a large employer in addition to documenting months of coverage under the plan.) A copy of this form will also be reported to the Internal Revenue Service.
If you were covered by more than one plan during the year, you should receive a Form 1095-B (or 1095-C) from each plan. When you file your tax return for this calendar year (most people will do this by April 15 next year) you will have to enter information about your coverage (or your exemption) on the return.
If you are a resident of a foreign country for the full calendar year, you will not have to pay a tax penalty, even if you don’t have minimum essential coverage.
No, if you are covered even one day during a month, you are considered to be insured for that month. Similarly, a person who is considered exempt from the individual responsibility requirement for even one day during a month is considered exempt for that month.
The rule for short coverage gaps is that only the first short coverage gap in a year will be recognized. You wouldn’t be penalized for lacking coverage in March, but you may owe a penalty for your second gap in coverage in August if you don’t otherwise qualify for an exemption during that period.
However for 2018, if you experienced hardship that prevented you from getting coverage, you can claim a hardship exemption directly on your 2018 federal income tax return.