Instructions For Form 8965 - Health Coverage Exemptions

a member of your tax household for any month had coverage for

Not required to file a tax return. If you aren't required to file a

all the months they were members of your tax household, you

tax return, your tax household is exempt from the shared respon-

will check the Full-year coverage box on your return. For infor-

sibility payment and you don't need to file a tax return to claim

mation on how to identify months during which an individual was

the coverage exemption. However, if you aren't required to file a

not a member of your tax household for one of these reasons,

tax return but choose to file anyway, you must claim the cover-

see

Member of tax household born or adopted during the year

age exemption on line 7 of Form 8965. (See the instructions un-

and

Member of tax household died during the year

in Part III, lat-

der

Part

II, later.)

er. You should file Form 8965 to identify these months only if you

Form 1040NR and Form 1040NR-EZ filers. If you file a Form

are otherwise filing Form 8965 to claim a coverage exemption.

1040NR or Form 1040NR-EZ (including a dual-status tax return

for your last year of U.S. residency) or someone claims a per-

Dependents of more than one taxpayer. Your tax house-

sonal exemption deduction for you on a Form 1040NR or Form

hold doesn't include someone you can, but don't, claim as a de-

1040NR-EZ, you are exempt from the shared responsibility pay-

pendent if the dependent is properly claimed on another taxpay-

ment. Don't attach Form 8965 to your Form 1040NR or Form

er's return or can be claimed by a taxpayer with higher priority

1040NR-EZ.

under the tie-breaker rules described in Pub. 501.

For more information, see chapters 1 and 6 of Pub. 519.

Household income. You will need to calculate your household

income if any of the following apply.

Only one Form 8965 should be filed for each tax house-

You wish to claim the coverage exemption for individuals

hold. If you can be claimed as a dependent by another

with household income below the filing threshold,

taxpayer, you don't need to file Form 8965 and don't

CAUTION

You wish to claim the exemption for coverage that is con-

owe a shared responsibility payment.

sidered unaffordable, or

You need to figure your shared responsibility payment.

More Information

For purposes of Form 8965, your household income is your

For more information on coverage exemptions, the shared re-

modified adjusted gross income (MAGI) plus the MAGI of each

sponsibility payment, and other terms discussed in these instruc-

individual in your tax household whom you claim as a dependent

tions, including answers to frequently asked questions and links

if that individual is required to file a tax return because his or her

to the final regulations issued by the Treasury Department and

income meets the income tax return filing threshold. Use the

Fil-

IRS, go to IRS.gov/SRP.

ing Requirements for Children and Other Dependents

chart to

determine whether your dependent is required to file his or her

Types of Coverage Exemptions

own tax return.

The

Types of Coverage Exemptions

chart shows the types of

Modified adjusted gross income (MAGI). For purposes of

coverage exemptions available and whether the coverage ex-

Form 8965, your MAGI is your adjusted gross income plus cer-

emption may be granted by the Marketplace, claimed on your

tain other items from your tax return.

tax return, or both. If you are claiming a coverage exemption in

Your MAGI for purposes of the individual shared re-

Part III, the right-hand column of the chart shows which code you

sponsibility provision may be different than the MAGI

should enter in column (c) to claim that particular coverage ex-

that applies for other tax purposes, including the premi-

emption.

CAUTION

um tax credit.

If the coverage exemption can be granted only by the Market-

place (for example, a coverage exemption based on member-

If you file Form 1040. If you file Form 1040, figure your

ship in certain religious sects or certain hardship exemptions),

MAGI by adding the amounts reported on Form 1040, lines 8b

apply to the Marketplace for that coverage exemption before fil-

and 37. If you claimed the foreign earned income exclusion,

ing your tax return. If the Marketplace hasn't processed your ap-

housing exclusion, or housing deduction, add the amounts from

plication before you file your tax return, complete Part I and enter

Form 2555, lines 45 and 50, or Form 2555-EZ, line 18. If your

“pending” in column (c) for each individual listed.

dependent has a filing requirement, but you elect to report the

dependent's income on Form 8814, include the dependent's

Definitions

MAGI in the household income by adding Form 8814, line 1b,

Tax household. For purposes of Form 8965, your tax house-

and the smaller of Form 8814, line 4 or 5.

hold generally includes you, your spouse (if filing a joint return),

If you file Form 1040A. If you file Form 1040A, figure your

and any individual you claim as a dependent on your tax return.

MAGI by adding the amounts on Form 1040A, lines 8b and 21.

It also generally includes each individual you can, but don't,

claim as a dependent on your tax return. (But see

Dependents of

If you file Form 1040EZ. If you file Form 1040EZ, figure

more than one

taxpayer, later.) To find out if you can claim

your MAGI by adding the amount on Form 1040EZ, line 4, and

someone as your dependent, see Exemptions for Dependents in

any tax-exempt interest reported in the space to the left of line 2.

Pub. 501 or Line 6c—Dependents in the instructions for Form

You can use Step 3 under Shared Responsibility Pay-

1040 or Form 1040A.

ment, later, to figure your household income.

TIP

Birth, death, or adoption. An individual is included in your

tax household in a month only if he or she is alive for the full

month. Also, if you adopt a child during the year, the child is in-

cluded in your tax household only for the full months that follow

the month in which the adoption occurs. If each individual who is

-2-

Instructions For Form 8965 - Health Coverage Exemptions - 2016 Page 2

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