Instructions For Form 8965 - Health Coverage Exemptions

Types of Coverage Exemptions

This chart shows all of the coverage exemptions available for 2017, including information about where each can be obtained and the

code that is to be used on Form 8965 when you claim the exemption. If your coverage exemption was granted by the Marketplace,

you will need to enter the Exemption Certificate Number (ECN) provided by the Marketplace (see the instructions for

Part

I). For addi-

tional detail about the eligibility rules for the coverage exemptions that are claimed on the tax return, see the instructions for Parts II

and III, later.

Coverage Exemption

Granted by

Claimed on

Code for

Marketplace

Tax Return

Exemption

Income below the filing threshold—Your gross income or your household income was less

No Code

than your applicable minimum threshold for filing a tax return.

See Part II

Coverage considered unaffordable—The

required contribution

is more than 8.16% of your

household

income.

Short coverage gap—You went without coverage for less than 3 consecutive months during

the year.

Citizens living abroad and certain noncitizens—You were:

A U.S. citizen or a resident alien who was physically present in a foreign country or

countries for at least 330 full days during any period of 12 consecutive months;

A U.S. citizen who was a bona fide resident of a foreign country or countries for an

uninterrupted period that includes the entire tax year;

A bona fide resident of a U.S. territory;

A resident alien who was a citizen or national of a foreign country with which the U.S. has

an income tax treaty with a nondiscrimination clause, and you were a bona fide resident of a

foreign country for an uninterrupted period that includes the entire tax year;

Not lawfully present in the U.S and not a U.S. citizen or U.S. national. For more

information about who is treated as lawfully present in the U.S. for purposes of this coverage

exemption, visit or

A nonresident alien, including (1) a dual-status alien in the first year of U.S. residency and

(2) a nonresident alien or dual-status alien who elects to file a joint return with a U.S. spouse.

This exemption doesn't apply if you are a nonresident alien for 2017, but met certain presence

requirements and elected to be treated as a resident alien. For more information, see Pub. 519.

Members of a health care sharing ministry—You were a member of a health care sharing

ministry.

Members of Indian tribes—You were either a member of a Federally-recognized Indian tribe,

including an Alaska Native Claims Settlement Act (ANCSA) Corporation Shareholder (regional

or village), or you were otherwise eligible for services through an Indian health care provider or

the Indian Health Service.

Incarceration—You were in a jail, prison, or similar penal institution or correctional facility after

the disposition of charges.

Aggregate self-only coverage considered unaffordable—Two or more family members'

aggregate cost of self-only employer-sponsored coverage was more than 8.16% of household

income, as was the cost of any available employer-sponsored coverage for the entire family.

Resident of a state that didn’t expand Medicaid—Your household income was below 138%

of the federal poverty line for your family size and at any time in 2017 you resided in a state that

didn't participate in the Medicaid expansion under the Affordable Care Act.

Member of tax household born or adopted during the year—The months before and

including the month that an individual was added to your tax household by birth or adoption. You

should claim this exemption only if you also are claiming another exemption on your Form 8965.

Member of tax household died during the year—The months after the month that a member

of your tax household died during the year. You should claim this exemption only if you also are

claiming another exemption on your Form 8965.

Members of certain religious sects—The Marketplace determined that you are a member of

Need ECN

a recognized religious sect.

See Part I

Ineligible for Medicaid based on a state’s decision not to expand Medicaid coverage—

The Marketplace found that you would have been determined ineligible for Medicaid solely

Need ECN

because the state in which you resided didn't participate in Medicaid expansion under the

See Part I

Affordable Care Act.

General hardship—The Marketplace determined that you experienced a hardship that

Need ECN

prevented you from obtaining coverage under a qualified health plan.

See Part I

Coverage considered unaffordable based on projected income—The Marketplace

Need ECN

determined that you didn’t have access to coverage that is considered affordable based on your

See Part I

projected household income.

Certain Medicaid programs that are not minimum essential coverage—The Marketplace

determined that you were (1) enrolled in Medicaid coverage provided to a pregnant woman that

isn’t recognized as minimum essential coverage; (2) enrolled in Medicaid coverage provided to

Need ECN

a medically needy individual (also known as Spend-down Medicaid or Share-of-Cost Medicaid)

See Part I

that isn’t recognized as minimum essential coverage; or (3) enrolled in Medicaid coverage

provided to a medically needy individual and were without coverage for other months because

the spend-down had not been met.

*The coverage exemption for members of Indian tribes is no longer granted by the Marketplace, except in Connecticut. See the instructions for Part I, later, to claim the

exemption.

-3-

Instructions For Form 8965 - Health Coverage Exemptions - 2016 Page 3

Related Articles

Related forms

Related Categories