Fillable Form 8885 - Health Coverage Tax Credit

Form 8885 (2012)

Page

• The child’s other parent can claim the child as a

contributions). If you were an eligible TAA recipient or

dependent under the rules for children of divorced or

PBGC pension payee, you can claim the HCTC for the

separated parents (see the instructions for Form 1040,

month of October if you met all the other conditions listed

line 6c, or Pub. 501, Exemptions, Standard Deduction,

on line 1 on October 1, 2012. If you were an ATAA or

and Filing Information, for details).

RTAA recipient, you can claim the HCTC for the month of

October only if, on October 1, 2012, all of the following

If both of the above apply, the child’s other parent

apply.

cannot treat the child as a qualifying family member for

the HCTC.

• You were not eligible for coverage under any qualified

health insurance plan (including any employer-sponsored

The child must also meet all of the other

▲

health insurance plan of your spouse) (other than the

conditions of a qualifying family member

plans listed under 3, 4a, or 4e in the definition of Qualified

defined earlier.

Health Insurance Plan) where the employer would have

CAUTION

paid 50% or more of the cost of the coverage.

Specific Instructions

• The plan was a type of plan listed under 3, 4a, or 4e in

Line 1

the definition of Qualified Health Insurance Plan.

• You met all of the other conditions listed on line 1.

Employer-sponsored health insurance plan. You

cannot claim the HCTC for any month that, on the first

Line 2

day of the month, either (1) or (2) next apply.

If your qualified health insurance plan covers

▲

1. You were covered under any employer-sponsored

anyone other than you and your qualifying

health insurance plan (including any employer-sponsored

family members, see Pub. 502, Medical and

health insurance plan of your spouse) (except insurance

CAUTION

Dental Expenses (Including the Health Coverage

substantially all of the coverage of which is of excepted

Tax Credit), before completing line 2.

benefits described in section 9832(c)) and the employer

Enter the total amount of insurance premiums paid for

paid 50% or more of the cost of the coverage.

coverage for you and all qualifying family members under

2. You were an ATAA or RTAA recipient and either of

a qualified health insurance plan (defined earlier) for all

the following applies.

months checked on line 1. But do not include any

a. You were eligible for coverage under any qualified

qualified health insurance premiums you paid to “U.S.

health insurance plan (including any employer-sponsored

Treasury–HCTC” or any insurance premiums on coverage

health insurance plan of your spouse) (other than the

that was actually paid for with a National Emergency

plans listed under 3, 4a, or 4e in the definition of

Grant. Also, do not include any advance (monthly)

Qualified Health Insurance Plan) where the employer

payments or reimbursement credits you received, as

would have paid 50% or more of the cost of the

shown on Form 1099-H, box 1.

coverage.

Example 1. You checked January on line 1. You paid

b. You were covered under any qualified health

$225 ($200 for basic coverage and $25 for dental benefits

insurance plan (including any employer-sponsored health

which are purchased separately) to your insurance

insurance plan of your spouse) (other than the plans listed

company for coverage in January. The $25 you paid for

under 3, 4a, or 4e in the definition of Qualified Health

dental benefits is ineligible for the HCTC. You would

Insurance Plan) and the employer paid any part of the

include the $200 you paid for your basic insurance on

cost of the coverage.

line 2.

Any amounts contributed to the cost of

▲

Example 2. Your insurance coverage for January cost

coverage by you or your spouse on a pre-tax

$225 ($200 for basic coverage and $25 for dental benefits

basis are considered to have been paid by the

ineligible for the HCTC). You paid $80 to “U.S. Treasury–

CAUTION

employer.

HCTC” for January. The $80 equals $55 (your 27.5%

share of the $200 eligible premium) plus the $25 for

Check the boxes on line 1 for each month that, on the

dental benefits ineligible for the HCTC. You received a

first day of the month, neither (1) nor (2) above applies

Form 1099-H showing an advance payment of $145

and you met all of the other conditions listed on line 1.

(72.5% of the $200 eligible premium) for January. You

Example 1. On October 1, 2012, your only health

would check January on line 1 but you would include

insurance coverage was under an employer-sponsored

nothing for January on line 2.

health insurance plan. The plan is not one in which

Line 5

substantially all of the coverage is of excepted benefits

described in section 9832(c). The employer paid 40% of

If you receive an advance payment in any month not

the cost of the coverage. You paid 20% of the cost of the

checked on line 1, you must reduce the amount on line 5

coverage through pre-tax contributions. You cannot claim

by the total of that advanced payment(s). If the result is

the HCTC for the month of October because the

less than zero, show the amount on line 5 as a negative

employer is considered to have paid 60% of the cost of

number by enclosing it in parentheses. This amount is

the coverage.

treated as an additional tax and must be treated as a

Example 2. Assume the same facts as in Example 1

positive amount and included in the total you enter on

except that the employer paid only 25% of the cost of the

Form 1040, line 60; Form 1040NR, line 59; Form 1040-SS,

coverage. The employer is considered to have paid 45%

line 5; or Form 1040-PR, line 5. On the dotted line next to

of the cost of the coverage (25% that was paid by the

that line enter “HCTC” and the amount of this additional

employer plus 20% that you paid through pre-tax

tax.

Form 8885 - Health Coverage Tax Credit - 2012 Page 5

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