Instructions For Form 8885 - Health Coverage Tax Credit

insurance plan of your spouse) (other than

Example 1. You checked January on

Specific Instructions

the coverage listed under item 3, 4a, or 4e

line 1. You paid $225 ($200 for basic

in the definition of

Qualified Health

coverage and $25 for dental benefits

Line 1

Insurance

Coverage) and the employer

which are purchased separately) directly

paid any part of the cost of the coverage.

to your health plan for your January

You must elect the HCTC to receive the

coverage. The $25 you paid for dental

benefit of the HCTC. Check the box for the

Any amounts contributed to the

benefits is ineligible for the HCTC. You

first eligible coverage month you are

cost of coverage by you or your

would include the $200 you paid for your

electing to take the HCTC. All of the

spouse on a pre-tax basis are

basic insurance on line 2.

CAUTION

statements listed on the form, and as

considered to have been paid by the

further explained in these instructions,

Example 2. You checked December

employer.

must be true as of the first day of that

on line 1. You participated in the advance

month. You must also check the box for

Example. You had health insurance

monthly payment program and paid only

$88 (27.5%) of your $320 December

each month after the election month for

coverage under an employer-sponsored

premium to “U.S. Treasury–HCTC.” You

which all of the statements listed on the

health insurance plan as of October 1. The

form are true as of the first day of that

employer paid 40% of the cost of the

received a Form 1099-H showing an

month, even if you aren’t claiming the

coverage. You paid 60% of the cost of the

advance payment of $232 (72.5% of the

HCTC for those months.

$320 premium) for your December

coverage through pre-tax contributions.

coverage. You wouldn’t include any part of

You can’t take the HCTC for the month of

Employer-sponsored health insurance

the December coverage premium on line 2

October because the employer is

coverage. Don’t check the box for any

considered to have paid 100% of the cost

because you already received the benefit

month that, as of the first day of the month,

of the coverage.

of the advance monthly payment program

either (1) or (2) applies.

for December. You must still file Form

Line 2

1. You were covered under any

8885 to elect the HCTC for December.

employer-sponsored health insurance

Line 5

plan (including any employer-sponsored

If your qualified health insurance

coverage covers anyone other

health insurance plan of your spouse)

If the resulting amount from line 5 is

than you and your qualifying

(except insurance substantially all of the

negative, zero, or blank, you can’t claim

CAUTION

family members, see Pub. 502, Medical

coverage of which is of excepted benefits

the HCTC on your income tax return.

described in section 9832(c)) and the

and Dental Expenses, before completing

However, you must still file Form 8885 to

employer paid 50% or more of the cost of

line 2, to determine which amounts are

elect the HCTC for any months you

considered to be paid for coverage for you

the coverage.

participated in the advance monthly

and your qualifying family members.

2. You were an eligible ATAA or

payment program.

RTAA recipient and either of the following

Enter the total amount of insurance

You received an excess advance

applies.

premiums paid by you for coverage for

monthly payment of the HCTC if you

you and all qualifying family members

a. You were eligible for qualified

received the benefit of an advance

under

Qualified Health Insurance

health insurance coverage (including any

monthly payment for any month not

Coverage

for all eligible coverage months

employer-sponsored health insurance

checked on line 1 (see Form 1099-H) or

checked on line 1. But don’t include any

plan of your spouse) (other than the

received a reimbursement of the HCTC

insurance premiums paid by you for

coverage listed under item 3, 4a, or 4e in

during the year by filing Form 14095 for

eligible coverage months for which you

the definition of

Qualified Health Insurance

any month not checked on line 1. You

received the benefit of the advance

Coverage) where the employer would

must reduce the amount on line 5 by the

monthly payment program. Also, don’t

have paid 50% or more of the cost of the

total of these payments. Use the

Excess

include any advance monthly payments

coverage.

Advance HCTC Repayment Worksheet

your health plan administrator received

b. You were covered under any

next to figure the amount of the excess

from the IRS, as shown on Form 1099-H,

qualified health insurance coverage

advance monthly payment that you must

box 1.

(including any employer-sponsored health

repay.

Instructions for Form 8885 (2017)

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Instructions For Form 8885 - Health Coverage Tax Credit - 2017 Page 4

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