Instructions For Form 1040ez - Income Tax Return For Single And Joint Filers With No Dependents - 2017 Page 20
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452017 Form 1040EZ—Lines 9 through 11
shared responsibility payment on line 11 for each month that
you, your spouse (if filing jointly), or someone you can or do
Line 9
9
claim as a dependent didn't have coverage. See the Instructions
for Form 8965 for information on coverage exemptions and figur-
Add lines 7 and 8a. Enter the total on line 9.
ing the shared responsibility payment. However, if you can be
Amount paid with request for extension of time to file. If
claimed as a dependent, you don’t need to check the box, claim
you requested an automatic extension of time to file Form
a coverage exemption, or report a payment. Leave the entry
1040EZ using Form 4868, include on line 9 any amount paid
space blank. You don’t need to attach Form 8965 or see its in-
with that form. Also include any amount you paid by electronic
structions.
funds withdrawal, credit or debit card, or the Electronic Federal
If you or someone in your household had minimum essential
Tax Payment System (EFTPS) to get an extension. If you paid
coverage in 2017, the provider of that coverage is required to
by credit or debit card, do not include on line 9 the convenience
send you and the IRS a Form 1095-A, Form 1095-B, or Form
fee you were charged. To the left of line 9, enter “Form 4868”
1095-C (with Part III completed) that lists individuals in your fami-
and show the amount paid.
ly who were enrolled in the coverage and shows their months of
coverage.
Line 10, Tax
Individuals enrolled in health insurance coverage through
10
the Marketplace generally receive this information on Form
1095-A, Health Insurance Marketplace Statement.
Do you want the IRS to figure your tax for you?
Individuals enrolled in health insurance coverage provided
by their employer generally receive this information on either
Yes. See chapter 30 of Pub. 17 for details, including who is eligible
Form 1095-B, Health Coverage, or on Form 1095-C, Em-
and what to do. If you have paid too much, we will send you a refund. If
you did not pay enough, we will send you a bill.
ployer-Provided Health Insurance Offer and Coverage.
No. Use the Tax Table later in these instructions.
Individuals enrolled in a government-sponsored health pro-
gram or in other types of coverage generally receive this in-
formation on Form 1095-B, Health Coverage.
You should receive the Form 1095-A by early February 2018
Line 11, Health Care: Individual
and Form 1095-B, or Form 1095-C, by early March 2018, if ap-
11
Responsibility
plicable. You don’t need to wait to receive your Form 1095-B or
Form 1095-C to file your return. You may rely on other informa-
For each month of 2017, you must either:
tion about your coverage to complete line 11. Don’t include Form
Have qualifying health care coverage for yourself, your
1095-A, Form 1095-B, or Form 1095-C with your tax return.
spouse (if filing jointly), and anyone you could claim as a de-
pendent (you are treated as having coverage for any month
Your health care coverage provider may have asked for your
in which you have coverage for at least 1 day of the month),
social security number. To understand why, go to
IRS.gov/
Qualify for an exemption from the requirement to have
ACASSN.
health care coverage, or
Minimum essential coverage. Most health care coverage that
Make a shared responsibility payment with your tax return
people have is minimum essential coverage.
and enter the amount on this line.
Minimum essential coverage includes:
If you had qualifying health care coverage (called minimum
Most types of health care coverage provided by your em-
essential coverage) for every month of 2017 for yourself, your
ployer;
spouse (if filing jointly), and anyone you could claim as a de-
Many types of government-sponsored health care coverage
pendent, check the box on this line and leave the entry space
including Medicare, most Medicaid coverage, and most
blank.
health care coverage provided to veterans and active duty
service members;
You can check the box even if:
Health care coverage you buy through the Marketplace; and
A child you could claim as a dependent who was born or
Certain types of health care coverage you buy directly from
adopted during the year wasn’t covered by your insurance
an insurance company.
during the month of or months before birth or adoption (but
the child must have had minimum essential coverage every
See the instructions for Form 8965 for more information on
month of 2017 following the birth or adoption), or
what qualifies as minimum essential coverage.
A spouse or anyone you could claim as a dependent who
Reminder—Health care coverage. If you need health care
died during the year wasn’t covered by your insurance dur-
coverage, go to
to learn about health in-
ing the month of death and months after death (but he or
surance options for you and your family, how to buy health insur-
she must have had minimum essential coverage every
ance, and how you might qualify to get financial assistance to
month of 2017 before death).
buy health insurance.
If you can’t check the box on this line, you must generally ei-
Premium tax credit. If you, your spouse, or a dependent enrol-
ther claim a coverage exemption on Form 8965 or report a
led in health insurance through the Marketplace, you may be
-20-
Instructions for Form 1040EZ
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