Individual Shared Responsibility Provision - Minimum Essential Coverage
The individual shared responsibility provision requires you and each member of your family to have qualifying health care coverage, qualify for a coverage exemption, or make an individual shared responsibility payment when you file your federal income tax return. Qualifying health care coverage is also called minimum essential coverage.
For Tax Year 2016, the IRS will not consider a return complete and accurate if the taxpayer did not:
- check the ”Full-year coverage” box on Form 1040, 1040A or 1040EZ, or
- submit Form 8965, Health Coverage Exemptions, claiming a coverage exemption, or
- report a shared responsibility payment on the tax return.
Most taxpayers have qualifying health care coverage for all 12 months in the year, and will check the "Full-year coverage" box.
Minimum Essential Coverage Chart
| Coverage Type | Qualifies As Minimum Essential Coverage | Doesn't Qualify As Minimum Essential Coverage |
|---|---|---|
|
Employer-sponsored coverage:
|
|
|
|
Individual health coverage:
|
 |
|
|
Coverage under government-sponsored programs:
|
|
|
|
Other coverage:
|
|
|
|
Certain coverage that may provide limited benefits:
*Medicaid programs that provide limited benefits generally don’t qualify as minimum essential coverage. However, HHS will provide a hardship exemption to individuals with certain types of limited-benefit Medicaid coverage. |
|
Publication 974, Premium Tax Credit, provides additional information to help you determine if your health care coverage is minimum essential coverage. If you need information about minimum essential coverage for a prior year, see that year's version of Form 8965.
Additional Information
Almost all taxpayers must report health care coverage, claim a coverage exemption or report a shared responsibility payment. Returns that do not reflect at least one of these options will be rejected if filed electronically. If filed on paper, returns that do not reflect at least one of these options will take longer to process and any refunds will be delayed. Taxpayers should respond promptly to IRS correspondence about their health care coverage
If you and everyone on your tax return had health coverage for every month of the year, then you will simply check the box on Form 1040, Form 1040-A, or Form 1040-EZ. No further action is required.
You are considered to have minimum essential coverage for the entire month as long as you are enrolled in and entitled to receive benefits under a qualifying plan or program for at least one day during that month.
If you are otherwise not required to file a tax return, you do not need to file a return solely to report your coverage.
If you are not required to file a tax return and don’t want to file a return, you do not need to file a return solely to report your coverage. Publication 974, Premium Tax Credit, provides additional information to help you determine if your health care coverage is minimum essential coverage.
You do not need to attach documentation or proof of minimum essential coverage to your tax return. Although nothing in the IRS rules or regulations requires you to provide proof of coverage at the time you file, if you have documents that verify your minimum essential coverage, you should show them to your tax preparer. The IRS will follow its normal compliance approach to filed tax returns and may ask you to substantiate the information on your tax return. Therefore, you should keep these documents with your tax records. Learn more about the types of documents you should keep at our Gathering Your Health Coverage Documentation page.
If you do not have minimum essential coverage and wish to obtain it through the Health Insurance Marketplace, the Marketplace has an open enrollment period each year as well as special enrollment periods for eligible taxpayers. The 2017 open enrollment period began Nov. 1 and runs through January 31, 2017. You must enroll by Dec. 15 to have coverage begin on January 1, 2017. For information about enrollment periods, which health insurance options are available to you, how to purchase health insurance coverage, and how to apply for financial assistance with the cost of insurance, visit HealthCare.gov.
