The Affordable Care Act and You
The individual shared responsibility provision of the Affordable Care Act (ACA) requires you, your spouse, and your dependents to have qualifying health insurance for the entire year, report a health coverage exemption, or make a payment when you file your tax return.
Many people already have minimum essential coverage and do not need to do anything more than maintain that coverage and report their coverage when they file their tax returns.
This chart explains how the Affordable Care Act affects you:
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IF YOU… |
THEN YOU… |
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Are a U.S. citizen or are a non-U.S. citizen living in the United States |
Must have qualifying health care coverage, qualify for a health coverage exemption, or make a payment when you file your tax return |
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Have health coverage through an employer or under a government program such as Medicare, Medicaid and coverage for veterans for the entire year |
Just have to check a box on your Form 1040 series return and do not have to read any further |
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Do not have coverage for any month of the year |
Should check the instructions to Form 8965, Health Coverage Exemptions, to see if you are eligible for an exemption |
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Are eligible for an exemption from coverage for a month |
Are not responsible for making an individual shared responsibility payment for that month and must claim the exemption or report an exemption already obtained from the Marketplace by completing Form 8965 and submitting it with your tax return |
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Do not have coverage and are not eligible for an exemption from coverage for any month of the year |
Are responsible for making an individual shared responsibility payment when you file your return |
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Are responsible for making an individual shared responsibility payment |
Will report it on your tax return and make the payment with your taxes |
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Received the benefit of more in advance payments of the premium tax credit than the amount of credit for which you qualify |
Will repay the amount in excess of the credit you are allowed subject to a repayment cap |
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IF YOU… |
THEN YOU… |
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Need qualifying health care coverage for the current year |
Visit Healthcare.gov to find out about the dates of open and special enrollment periods for purchasing qualified health coverage. |
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Enroll in health insurance through the Marketplace for yourself or someone else on your tax return |
Might be eligible for the premium tax credit |
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Did not enroll in health insurance from the Marketplace for yourself or anyone else on your tax return |
Cannot claim the premium tax credit |
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Or another person on your tax return who is enrolled in coverage through the Marketplace is not eligible for health care coverage through your employer or under a government program |
Might be eligible for the premium tax credit |
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Are eligible for the premium tax credit |
Can choose to get premium assistance now to lower your monthly payments or get all the benefit of the credit when you claim it on your tax return |
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Choose to get premium assistance now |
Will have payments sent on your behalf to your insurance provider. These payments are called advance payments of the premium tax credit |
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Get the benefit of advance payments of the premium tax credit and experience a significant life change, such as a change in income or marital status |
Report these changes in circumstances to the Marketplace when they happen |
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Get the benefit of advance payments of the premium tax credit |
Will report the payments on your tax return and reconcile the amount of the payments with the amount of credit for which you are eligible |
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