Health Coverage and Taxes



Tax Scams Are Targeting Uninsured, I.R.S. Warns

The Internal Revenue Service is warning consumers about tax scams involving the Affordable Care Act and penalties imposed under the law on people who go without health insurance.  In some cases, the agency said, unscrupulous tax preparers tell clients to pay the penalties directly to them, and they keep the money.  Most people do not owe the payment at all because they have health coverage, such as Medicaid or employer-sponsored insurance, or qualify for one of many available exemptions.

For the complete New York Times Article click on the link/icon below


How Do You Report Suspected Tax Fraud Activity?

Link to IRS page

Complaint form 14157 Link



Remember: If you applied for Financial Assistance (also called Advanced Premium Tax Credit) through the Marketplace (, you MUST file a Tax Return (even if you have not in the past).

Health plans that qualify as Minimum Essential Coverage (MEC)

If you’re covered by any of the following types of plans, you’re considered covered under the health care law and don’t have to pay a penalty.

  • Any Marketplace plan, or any individual insurance plan you already have
  • ANY EMPLOYER PLAN (including COBRA plans, with or without “grandfathered” status)
  • Retiree health plans
  • Medicare
  • Medicaid
  • The Children’s Health Insurance Program (CHIP)
  • TRICARE (for current service members and military retirees, their families, and survivors)
  • Veterans health care programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spina Bifida Health Care Benefits Program)
  • Peace Corps Volunteer plans
  • Self-funded health coverage offered to students by universities for plan or policy years that begin on or before Dec. 31, 2014

Other plans may qualify. Ask your health coverage provider.

Health plans that don’t count as coverage

Some products that help pay for medical services don’t qualify as minimum essential coverage. If you have only this kind of product, you may have to pay the fee. Examples include:


Brochure: Free File: Do Your Federal Taxes for Free

IRS Site Topic: Indiviudal Shared Responsibility Provision – Reporting and Calculating the Payment

Health Care Law: What’s New for Individuals and Families, IRS Publication 5187 IRS Pub 5187

[IRS Forms]

NEW Forms when filing 2015 Taxes

Questions and Answers about Health Care Information Forms for Individuals (Forms 1095-A, 1095-B, and 1095-C)

“Starting early in 2016, you may receive one or more forms providing information about the health care coverage that you had or were offered during the previous year. Much like Form W-2 and Form 1099, which include information about the income you received, these new health care forms provide information that you may need when you file your individual income tax return. Also like Forms W-2 and 1099, these new forms will be provided to the IRS by the entity that provides the form to you.

The new forms are:

  • Form 1095-A, Health Insurance Marketplace Statement.  The Health Insurance Marketplace (Marketplace) sends this form to individuals who enrolled in coverage there, with information about the coverage, who was covered, and when.
  • Form 1095-B, Health Coverage.  Health insurance providers (for example, health insurance companies) send this form to individuals they cover, with information about who was covered and when.
  • Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.  Certain employers send this form to certain employees, with information about what coverage the employer offered. Employers that offer health coverage referred to as “self-insured coverage” send this form to individuals they cover, with information about who was covered and when.”

For the full article:

IRS Forms

The deadline for the Marketplace to provide Form 1095-A is February 1, 2016.  However, the deadline for insurers, other coverage providers, and certain employers to provide Forms 1095-B and 1095-C has been extended to March 31, 2016. Consumers expecting to receive a Form 1095-A should wait to file their 2015 income tax return until they receive that form, but it is not necessary to wait for Forms 1095-B or 1095-C in order to file.  CMS

[Health Insurance Marketplace Communication]


[Healthcare Marketplace Exemptions]


There are 2 types of Exemptions: (1) IRS – you will check the appropriate box on your tax form when you file your Federal taxes OR (2) Marketplace – you will complete a paper application and mail it to the Marketplace.

If your Marketplace Exemption Application is approved, you will get an Approval Notice in the mail.  It will include an Exemption Certificate Number (ECN) which you will enter on your Federal tax return.

If you are still waiting on an Exemption Application decision/response from the Marketplace when you file your Federal taxes, make sure to put “Pending” when it asks you for this information.

HIMExemption-Application-Instructions – Health Insurance Marketplace packet that includes Instructions for General Questions & Information found on Most of the Exemption Applications plus other specific Exemption Application Instructions.  Tennessee is a Federally Facilitated Marketplace so please disregard Pages 7 & 8.  Also, instructions on pages 4-6 are now outdated…see Affordability Exemptions below

HIMExemptionsByApplicationorIRS – Explains the Exemptions you can Apply for through the Health Insurance Marketplace, the Exemptions you must Claim when you File Taxes, and the Exemptions you can complete either way.

HIM2015Affordability-ffm-Exemption – This is for 2015 Coverage.  Affordability Exemptions for 2014 Coverage can be claimed when you file taxes.

HIMListofHardshipExemptions – List of Hardship Exemptions which include being homeless, experiencing a natural disaster, filing for bankruptcy, and others.

HIMHardship-Exemption – Use this form to Apply for a Hardship Exemption.

HIMHealth-Care-Sharing-Ministry-Exemption – Use this form to Apply for an Exemptiion based on your membership in a Health Care Sharing Ministry

From Alliance of Healthcare Sharing Ministries

A health care sharing ministry (HCSM) provides a health care cost sharing arrangement among persons of similar and sincerely held beliefs. HCSMs are operated by not-for-profit religious organizations acting as a clearinghouse for those who have medical expenses and those who desire to share the burden of those medical expenses.

  • HCSMs receive no funding or grants from government sources.
  • HCSMs are not insurance companies. HCSM do not assume any risk or guarantee the payment of any medical bill.

From the Patient Protection and Affordable Care Act

‘‘(B) HEALTH CARE SHARING MINISTRY.— HEALTH CARE SHARING MINISTRY. ‘‘(i) IN GENERAL.—Such term shall not include any individual for any month if such individual is a member of a health care sharing ministry for the month.—The term ‘health care sharing ministry’ means an organization—‘‘(I) which is described in section 501(c)(3) and is exempt from taxation under section 501(a),‘‘(II) members of which share a common set of ethical or religious beliefs and share medical expenses among members in accordance with those beliefs and without regard to the State in which a member resides or is employed, ‘‘(III) members of which retain membership even after they develop a medical condition, ‘‘(IV) which (or a predecessor of which) has been in existence at all times since December 31, 1999, and medical expenses of its members have been shared continuously and without interruption since at least December 31, 1999, and ‘‘(V) which conducts an annual audit which is performed by an independent certified public accounting firm in accordance with generally accepted accounting principles and which is made available to the public upon request.”

HIMAmericanIndianAlaskaNativeTribal-exemption – Use this form to Apply for an Exemption based on your membership in a Federally Recognized Tribe, your status as a Stakeholder in the Alaska Native Claims Settlement Act (ANCSA) Corporation, and/or if you are otherwise Eligible for Services through an Indian Health Care Provider

HIMIncarceration-Exemption – Use this form to Apply for an Exemption based on having served time in prison or jail during the healthcare coverage year.  If you are incarcerated, Marketplace enrollment is not an option for you.

You are NOT considered incarcerated IF you are on Probation, Parole, or Home Confinement/House Arrest.  You are NOT considered incarcerated IF you are being held waiting charges or conviction but are NOT currently convicted of crime.

For more information on applying for Medicaid in preparation for getting released OR applying for Marketplace coverage after your release (qualifies for a Special Enrollment Period) please visit

HIMReligious-Sect-Exemption – Use this form to Apply for an Exemption based on your membership in a recognized religious sect whose members object to health insurance.

From the Patient Protection and Affordable Care Act

‘‘(A) RELIGIOUS CONSCIENCE EXEMPTION.—Such term shall not include any individual for any month if such individual has in effect an exemption under section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.

From the IRS Publication 517

(2) As a follower of the established teachings of the sect or division, you must be conscientiously opposed to accepting benefits of any private or public insurance that makes payments for…medical care or provides services for medical care.  (3) You must waive all rights to receive…any payment or benefit and agree that no benefits or payments will be made to anyone else based on your wages and self-employment income. (4) The Commissioner of Social Security must determine that: Your sect or division has the established teachings as described in (2) above, b. It is the practice, and has been for a substantial period of time, for members of the sect or division to provide for their dependent members in a manner that is reasonable in view of the members’ general level of living, and c. The sect or division has existed at all times since December 31, 1950.

HIMLowIncShCovgGapNotLawPres – Information about Exemptions for Low Income, Short Coverage Gaps, and Not Being Lawfully Present

Once you have completed the Exemption Application (make sure you signed it), you will mail your Application (please make a copy for yourself to keep) and any documents or paperwork that the application said to include (again, make sure you have copies of any documents or paperwork you send) to the following address:

Health Insurance Marketplace – Exemption Processing
465 Industrial Blvd
London, KY 40741

Be sure to use the correct amount of postage which will depend on the weight of your envelope.  


You are not required to but may want to consider Extra Postal Services such as

(1) Certificate of Mailing 
PS Form 3817 – Proof that your envelope was mailed

(2) Certified Mail PS Form 3800 – Proof that your envelope was sent, when it was delivered, or when a delivery attempt was made

(3) Return Receipt PS Form 3811 – Proof of who signed to receive your envelope, the date the envelope was received, and the actual delivery address it was delivered to

For more information about extra postal services please visit

[Tax Assistance]

Free Tax Prep Help VITA Sites

East TN State University, (ETSU) VITA, 200 Ross Dr, Sam Wilson Hall, Rm 109, Johnson City 37614
Feb 7th – Apr 11th 2015, Sat 10 am – 3 pm, English, Appointment NOT Required

Community Information Center, 804 Watauga Ave, Elizabethton 37643
Jan 24th – Apr 11th 2015, Sat 9 am – 6 pm, English, Appointment NOT Required

People Incorporated, 701 Goode St, Bristol Public Library, Bristol 24201
Jan 31st – Apr 14th 2015, Tue 5 pm – 7:30 pm, Sat 10 am – 2 pm, English, Appointment NOT Required

Appalachian Community Action, 175 Military Ln, Gate City 24251
Jan 26th – Apr 15th 2015, English, Appointment REQUIRED
Call 276.386.6441

People Incorporated, 450 Commerce Dr, VISSTA Training Center, Abingdon 24210
Jan 31st – Apr 11th 2015, Sat 10 am – 2 pm, English & Spanish, Appointment NOT Required
Call 276.623.9000

For more sites within 100 miles of 37601 please click on

Or for all VITA (Volunteer Income Tax Assistance) click on


Free Tax Prep Help AARP

Click on


Free File [see video below]

[Visual Information]