Understanding how health care coverage and tax obligations intersect can be confusing, especially when it comes to past filing requirements. If you were uninsured before 2019, you may have needed to file IRS Form 8965 to claim an exemption and avoid paying the Affordable Care Act (ACA) penalty for not having health insurance.
However, due to changes in tax law, this form is no longer applicable for tax years 2019 and beyond. That said, if you’re filing unfiled tax returns from 2018 or earlier, you may still need to submit Form 8965 to claim a health coverage exemption.
Key Takeaways
- IRS Form 8965 was used to claim a health care coverage exemption before 2019.
- The Tax Cuts and Jobs Act (TCJA) of 2017 eliminated the ACA penalty, making the form irrelevant for 2019 and later tax years.
- Certain groups-including low-income earners, those who couldn’t afford coverage, and members of federally recognized tribes-may still qualify for exemptions if filing for 2018 or earlier.
- Filing Form 8965 involves five key steps to properly submit it with your tax return.
- If you need help with unfiled back taxes, audits, or tax form filings, professional tax assistance can simplify the process.
While most taxpayers no longer need to file Form 8965, it remains relevant for those submitting back taxes for years when the ACA penalty was still in place. Understanding who qualifies for an exemption and whether this form is necessary for your situation is essential before filing.
Who Needs to File Form 8965?
IRS Form 8965 was originally required for taxpayers who did not have health insurance coverage and wanted to claim an exemption to avoid the ACA’s shared responsibility payment (SRP), also known as the health insurance penalty.
However, with the passage of the Tax Cuts and Jobs Act (TCJA) of 2017, this penalty was eliminated for tax years 2019 and beyond, meaning most taxpayers no longer need to file Form 8965.
But there’s an exception:
If you need to file back taxes for 2018 or earlier, and you did not have health insurance, you may still need to complete and submit Form 8965 to claim an exemption.
When Is Form 8965 Still Needed?
- You are filing a tax return for 2018 or earlier and need to claim an exemption for not having health coverage.
- You want to avoid the ACA penalty for a pre-2019 tax year by proving you qualified for an exemption.
- You meet specific exemption criteria, such as low income, unaffordable coverage, tribal membership, or financial hardship.
- You have outstanding tax debt related to previously unfiled returns.
If you’re unsure whether Form 8965 applies to your tax situation, consulting a tax professional can help determine your eligibility for an exemption.
Determining Factors for Exemptions on Filing Form 8965
IRS Tax Form 8965 exemptions are relief provisions that exist to reduce or eliminate an individual’s shared responsibility payments (SRPs). Individuals can claim an exemption if they meet certain criteria, such as having no minimum essential coverage during the tax year. Exemptions can also be claimed for certain life events, such as getting married or having a baby. Knowing about these exemptions is important in order to avoid SRPs and keep your taxes low.
There are many different exemptions taxpayers may be eligible to claim to opt out of health insurance coverage and not have to pay the IRS penalty. Here are some of the most common categories to be aware of:
Low Income Exemption
You don’t have to pay taxes if your income is below the threshold, and this is an exemption. The income limit for single filers in 2018 was $12,000.
Can’t Afford the Cost
The required contribution must be 8.05% or less of your household income to be considered unaffordable.
Living Abroad
You must have lived in another country or countries for at least 330 days during 12 consecutive months for this exemption.
Tribal Membership
Members of federally recognized American Indian tribes or those who could receive tribal health care services may claim an exemption.
Hardship Exemption
Some taxpayers may not have been able to get health plan coverage because of a hardship. This category includes those who were homeless, victims of domestic violence, evicted from their homes, faced excessive health care bills, or had other reasons keeping them from getting insurance.
Incarceration
Spending time in jail or prison during the applicable tax year would be an exemption.
Health Care Sharing Ministry or Religious Sects
Membership in a health care sharing ministry or religious sect as identified by the health insurance marketplace may exempt taxpayers.
A Household Member Died, Was Born, or Was Adopted
You may be able to claim an exemption in some circumstances if someone in your household died, was born, or was adopted the months before, including the month that the change took place.
These are common exemptions to report on Form 8965, though there are a few others. Make sure you discuss your situation with a tax professional if you believe you qualify for an exemption that will warrant submitting the form.
5-Step Instructions to Filing Form 8965
You may need to submit back taxes, which are unfiled tax returns for previous years. Form 8965 will still apply if you submit a return for 2018 or before and are trying to claim exemptions from health care coverage to avoid the penalty. Here are steps to take to do this properly:
1. Find the Right Form
The latest version of Form 8965 can be found on the IRS website.
2. Enter Your Basic Information
Enter your name and Social Security number at the top of Form 8965. This must be accurate to avoid IRS issues.
3. Determine Which Part You Should Complete
There are three parts to Form 8965. The first should be used if you are reporting insurance marketplace-granted exemptions, which you need to apply for in advance with the marketplace. Include the name of the individual you are reporting for, their Social Security number, and the exemption certificate number. Part II is used if your income is below the tax filing threshold. Part III should be completed if your exemptions don’t apply to the first two sections.
4. Enter the Right IRS Code
Part III exemptions require that you use the name and code of the appropriate exemption per the IRS’s designations, which can be found on the Instructions for Form 8965 in a chart.
5. Submit Form 8965 With Your Tax Return
Attach and send Form 8965 with your annual tax return. You only need to submit one form, even if you have more than one exemption to report, using a separate line for each.
Remember that Form 8965 can only be used for tax returns before 2019. You can file back taxes anytime, but you only have three years from the date the original return was due if you want to be able to claim a refund for that tax year. A tax professional can help you understand how to complete this form and determine if you qualify for exemptions.
How to Correct an Error on Form 8965
Mistakes happen, and if you filed Form 8965 incorrectly, you may need to amend your tax return to fix the issue. The IRS allows taxpayers to correct errors using Form 1040-X, Amended U.S. Individual Income Tax Return.
Steps to Correct an Error on Form 8965:
- Review Your Original Return – Check the specific error on Form 8965 and compare it with IRS instructions to identify what needs fixing.
- Complete IRS Form 1040-X – This form is used to amend previously filed tax returns. Indicate the corrections to Form 8965 in the appropriate section.
- Attach the Corrected Form 8965 – Include the revised Form 8965 with your amended tax return.
- Mail Your Amended Return – The IRS does not accept e-filed Form 1040-X, so you’ll need to mail your corrected return to the appropriate IRS processing center (listed in the form instructions).
- Keep Copies for Your Records – Maintain a copy of the corrected tax return and all supporting documents in case the IRS requests verification.
Important: If you mistakenly claimed an exemption you weren’t eligible for, or if your exemption was denied by the IRS, correcting the error as soon as possible can prevent penalties or further IRS inquiries.
Get Expert Tax Help Today
Whether or not you need to submit Form 8965 with back taxes will depend on your exemption eligibility and other factors. You can always consult with the team at Silver Tax Group with questions about this form, even though it is no longer being used for tax years 2019 and later. It may still apply to your tax situation before 2019.
The Silver Tax Group team delivers expertise in any tax-related area, including IRS audits, tax fraud, tax defense, emergency tax services, offers in compromise, overdue tax returns, tax debt, and general tax consulting. Reach out to our team to speak to a tax expert about Form 8965 or your unfiled tax returns.
Frequently Asked Questions About IRS Form 8965
What is IRS Form 8965, and who needs to file it?
IRS Form 8965 was used to claim a health coverage exemption and avoid the Affordable Care Act (ACA) penalty for not having health insurance. However, due to the Tax Cuts and Jobs Act (TCJA) of 2017, the penalty was eliminated starting in 2019, so Form 8965 is no longer required for tax years 2019 and beyond. If you are filing back taxes for 2018 or earlier, you may still need to complete this form to claim an exemption.
Do I need to file Form 8965 if I was uninsured in 2019 or later?
No, Form 8965 is no longer required for tax years 2019 and beyond. The ACA penalty for not having health insurance was eliminated by the Tax Cuts and Jobs Act of 2017, which means taxpayers filing 2019 or later returns do not need to report a health coverage exemption.
What are the common exemptions that qualify for Form 8965?
For tax years 2018 and earlier, taxpayers could claim an exemption from the ACA penalty if they met certain criteria, including:
- Low-income exemption (income below the IRS filing threshold)
- Unaffordable health coverage (insurance cost exceeding 8.05% of household income)
- Tribal membership (membership in a federally recognized American Indian tribe)
- Hardship exemptions (homelessness, eviction, excessive medical expenses, etc.)
- Living abroad (residing outside the U.S. for at least 330 days in a 12-month period)
How do I file Form 8965 for an old tax year?
If you are filing back taxes for 2018 or earlier and need to claim an exemption:
- Download IRS Form 8965 from the IRS website.
- Complete the form by entering your personal details and exemption information.
- Use the correct exemption code based on the IRS exemption chart.
- Attach Form 8965 to your tax return and submit it to the IRS.
If you need to correct an error on a previously filed return, you may need to file an amended tax return using Form 1040-X
What happens if I didn't file Form 8965 when I should have?
If you were required to file Form 8965 for a pre-2019 tax year and did not, you may have been incorrectly assessed the ACA penalty. You can correct this by filing an amended return with the proper exemption. If you have outstanding tax debt due to this error, addressing it quickly can help avoid additional IRS penalties and interest.