Federal Health Coverage Tax Credit
Extracted from PDF file 2021-federal-form-8885.pdf, last modified September 2021
Health Coverage Tax CreditForm 8885 Health Coverage Tax Credit Department of the Treasury Internal Revenue Service ▶ ▶ Go OMB No. 1545-0074 2021 Attach to Form 1040, 1040-SR, 1040-NR, 1040-SS, or 1040-PR. Attachment Sequence No. 134 Recipient’s social security number to www.irs.gov/Form8885 for instructions and the latest information. Name of recipient (if both spouses are recipients, complete a separate form for each spouse) Before you begin: See Definitions and Special Rules in the instructions. ! ▲ Do not complete this form if you can be claimed as a dependent on someone else’s 2021 tax return. CAUTION Part I 1 Election To Take the Health Coverage Tax Credit Check the box below for the first month in your tax year that you elect to take the Health Coverage Tax Credit (HCTC). All of the following statements must be true as of the first day of that month. You must also check the box for each month after your election month that all of the following statements were true as of the first day of that month. • You were an eligible trade adjustment assistance (TAA) recipient, alternative TAA (ATAA) recipient, reemployment TAA (RTAA) recipient, or Pension Benefit Guaranty Corporation (PBGC) payee; or you were a qualifying family member of an individual who fell under one of the categories listed above when he or she passed away or with whom you finalized a divorce. • You and/or your family member(s) were covered by HCTC-qualified health insurance coverage for which you paid the entire premiums, or your portion of the premiums, directly to your health plan or to “US Treasury-HCTC.” • You were not enrolled in Medicare Part A, B, or C, or you were enrolled in Medicare but your family member(s) qualified for the HCTC. • You were not enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). • You were not enrolled in the Federal Employees Health Benefits Program (FEHBP) or eligible to receive benefits under the U.S. military health system (TRICARE). • You were not imprisoned under federal, state, or local authority. • Your or your spouse’s employer (or former employer) did not pay 50% or more of the cost of coverage. • You did not receive a 100% COBRA premium reduction from your former employer or COBRA administrator. January July Part II 2 February August March September April October May November June December Health Coverage Tax Credit Enter the total amount paid directly to your health plan for HCTC-qualified health insurance coverage for the months checked on line 1. See instructions. Do not include on line 2 any insurance premiums paid to “US Treasury-HCTC” or any advance monthly payments made on your behalf as shown on Form 1099-H or any insurance premiums you paid for which you received a reimbursement of the HCTC during the year by filing Form 14095 . . . . . . . . . . . . . . . . . . . . . . ! ▲ 2 You must attach the required documents listed in the instructions for any amounts included on line 2. If you do not attach the required documents, your credit will be disallowed. CAUTION 3 Enter the total amount of any Archer MSA or health savings accounts distributions used to pay for HCTC-qualified health insurance coverage for the months checked on line 1 . . . . . . . . . . 4 Subtract line 3 from line 2. Enter the result, but not less than zero 5 Health Coverage Tax Credit. If you received the benefit of the advance monthly payment program for any month not checked on line 1 or received a reimbursement of the HCTC during the year by filing Form 14095 for any month not checked on line 1, see the instructions for line 5 for more details. Otherwise, multiply the amount on line 4 by 72.5% (0.725). Enter the result here and on Schedule 3 (Form 1040), line 13c; Form 1040-SS, line 10; or Form 1040-PR, line 10 . . . . . . . . . . For Paperwork Reduction Act Notice, see your tax return instructions. . . . . . . . . . Cat. No. 34641D . . . 3 4 5 Form 8885 (2021)
2021 Form 8885
More about the Federal Form 8885 Other TY 2021
We last updated the Health Coverage Tax Credit in January 2022, so this is the latest version of Form 8885, fully updated for tax year 2021. You can download or print current or past-year PDFs of Form 8885 directly from TaxFormFinder. You can print other Federal tax forms here.
Other Federal Other Forms:
|Form Code||Form Name|
|Form W-4V||Voluntary Withholding Request|
|Form 8962||Premium Tax Credit|
|Form 8840||Closer Connection Exception Statement for Aliens|
|Form 14039||Identity Theft Affidavit|
|Form 12509||IRS Statement of Disagreement|
The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 8885 from the Internal Revenue Service in January 2022.
Historical Past-Year Versions of Federal Form 8885
We have a total of ten past-year versions of Form 8885 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:
2011 Form 8885
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