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Health Insurance Coverage IRS Form 8941

Health Insurance Coverage as Defined in the Instructions of IRS Form 8941

For credit purposes, health insurance coverage means benefits consisting of medical care (provided directly, through insurance or reimbursement, or otherwise) under any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization contract offered by a health insurance provider. A health insurance provider is either an insurance company or another entity licensed under state law to provide health insurance coverage. Health insurance coverage also includes coverage under the following plans.

  • Limited scope dental or vision plans.
  • Long-term care plans.
  • Nursing home care plans.
  • Home health care plans.
  • Community-based care plans.
  • Any combination of the above.

In addition, health insurance coverage includes the following.

  • Coverage only for a specified disease or illness.
  • Hospital indemnity or other fixed indemnity insurance.
  • Medicare supplemental health insurance.
  • Certain other supplemental coverage.
  • Similar supplemental coverage provided to coverage under a group health plan.

Caution: Employer premiums paid for health insurance coverage can be counted in figuring the credit only if the premiums are paid under a qualifying arrangement.

Health insurance coverage does not include the following benefits:

  • Coverage only for accident, or disability income insurance, or any combination thereof.
  • Coverage issued as a supplement to liability insurance.
  • Liability insurance, including general liability insurance and automobile liability insurance.
  • Workers’ compensation or similar insurance.
  • Automobile medical payment insurance.
  • Credit-only insurance.
  • Coverage for on-site medical clinics.
  • Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.

Also, because the coverage must be offered by a health insurance provider as discussed above, health insurance coverage does not include benefits provided by the following.

  • Health reimbursement arrangements (HRAs).
  • Flexible spending arrangements (health FSAs).
  • Coverage under other self-insured plans.
  • Health savings accounts (HSAs).

However, health insurance coverage may include coverage under the following plans.

  • Church welfare benefit plans.
  • Multiemployer health and welfare plans that provide coverage through a health insurance provider.