Penalties for not having insurance

Health Care Reform says that if you do not have health insurance, you may have to pay a fee—or you may be exempt from the penalty

The fee for not having health coverage is calculated one of 2 ways. If you or your dependents don’t have insurance that qualifies as minimum essential coverage you’ll pay either a percentage of your household income or a flat fee — whichever is higher.

The fee in 2016

If you don’t have coverage in 2016, you’ll pay the higher of these two amounts:

  • 2.5% of your yearly household income.(Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
  •   $695 per adult for the year ($347.50 per child under 18). The maximum penalty per family using this method is $2,085. Most people must have health coverage or pay a fee (also known as “the penalty,” the    “individual shared responsibility payment,” or the “individual mandate”). Under some circumstances, you won’t have to make the payment. This is called an “exemption.

Exemptions from the payment

You may qualify for an exemption from the penalty for not being insured if:

  • You’re uninsured for less than 3 months of the year
  • The lowest-priced coverage available to you would cost more than 8% of your household income
  • You don’t have to file a tax return because your income is too low (Learn about the filing limit (PDF)
  • You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
  • You’re a member of a recognized health care sharing ministry
  • You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
  • You’re incarcerated (either detained or jailed), and not being held pending disposition of charges
  • You’re not lawfully present in the U.S.
  • You qualify for a hardship exemption

 “Obamacare” Plans (Bronze, Silver, Gold, Platinum, Catastrophic)

  • Open Enrollment Period: November 15 to February 15   During this time you can apply for a Qualified Health Plan or change your health plan. Sign up by December 15, and your new coverage will begin on January 1.
  • Special Enrollment Period: Here are some of the reasons you may qualify to change your plan outside of Open Enrollment
  • Losing Group Insurance
  • Marriage or Divorce
  • Having a baby or adopting a child
  • Moving to a new area

  Call to find out if you qualify for a tax credit to save money on your premium and possibly get a lower deductible and coinsurance.

Dixie Rogers Insurance Services     208-866-3674