If you can afford it, you will need minimum essential coverage
AAA
  1. 5 Things You Should Know About The New Health Insurance Marketplace
  2. All Marketplace plans must cover Essential Health Benefits
  3. If you can afford it, you will need minimum essential coverage
  4. Important Dates to Know
If you can afford it, you will need minimum essential coverage

If you can afford it, you will need minimum essential coverage

4. If you can afford it, you will need minimum essential coverage – or pay a fee

If you can afford health insurance and you don’t have coverage in 2014, you may have to pay a fee of 1% of your yearly income or $95 per person ($47.50 per child), whichever is higher. The fee increases to 2.5% of income or $695 per person in 2016. While the penalty seems relatively cheap, it is important to remember that without health insurance you will also be responsible for the entire cost of your medical care.

To avoid the fee, you need coverage that qualifies as minimum essential coverage. For 2014, you will be considered covered (and won’t have to pay a fee) if you have any of the following plans:

  • Any employer plan (including COBRA)
  • Any individual insurance plan that you already have
  • Any Marketplace plan
  • Medicaid
  • Medicare
  • Peace Corps Volunteer plans
  • The Children’s Health Insurance Program (CHIP)
  • TRICARE (active and retired military, families and survivors)
  • Veterans health care programs

If you don’t have coverage in 2014 you may not have to pay the fee if you:

  • Are a member of a federally recognized Indian tribe
  • Are insured for at least nine months of the year
  • Don’t have to file a tax return because of low income
  • Have a very low income and you cannot afford coverage (you must complete an application on the Marketplace to determine whether your income qualifies you for an exemption)
  • Participate in a health care sharing ministry
  • Would qualify for Medicaid (under the new income limits) but your state has chosen not to expand eligibility
  • Are a member of a recognized religious sect (such as the Amish and some Mennonite sects) that objects to health insurance

Tip: What determines if you can afford coverage? The IRS determines affordable coverage. Coverage is not considered affordable if it costs more than 9.5% of your pre-tax annual household income or if your income falls below income-tax thresholds.

Important Dates to Know

  1. 5 Things You Should Know About The New Health Insurance Marketplace
  2. All Marketplace plans must cover Essential Health Benefits
  3. If you can afford it, you will need minimum essential coverage
  4. Important Dates to Know
If you can afford it, you will need minimum essential coverage
RELATED TERMS
  1. Elder Law

    Elder law is a legal specialty focusing on the rights and needs ...
  2. Net Premiums Written

    The sum of premiums written by an insurance company over the ...
  3. Business Net Retention

    The amount of policies that remain after accounting for policies ...
  4. Case Management

    Planning, processing and monitoring the healthcare services given ...
  5. Policyholder Surplus

    The assets of a mutual insurance company minus its liabilities. ...
  6. Insurance Coverage Area

    The geographic region in which an insurance policy’s benefits ...
  1. What's the difference between renter's insurance and homeowner's insurance?

    Renters insurance and homeowners insurance offer similar benefits for occupants and homeowners, but in different ways and ...
  2. What's the difference between Social Security Disability Insurance (SSDI) and Supplemental ...

    Both Social Security Disability Insurance and Supplemental Security Income are administered by the Social Security Administration, ...
  3. On average, what can I expect my private mortgage insurance (PMI) rate to be?

    Learn the several factors that come into play when insurance companies determine the private mortgage insurance rate for ...
  4. Why do I need to pay private mortgage insurance (PMI)?

    The extra interest payments caused by private mortgage insurance may seem excessive, but there's a good reason lenders need ...
comments powered by Disqus
Related Tutorials
  1. No results found.
Trading Center