What Is The Time Frame To Enroll
The open enrollment period for Obamacare plans is the time of the year when most people can sign up for a marketplace health insurance plan. These dates change every year, but tend to fall in the autumn for coverage starting in January. If you miss the open enrollment period you’ll have to wait another year to sign up, unless you qualify for a special enrollment period through a life event like losing a job, having a child, or getting married.
Most people can enroll at Healthcare.gov. But residents of 18 states will need to sign up through their state’s website. If you miss the deadline to enroll, you may face state fines if your state imposes them, so be sure to stay on top of your enrollment.
If you truly cannot afford health coverage, you may want to see if you qualify for Medicaid. You can apply for Medicaid at any time of year.
You can also enroll in independent health insurance throughout the year. An insurance agent can help you choose the best plan for you.
Is There A Penalty For Not Having Health Insurance
Too often, people learn that the personal penalty for not having health insurance is the exorbitant healthcare bills. If you fall and break your leg, hospital and doctor bills can quickly reach $7,500for more complicated breaks that require surgery, you could owe tens of thousands of dollars. A three-day stay in the hospital might cost $30,000. More serious illnesses, such as cancer, can cost hundreds of thousands of dollars. Without health insurance, you are financially responsible for these bills. Two-thirds of people who file for bankruptcy indicate that medical bills contributed to their financial situation, according to a 2019 study.
The Affordable Care Act increased the number of people with insurance and lowered those who couldnt afford to pay their health bills. While the federal health insurance coverage mandate and shared responsibility payment was in effect, from 2014 through 2018, the number of people in the United States who got health insurance increased by around 20 million.
Since 2019, there is no federal penalty for not having health insurance, says Brad Cummins, the founder and CEO of Insurance Geek. However, certain states and jurisdictions have enacted their health insurance mandates. The states with mandates and penalties in effect are:
- Preventive and wellness services
- Pediatric services
Reasons To Get Health Insurance
While you may not want to spend the money on health insurance, there are important reasons that it should be a high priority. Dealing with an unexpected medical emergency like appendicitis or a broken leg from an accident can be very expensive. According to HealthCare.gov, casting a broken leg can cost $7,500. If you need to stay in the hospital for three days, expect a bill for around $30,000.
Medical debt can bankrupt you. If you are in a car wreck and break both legs, you’ll be in the hospital for a few days. A bill of $15,000 for the broken legs and $30,000 for the three-day stay could suddenly put you in $45,000 of debt. Many hospitals will work with you to set up a payment plan, but the minimum payments may still be more than you can afford and it may take you decades to pay off the debt.
Health insurance makes it easier to get preventive care, too, so that you do not need more expensive procedures later. Taking care of small things like ear or sinus infections can prevent you from developing more serious complications.
Many plans help cover the cost of annual physicals. Annual physicals can identify unknown medical problems, possibly preventing you from collecting unexpected medical bills.
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Was Health Insurance Mandatory For The Entire Year
For all years after the ACA went into effect until Jan. 1, 2019, health insurance was mandatory for the entire year. Youll only pay a penalty, though, for any months of the year before 2019 that you were uninsured. So, if you did have coverage for some of the year, the penalty fee will only apply to the non-covered months. Technically, you dont have to have health insurance all 365 days a year to avoid the tax penalty. If you have coverage for even just one day of a month, the IRS considers this as having minimum essential coverage for the entire month.
In addition, you could also qualify for a short coverage gap exemption. You will qualify for this exemption if your lack of health insurance coverage was for a period of less than three months. However, this coverage only applies to the first gap each year, so if you lack health insurance more than once during a calendar year, the exemption will only cover the first gap. For example, if you do not have insurance in May and then again in September, you will only be exempt for May and have to pay the penalty for your second gap.
How To Apply For An Exemption For 2018 And Earlier
Depending on the type of exemption you qualify for, you will need to submit an application to Healthcare.gov or request the exemption from the Internal Revenue Service when you file your taxes. .
- Federal Health Insurance Marketplace : Go to HealthCare.gov to determine which exemption to request. Print out, complete and mail the federal Application for Exemption. The completed form and any supporting documents should be mailed to:Health Insurance Marketplace – Exemption Processing465 Industrial Blvd.London, KY 40741
- IRS: Information for claiming an exemption through the IRS when you file your taxes can be found at www.irs.gov.
MNsure uses the federal Health Insurance Marketplace to process exemption applications. The federal government will notify you if you qualify for an exemption. If you apply to HealthCare.gov and qualify, you will receive an exemption certificate number that you’ll need for your federal income tax return you file for the year of the exemption. For questions about the status of your application or your eligibility for an exemption, visit HealthCare.gov, or call the Health Insurance Marketplace Help Center at 800-318-2596. TTY users should call 855-889-4325. If you have questions about how to get a copy of and where to submit the application form, call the MNsure Contact Center at 855-366-7873 or 651-539-2099.
What Are My Options For Complying With Obamacare
You have 3 options and two of them involve a penalty:
- Get no insurance and pay a penalty for no health insurance at tax time.
- Get cheap insurance and pay a penalty at tax time.
- Enroll in a qualified health plan. This option does not have to be through Covered California to avoid the penalty, but it does have to be a Covered California plan in order to qualify for a government subsidy.
- Enroll in a Health Care Sharing Plan, which is exempt from the penalty and my offer lower premiums than traditional health insurance.
Can I Go The Hospital If I Do Not Have Health Insurance
Hospitals in the United States of America are required to provide service to anyone in the case of an emergency so you can go to any hospital. However, you may be responsible for covering the entire cost of this visit which can be expensive.
It is important to not put off an emergency visit due to the expense because you are putting your health at risk.
If you meet the income requirements, some hospitals might enroll you in Medicaid when you are there for your medical visit. Medicaid will then help cover the costs of the services at the hospital.
Medicaid will also pay for treatment of a serious medical emergency for those who meet Medicaid requirements but do not have the required immigration status to enroll in Medicaid.
States that did not expand their Medicaid program under the Affordable Care Act may have different requirements for enrollment than states that did. This information could be subject to change if the Affordable Care Act is repealed.
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What Type Of Plan Is Best For Basic Protections
As of 2021, individuals are only eligible for HSAs if they have a $1,400 deductible, but can save up to $3,600 a year for health care services if they choose to enroll in an HDHP. Families are eligible for an HSA if they have a $2,800 deductible and can save up to $7,200 a year.
There are many advantages to an HDHP with an HSA which include:
- Low monthly premiums.
- Financial protections that limit your health care spend exposure.
- Funds in HSAs collect interest.
- HSA funds roll over year to year.
- Funds are saved for future medical costs and retirement health costs.
- HSA contributions are tax-deductible.
Aca Goal: Insure Most Americans And Keep Them Insured
The overarching goal of the Affordable Care Act was to extend health insurance coverage to as many Americans as possible. In that regard, it’s had significant success. From 2010 through 2016, the number of people with health insurance in the U.S. increased by roughly 20 million. And although the uninsured rate has been increasing since 2017, it has been below 10% since 2015.
But while access to health insurance is important, it’s also important that people maintain their coverage going forward. Keeping as many people as possible in the risk poolespecially when they’re healthy and not in need of immediate carekeeps premiums affordable. And while health insurance coverage is certainly not cheap, it would be far more expensive if people could just wait to purchase coverage until they were in need of medical care.
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Rhode Island Individual Mandate
- Effective date: January 1, 2020
- Requires individuals and their dependents have ACA-compliant health insurance
- Imposes a penalty on residents who go without health insurance but can afford it
- Provides state subsidies to help lower income residents afford health insurance
The penalty for failure to have ACA-compliant health insurance is the same as it would have been under the federal individual mandate. It will cost a family $695 for each uninsured adult and $347.50 for each uninsured child or 2.5% of the household income, whichever amount is greater. Penalties also increase annually with inflation. However, the maximum a household can be penalized cant be greater than the total annual premium for an average bronze plan in Rhode Island.
Rhode Island allows for exemptions in certain situations. And, as of December 31, 2020, Rhode Island expanded its eligibility criteria to include a COVID hardship exemption. This new exemption recognized the impact that the pandemic may have had on residents ability to afford and get health insurance. If you live in Rhode Island, you may be eligible to file a hardship exemption if, as a result of the COVID pandemic:
- You lost minimum essential coverage in 2020, or
- You experienced a hardship that made you unable to get minimum essential coverage in 2020.
How The Penalty Worked
Your individual mandate tax is the greater of either 1) a flat-dollar amount based on the number of uninsured people in your household or 2) a percentage of your income .
This means wealthier households will wind up using the second formula, and may be impacted by the upper cap on the penalty. For example: for 2017, an individual earning less than $37,000 would pay just $695 while an individual earning $200,000 would pay a penalty equal to the national average cost of a bronze plan . This is because 2.5% of his income above the tax filing threshold would work out to about $4,740, which is higher than the national average cost of a bronze plan. The IRS publishes the national average cost of a bronze plan in August each year that amount is used to calculate penalty amounts when returns are filed the following year.
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Who Does The Individual Mandate Apply To And Who Is Exempt
Almost all U.S. citizens who did not have health insurance between 2010 and 2018 may still owe a penalty fee next year or in the future based on the individual mandate. This fee comes in the form of an extra tax you must pay for the time you didnt have coverage. People who qualify for a health coverage exemption for past years includes anyone who:
- Was incarcerated.
- Had an income that was so low that filing a tax return was not a requirement.
- Were members of a Native American tribe.
- Had a religion that objects to having health insurance.
- Belonged to a healthcare sharing ministry.
- Was in the U.S. illegally.
- Qualified for a hardship exemption.
- Paid more than a certain percentage of their income to their health insurance. The IRS set the exact percentage each year.
You can also visit HealthCare.gov to learn more about exemptions from the individual mandate and how to apply for an exemption if you qualify.
Starting in 2019, though, you do not have to pay any kind of penalty fee or tax if you do not have coverage, regardless of whether or not you qualify for an individual mandate exemption. However, there are a few states that still enforce the individual mandate which well talk about below.
Why Do I Need Insurance If Theres No Penalty
The cost of self-pay and out-of-pocket expenses for healthcare are highyear after year, the cost of routine care increases. Things like Emergency Room visits and hospital admissions stand to put a heavy financial burden on families without substantial savings for crises.
With over half of American bankruptcy filings being associated with medical debt, having health insurance can provide many financial protections. Without insurance, unforeseen health problems can expose you to crippling costs.
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How To Avoid Paying A Penalty For No Health Insurance
The easiest way to avoid paying a penalty for not having health insurance is to enroll in an accepted and credible health plan for your state. The Affordable Care Act, sometimes called Obamacare, specifies anopen enrollment period when people can enroll in plans offered through the federal or state health insurance marketplaces. An open enrollment period is a set time when people can sign up for or change their plans. When you sign up for health insurance during the open enrollment, the insurer must provide you insurance. If you do not sign up during this time, you cannot sign up until the next open enrollment unless you experience certain life events.
In 2021, due to COVID, there was a Special Enrollment Period between Feb. 15 and Jun. 30, according to Cummins. During this time, over 1.5 million Americans signed up for new insurance coverage through healthcare.gov. For 2022, open enrollment begins on Nov. 1, 2021, and ends on Dec. 15, 2021.
Besides plans on the Marketplace, you can during three main periods in the yearthough, in some states, like New York, you can enroll in a supplemental plan year-round:
- Initial enrollment period
- Open enrollment period
- Special enrollment period
Option #3 Shop Around
Perhaps you dont have insurance solely because you think it is too expensive. Maybe it is just a state of mind. There are many quality, affordable plans available today. Shopping around is a great way to compare different companies. Premium rates will vary based on age, health history, medical conditions, and life style choices. Seeing different options side by side can help you see what choices are available.
You can use the comparison tool on this page right now. The tool will show you rates and quotes from top companies so you can compare. If you have additional questions after you use the comparison tool, you can contact one of our independent agents who can help you. By shopping around you can rest assured that you found the right coverage for the right price.
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No More Tax Penalties
In 2018, the ACA tax penalty was $695 for adults and $347.50 for children, or 2% of one’s annual income, whichever amount was more. However, on December 22, 2017, when President Trump signed the Tax Cuts and Jobs Act, it repealed the ACA-related tax on Americans who refuse to purchase health insurance.
As of 2019, Americans without health insurance are not taxed by the government. However, individuals and families who choose to go without health insurance do so at their own risk.
If My Plan Is Not Aca
All ACA-compliant plans in the individual and small group markets are required to cover the ACAs essential health benefits without any caps on the total amount that the plan spends on your care. So theyll provide a solid safety net if you end up needing significant medical care . And all ACA-compliant plans are required to cover pre-existing conditions without any waiting periods.
But if you buy a plan thats not ACA-compliant, the insurer will be likely to use medical underwriting to adjust the premiums or the coverage based on your medical history, and the plan wont have to cover the essential health benefits unless the state has its own requirements .
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