Here’s the bad news first: the penalty has increased since 2014. The penalty for being uninsured in 2015 is $325 per adult and $162.50 per child (up to $975 for a family) or 2% of household income, whichever is greater. Yikes. You’ll sometimes hear this penalty called the “individual responsibility payment.” If you went without coverage for only part of 2015, you’ll only owe part of the fee.
There is good news, though! For some Americans who do not already have insurance through their employer, their parents, Medicaid, Medicare, the Veterans health care program, individual insurance, or healthcare.gov– you may be exempt.
The Affordable Care Act allows certain people to claim exemptions, even if they were uninsured in 2015. These people may be followers of particular religious groups, members of Native American tribes, and people who do not meet the minimum income requirement, leaving them unable to afford healthcare coverage.
For the most part, if you were uninsured in 2015, you’ll have to pay the penalty. But, here’s a list of specific cases where you may be able to get an exemption.
Exemptions include:
- You’re uninsured for less than 3 consecutive months of the year
- Your lowest-priced coverage option is more than 8% of your household income
- You don’t have to file a tax return because your income is under the IRS filing requirement ($10,000 if single, 20,000 married filing jointly)
- 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, and not awaiting the administering of charges against you
- You’re not lawfully present in the United States,
- You may qualify for the Cancellation Hardship Exemption if you received a cancellation notice due to your health plan not meeting minimum requirements.
- You also may qualify for a hardship exemption if your circumstances affected your ability to purchase health coverage
(List from Intuit.)
Still not sure if you qualify for an exemption? Give Mazuma a call, we can help.