Am I required to have health insurance?

Starting January 1, 2014, the federal government is requiring most Americans to have health insurance, or pay a penalty at the end of the year through the filing of an individual’s federal tax return. This means all individuals must have health insurance coverage which meets the “minimum essential coverage” standard. This requirement is what is commonly referred to as the “individual mandate.” The Internal Revenue Service (IRS) is responsible for enforcing this requirement. For individuals who fail to have insurance in 2016, the penalty will be the greater of $695 or 2.5% of your income. Certain exemptions from this general rule may apply. For more information about whether you might qualify for an exemption, please contact the customer service center, or your tax professional. Amongst other qualifying exemptions, listed below are examples of certain “hardship exemptions” for which you might qualify:

  • You were homeless.
  • You were evicted in the past 6 months or were facing eviction or foreclosure.
  • You received a shut-off notice from a utility company.
  • You recently experienced domestic violence.
  • You recently experienced the death of a close family member.
  • You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
  • You filed for bankruptcy in the last 6 months.
  • You had medical expenses you couldn’t pay in the last 24 months, that resulted in substantial debt.
  • You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
  • You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child.
  • As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
  • You were determined ineligible for Medicaid because your state didn?t expand eligibility for Medicaid under the Affordable Care Act.
  • Your individual market coverage was cancelled, and you consider the other plans are unaffordable.

Related FAQs:
What is Connect for Health Colorado?
What is Minimum Essential Coverage?
How do I apply for an exemption from having Health Insurance?