Based on the Affordable Care Act (ACA), all Americans are required to have health insurance. If there is a period of time where an individual does not have health insurance, they will have to pay a penalty. All of this will occur during tax season. While things may change in the future under a different presidential administration, but unless something changes, you must abide by the laws under the ACA. Learn more about top basic ACA health insurance guidelines, a go-to look at paying a penalty and exemptions.

Basic ACA Health Insurance Guidelines

According to federal law, all Americans are required to have health insurance. By abiding by this law, you as a citizen can take advantage of free preventative care, insurance companies not denying you for pre-existing conditions and more. Insurance can be through your employer or separately, such as the Health Insurance Marketplace. If you have insurance, you will receive one of three forms: 1095-A, 1095-B or 1095C. The 1095-A will come from the Healthcare Insurance Marketplace, 1095-B is sent from those who have insurance not under their employer and the 1095-C is for those with insurance through their employer.

Premium Tax Credit

For some Americans, there is the Premium Tax Credit available to assist with paying premiums. In order to qualify, in the IRS’ The Premium Tax Credit, it says income must fall between 100 and 400 percent of the federal poverty line based on the size of your family. Next, unless there are certain extenuating circumstances, you cannot receive the credit if you file “Married Filing Separately.” They add that dependents cannot receive the tax credit, you must be covered through the Health Insurance Marketplace, are not eligible for other government programs and pay your premiums.

Paying a Penalty

Those who do not have health insurance have to pay a fine. You will be charged for the months that you and/or members of your family were not insured. You will have to pay your fine when you file your tax returns. According to HealthCare.gov’s The Fee for Not Having Health Insurance, you will pay the higher of the following two: 2.5 percent of household income (with a maximum  of total yearly premium for Bronze plan from the Marketplace) or $695 per adult and $347.50 for children under 18 (up to $2,085).

Exemptions

There are exemptions to paying the mandatory fine for not having health insurance. They include having insurance offered through an employer that is higher than you can afford, you are not a legal citizen or are in prison, or if you are in a healthcare sharing ministry. In addition, those who are impacted by a natural disaster, are homeless or other reasons are also exempt. You can speak with your local premier tax specialist to see if you are exempt from paying the fine.

Understanding healthcare and tax laws can be difficult—but Bloch, Rothman and Associates can help. Our quality one-on-one service will help you prepare for your next return and answer all questions you have about health insurance mandates and more. Learn about our personal tax preparation to see how we can best help you!