Tax and Penalty Information

Will I have to pay a penalty or fee if I didn't have health insurance? 

Yes (maybe). If you did not have health insurance in 2016 and do not qualify for an exemption, you will pay the higher of these two amounts:

  • 2.5% of your yearly household income
  • $695 person ($347.50 per child under 18)

In future years, the fee is adjusted for inflation.

Tax information 

You will be asked if you had health care coverage each year when filing your taxes.  If you did not have coverage, look at the information above to see how much you owe.  

If you received an APTC (Advance Premium Tax Credit) through the Marketplace to help pay for your health insurance, you will receive Form 1095-A to reconcile your payments with your tax credits and pay any difference.  

Check out the Health Care Law and You chart from the IRS for more information. 

Exemptions

This list of exemptions and an exemption calculator are available on healthcare.gov

Income-related exemptions

  • The lowest-priced coverage available to you, through either a Marketplace or job-based plan, would cost more than 8% of your household income
  • You don’t have to file a tax return because your income is below the level that requires you to file

Health coverage-related exemptions

  • You were uninsured for no more than 2 consecutive months of the year
  • You lived in a state that didn’t expand its Medicaid program but you would have qualified if it had
  • You were enrolled in a type of health coverage through Medicare or TRICARE that covers only certain limited services (e.g. emergency-only Medicaid)

Group membership exemptions

  • 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

Other exemptions

  • You’re incarcerated (serving a term in prison or jail)
  • You’re a U.S. citizen living abroad, a certain type of non-citizen, or not lawfully present. Learn more about the definition of “lawfully present.”
  • You experienced one of the hardships below

 

Hardship exemptions and forms

In addition to the exemptions above, you may qualify for a “hardship” exemption. Hardships are life situations that keep you from getting health insurance.

To claim a hardship exemption, you must fill out a paper application and mail it in to the Marketplace. For details and forms, follow the links below.

Hardships that qualify you for exemptions include: