Health Insurance Federal Tax Penalty Facts

If you can afford health insurance but choose not to buy it, you must have a health coverage exemption or pay a federal tax penalty.

The federal tax penalty for not having health insurance in 2015

If you do not have health insurance in 2015, you’ll pay the higher of these two amounts:

  • 2% of your yearly household income
  • $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975

The federal tax penalty for not having health insurance in 2014

If you did not have health insurance in 2014, you’ll pay the higher of these two amounts:

  • 1% of your yearly household income

  • $95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285

     
 

Did you have to pay the federal tax penalty with your 2014 taxes? You still may be able to get 2015 coverage if you:

  • Are not currently enrolled in coverage through the Health Insurance Marketplace for 2015

  • Paid the federal tax penalty with your 2014 federal income tax return for not having health insurance in 2014

  • Became aware of, or understood that the implications of, the federal ACA tax penalty for not having health insurance until after the end of Open Enrollment (February 15, 2015) in connection with preparing 2014 taxes

This Special Enrollment Period will start on March 15 and run through April 30, 2015. To learn if you qualify or have questions call us at 855-639-5788.

 

The federal tax penalty after 2015

The federal tax penalty increases every year. In 2016, it increases to 2.5% of income ($695 per person or $2,085 maximum per family).

HEALTH INSURANCE TERMS


COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy


in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.