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Individual Mandate And The Tax Penalty

  • admin
  • March 23, 2015 10:42 PM

Individual Mandate And Tax Penalty

Every person in the country can and must now have health insurance. Age, occupation and past health history do not matter. All people are to be covered, and all people are entitled to the same level of care.

The difference is the cost of the care. Those persons with higher income can afford higher-end policies with lower co-pays and deductibles.

Persons with lower income, who might qualify for federal subsidies, can purchase reduced priced insurance. However, the deductibles and co-payments will be higher.

The Affordable Care Act, or Obamacare as it is frequently called, provides a system for allowing people to purchase insurance. Individuals can still purchase policies from private companies, use their company group policies or buy a policy through either the federal exchange or in some cases a state exchange.

Acquiring health insurance is either an individual or family mandate. There are some exceptions, but primarily the individual mandate requires that most Americans obtain insurance or pay a tax penalty.

The individual mandate went into effect at the beginning of January 2014, and continues each year. Those people who do not participate or have any kind of health care coverage could face a health insurance tax penalty.

The assessment of the health insurance tax penalty would be a part of the federal income tax return and would either decrease the refund that may normally be received or increase the amount of taxes that may be owed to the Internal Revenue Service.

Under the Individual Mandate approach, any person that does not have health coverage or an exemption will pay the health insurance tax penalty for each full month when coverage is not in place. Therefore, the issue is not should a person have insurance.

Instead, the question is what level of insurance coverage are you going to retain.

Understanding What Minimum Coverage Means

It is necessary that individuals have minimum insurance coverage.

All four plans being offered by the federal government will meet the minimum coverage requirement. Other insurance options meeting this provision include:

• Employee-sponsored insurance, including COBRA Coverage and retiree coverage

• Medicare Part A coverage and Advantage plans

• Most Medicaid Coverage

• Children’s Health Insurance Program coverage

• Certain types of policies available through the Veterans Administration

• Coverage provided to Peace Corps volunteers

There are other programs that might qualify as minimum coverage. Thus, individuals should confirm with an insurance company to be certain that they comply with the mandates of the Affordable Care Act.

It is also important to know that certain specialized or short-term health plans do not meet the minimum coverage criteria. These policies include:

• Short Term Health Plans

• Fixed Benefit Health Plans

• Some Medicaid plans covering only certain benefits

• Vision or Dental only and limited benefits plans

The Affordable Care Act provides four levels of coverage, including, bronze, silver, gold and platinum. The four classes of insurance provide the same coverage, with the difference being the amount of deductibles and co-payments that have to be paid by the individual or family.

Coverage Differences

The out-of-pocket expenses are greater for the bronze level than the platinum level. However, the premium for the platinum plan is more expensive than the bronze level. Thus an individual or family has to examine their own health needs and budgets to determine which plan is best for them.

Furthermore, it is important to keep in mind that the size of the family and the total family income may allow for some federal assistance in the form of premium assistance or enrollment in the Medicaid program.

Steps to Follow

There are certain steps to follow that can make the process easier. First, online health insurance is available through the federal government and the various state exchanges.

There are many online health insurance websites outside of the federal and state exchanges. Check these sites closely if you do not want to use the federal exchanges. Make certain that all the individual mandate requirements are met when you are deciding on a policy.

Finally, before agreeing to purchase anything, make sure that you either have a policy that meets the minimum requirements, or you are enrolled in the federal program.

Secondly, be aware that you cannot just ignore the issue. If you do not have adequate coverage, you will face the Health Insurance Penalty.

Finally, it is important to remember that the Affordable Care Act allows people, who once could not purchase insurance for various reasons, to now get coverage. And that’s a good thing!

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