Qualifying Health Coverage

 

Qualifying Health Coverage

Any health insurance that meets the Affordable Care Act requirement for coverage. If you have qualifying health coverage (or “minimum essential coverage” or “MEC”) you don’t have to pay the penalty for being uninsured through the 2018 plan year.

Examples: individual plans, including Marketplace plans; job-based plans; Medicare; and Medicaid & CHIP.

A more complete list of qualifying health coverage:

  • Job-based plans
  • Health Insurance Marketplace® plans
  • Most individual plans bought outside the Marketplace
  • Medicare
  • Medicaid
  • The Children’s Health Insurance Program (CHIP)
  • TRICARE
  • COBRA
  • Plans sold through the Small Business Health Insurance Program (SHOP) Marketplace

Fee for not having Health Insurance

For plan years through 2018, if you can afford health insurance but choose not to buy it, you may pay a fee called the individual Shared Responsibility Payment when you file your federal taxes. (The fee is sometimes called the “penalty,” “fine,” or “individual mandate.”)

Starting with the 2019 plan year (for which you’ll file taxes by July 15, 2020), the Shared Responsibility Payment no longer applies.

Note: Some states have their own individual health insurance mandate, requiring you to have qualifying health coverage or pay a fee with your state taxes for the 2019 plan year. If you live in a state that requires you to have health coverage and you don’t have coverage (or an exemption):

  • You’ll be charged a fee when you file your 2019 state taxes.
  • You won’t owe a fee on your federal tax return.

Check with your state or tax preparer to find out if there is a fee for not having health coverage.