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What is the Fee for Not Having Health Insurance Coverage?

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Penalty for No Health Insurance in Starts in 2014

What is the fee for not having Healthcare Insurance?A lot of the medical practices we service are asking us questions about the Affordable Care Act (Obamacare) and how it may affect their patients. 

One of the questions we hear asked is if there is a fee, penalty or tax for not having health insurance  as some of the young adults don’t want health insurance and just pay cash if they do need to see a doctor.

According to the government:

Starting January 1, 2014, if someone doesn’t have a health plan that qualifies as minimum essential coverage, he or she may have to pay a fee that increases every year: from 1% of income (or $95 per adult, whichever is higher) in 2014 to 2.5% of income (or $695 per adult) in 2016. The fee for children is half the adult amount. The fee is paid on the 2014 federal income tax form, which is completed in 2015. 

So yes, call it what you want, a fee, a penalty or a tax but if you do not purchase health insurance coverage you will have to pay a fine.

  2014 2016
Adult  $ 95.00  $ 695.00
Child  $ 47.50  $ 347.50

What are your thoughts? Leave me a comment below.

is a 20 year veteran of healthcare having managed medical practices. He advises medical practices, physicians and practice administrators on how to run their practice and manage their medical billing and revenue cycle management. Manny speaks, blogs and makes videos at, a blog that is tops in the medical billing and coding field. READ MORE

7 Responses to “What is the Fee for Not Having Health Insurance Coverage?”

  1. Silvia Lut says:

    I can not believe there is a fee, if you are not health insured. I changed my plan, and do not feel that the new plan is that affordable at all. So how a person with low income is supposed to pay any insurance is very questionable. To put a fee on people who still can not pay an insurance seems more then ridiculous…
    Silvia L.

  2. Mike Riley says:

    If the fee is paid on the Tax forms, you still haven’t answered the question: Is it a yearly fee or a monthly fee that is accrued throughout the year? For B. Brandt, this is not the place for partisan politics.

  3. Anonymous says:

    For me, still much less than paying the monthly premium ($395) and carry a major medical policy.

    • B.Brandt says:

      The premiums that are more affordable still come with a $5,000 deductible, so bottom line still not receiving medical care even with health insurance, since the prices for services before deductible are met are too high, and an individual would have to see a doctor every week for six months or longer in order to reach deductible. This means that these policies are affordable for those who don’t need them, like Mr. Obama, these premiums are much higher than BEFORE this “affordable act”. Seems to me this is just Obama’s way of bringing the USA out of debt by having the IRS collect fees . This is not helping ensure that US citizens receive quality care or any care. What a façade!

  4. Kay says:

    Is this fee paid monthly or yearly?

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The analysis of any medical billing or coding question is dependent on numerous specific facts -- including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies (as well as coding itself) are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly.

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