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What is the Fee for Not Having Health Insurance Coverage?

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What is the fee for not having health insurance?Penalty for No Health 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 yearly household income (or $95 per adult, whichever is higher) in 2014, to 2% of income (or $325 per adult), 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 federal income tax form.

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.

Here are the penalties by year. As you can see a family choosing not to have health insurance in 2016 will have to pay a fine of $2,085.

 

FEE FOR NOT HAVING HEALTH INSURANCE 
  2014 2015 2016
Adult  $ 95.00 $ 325.00  $ 695.00
Child  $ 47.50 $ 162.50  $ 347.50

Max Family
Penalty

$ 285.00 $ 975.00 $ 2,085.00

 

Here is a link to HealthCare.gov where you can check out the fee you pay if you don’t have health coverage and if you can get an exemption from the fine or tax.

What are your thoughts? Can you pay more than 2 grand for not having health insurance next year? 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 www.CaptureBilling.com, a blog that is tops in the medical billing and coding field. READ MORE

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

  1. Tiffanie says:

    If my husband has coverage but me and my 2 children do not what will that look like for us? We are filing jointly but he is insured through his job.

    • Manny Oliverez says:

      Tiffanie, I am sorry to say that I believe you and your children will have to pay a penalty for not having health coverage. Your tax professional should be able to tell you exactly the amount of tax you will have to pay for not having health insurance.

      Here is some info directly from HealthCare.gov:

      “The fee for not having coverage in 2014

      If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts:

      1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

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

  2. vvvvvvvvvvv says:

    Don’t reproduce, how’s that?

  3. Atwas911 says:

    Another example of criminals within out government straight up robbing the poor and giving to their rich buddies.. Why not tax the business that are filtering their money all over the world so they don’t have to pay taxes.. or pay a livable wage.. or produce goods that are toxic and dangerous just so they can pay slave wages.. The American people are under direct attack from these criminal.. All of our Politicans and bought and paid for, our courts are just as crooked and back scratching.. America is in a grave state.

  4. Lorena says:

    I cannot believe my tax assessor charged me $400.00 and my spouse $400.00 this year for not having health insurance . Its crrrrrrraaaazzzy!

  5. Scott says:

    I’m sorry but if you don’t use it you shouldn’t get taxed for it. It should not have been made in to a law. It is just a new way for greed. One should not have to pay for something they don’t want. If they don’t use it why pay for it. It’s not cheap.

  6. 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.

  7. 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.

  8. 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!

  9. 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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