The Health Care Collaborative (HCC) of Rural Missouri is working on behalf of Lafayette County residents to help individuals and families meet federal law (Affordable Care Act or ACA) for health insurance. This means most people are required to get insured or potentially pay a penalty. The deadline to apply for insurance through Missouri’s federal exchange, the Health Insurance Marketplace, is January 31, 2016.
If you had insurance in 2015 through a private insurer, the Health Insurance Marketplace, Medicaid or Medicare, you will need to indicate that when you file your 2015 tax return. If you could afford insurance but opted not to purchase a plan – on or off the exchange – you may be required to pay a fee. You pay the fee when you file your Federal tax return.
Some individuals and families will qualify for an insurance waiver that exempts them from paying the penalty fee. Exemptions include, but are not limited to, certain “hardships” like homelessness, eviction or facing foreclosure on your home, you filed for bankruptcy, you received a shut-off notice from a utility company, you were a victim of domestic violence, you experienced a fire, flood or natural disaster, you had medical expenses that resulted in substantial financial debt, unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member, among other hardships.
Income hardships include, but are not limited to, not filing a tax return because your income is below the level that requires you to file, or the lowest-priced coverage available to you – through either a Marketplace or job-based plan – would cost more than 8.05 percent of your household income.
There are also health coverage-related exemptions if you were uninsured for no more than two consecutive months of the year, or if you live in a state (like Missouri) that didn’t expand Medicaid but you would have qualified if it did. Other exemptions include incarceration, or not having legal U.S. status, among a number of other exemptions.
HCC will walk you through this process to help you enroll in the Marketplace, Medicaid, Medicare or apply for a waiver – whichever fits your circumstance.
As for the penalty costs for 2015, the fee is calculated in two different ways – as a percentage of your household income, (this year the percentage is 2 percent), or per every uninsured person in the household. This equates to $325 per adult, and $162.50 per child. You will pay whichever is higher (i.e. the percentage of household income or the total fee assessed per person). The maximum fee the federal government will collect for a household in the 2015 tax season is $975.
If you received health insurance through the Marketplace, you may have received a tax document in the mail, called Form 1095-A. If you haven’t, be on the lookout for it. This form is necessary in order to complete your Federal income tax return. Centers for Medicare & Medicaid Services (CMS) suggest that you wait to file your income tax return until you receive this document in the mail, which is slated to arrive by early February.
If you received a subsidy or tax credit through the Marketplace to help lower the cost of your monthly premium, you are required to file a tax return. This will reconcile the difference between the amount of financial assistance you received to reduce your monthly health insurance premium with the actual amount of the discount that you should have received based on your 2015 earnings. You will either be required to pay the difference or receive a refund. Those who don’t file a tax return and reconcile the tax credit received will not be eligible for reduced premium costs in the future.
The HCC will help you navigate these new guidelines. For assistance, call Iva Eggert at 1.877.344.3572.