How Do I Get Health Insurance
You can get it through:
- your job or your spouse’s job, if the employer offers it.
- your parent’s plan until you turn 26.
- a government program like CHIP, Medicaid, or Medicare.
- your college if they offer a student plan.
- a membership association, union, or church.
- an insurance company or agent.
- the federal health insurance marketplace.
Things You Should Know
For covered dependents age 19-26 that are getting married, and the effect on their GIC health insurance coverage
Most dependents age 19 to 26 are covered under the insureds family health plan. The Affordable Care Act allows coverage for your dependent up to age 26, whether or not they are married. If your dependent age 19 to 26 is coverage under another status, such as full-time student, contact the GIC at for your dependents coverage options.
Dependents turning age 26 health insurance options
If your dependent is turning age 26 and is a Massachusetts resident, he/she may purchase health insurance from the Health Connector. If he/she lives out of state, contact the Health Insurance Marketplace for coverage information in that state. Alternately, he/she may elect GIC COBRA coverage.
How to cover disabled children ages 19-26
Please note that in order for a dependent to apply for handicapped dependent coverage, he or she must meet one of the following conditions:
- became mentally or physically incapable of earning his/her own living prior to age 19 or
- became permanently and totally disabled and became so on or after age 19 and is under age 26.
- These dependents will only be covered until the last day of the month they turn 26.
If your dependent meets one of thee conditions, you must fill out a Handicapped Dependent Application and return it to the GIC.
Can My Parents Kick Me Off Their Health Insurance Before I Turn 26
Yes, your parents can kick you off their health insurance. Once you turn 18, your health care bills are ultimately your responsibility, and so is having health insurance coverage. Getting your own policy through your employer or school may even be cheaper or offer better coverage than staying on a parents policy until you age out. Plus, the further you live from your parents, its more likely that your doctors will be out of network, so having your own health insurance can result in lower out-of-pocket costs.
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How Many Months Do You Need Health Insurance To Avoid A Penalty
In the states with individual mandates , you must have qualifying health insurance coverage for nine months out of the year. Short gaps of coverage, typically less than two or three consecutive months, will exempt you from paying the penaltybut you will need to declare it on your state taxes.
At a federal level and for all states without an individual mandate, there are no longer any tax penalties for citizens without health insurance.
What Other Health Care Services Do Provinces And Territories Provide
Provinces and territories may also offer additional benefits under their respective health insurance plans, funded and delivered on their own terms and conditions. These benefits are often targeted to specific population groups , and may be partially or fully covered. While these services vary across different provinces and territories, examples include prescription drugs, dental care, optometric, chiropractic, and ambulance services.
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Individual Health Insurance For Washington State Residents
Under the Patient Protection and Affordable Care Act , most people are currently required to enroll in health insurance or pay a penalty. However, as of January 1, 2019, Congress removed the penalties to being uninsured, with some exceptions, though the requirement to have insurance remains.
Washington State residents are fortunate to have several options for obtaining coverage. If you do not have health insurance through your employer or government programs like Medicare and Medicaid, you can buy insurance for yourself and your family as individuals. This article provides information about applying for and comparing individual insurance products in Washington, including products sold through the Washington Health Benefit Exchange and products offered in the outside market. It is current as of October 2020.
Individual Insurance: What Are Your Choices
There are two ways for Washington residents to buy an individual health plan: through the states official Exchange website or off-Exchange directly with an insurance company. Most people choose to apply through the state Exchange website.
The Washington Health Benefit Exchange Marketplace
Washington residents can compare and shop for health insurance through the state Health Benefit Exchange website, Washington Healthplanfinder. This official state website offers health and dental plans that meet the health reform standards of the Affordable Care Act. Learn more about these qualified plans here.
Applying for coverage through Washington Healthplanfinder is the best way to learn if you qualify for a free or reduced-cost plan. When you apply through Washington Healthplanfinder, the application will ask questions about your household and finances to see if you qualify for many different health coverage programs, including free Apple Health program or a reduced-cost private plan. If you qualify for a reduced-cost private plan, Washington Healthplanfinder will help you find plans that have lower costs due to federal and state financial assistance programs, such as:
Note: Non-citizens without immigration documents are not eligible to buy private health plans through the Exchange but may use the Washington Healthplanfinder application to seek coverage for family members or limited-scope Apple Health programs for themselves. Learn more here.
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Choosing A Health Insurance Plan
Reading the fine print is important when choosing health care plans. These questions may help:
- Can I go to any doctor, hospital, clinic, or pharmacy I choose?
- Are specialists, such as eye doctors and dentists covered?
- Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
- Does the plan cover home care or nursing home care?
- Will the plan cover all medications my physician may prescribe?
- What are the deductibles? This is the amount you must pay each year before your insurance company will begin paying claims.
- Are there any co-payments? This is the amount of money you pay each time you receive medical services or a prescription.
- If there is a dispute about a bill or service, how is it handled?
Do I Need To Show Proof Of Health Insurance For My Taxes
Youll need to show documentation that you had health insurance in 2018 to avoid paying a penalty. Depending on how you get your insurance, this documentation will be one of the following: Form 1095-A , Form 1095-B , or Form 1095-C . Past 2018, you no longer need to show proof of health insurance on your taxes.
However, if you received a federal tax credit, you will need to file your tax returns with the right documentation. Form 1095-A is provided to anyone with Marketplace coverage. Your insurance company will issue Form 1095-B, listing everyone who was covered and when during a calendar year. You can also submit this form as part of your documentation when preparing your taxes. Form 1095-C is provided to employees by employers who provide health insurance benefits, when an employee opts into those benefits.
If you want to be extra careful you can keep documentation that shows you had coverage for 2018 and earlier. This can include insurance cards, explanation of benefits , or statements from your insurer. This may also be a W-2 or payroll statements reflecting health insurance deductions.
Grab our free guide to see what you need to know about Marketplace insurance and your taxes.
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No Mandatory Health Insurance: Advantages
The primary upside to health insurance no longer being mandatory at the federal level is the money you dont have to spend on premiums that remains in your pocket. That could be helpful if youre trying to pay off student loans or save money toward a down payment on a home.
Of course, if your employer offers some type of health insurance coverage as part of your benefits package, you may be able to get affordable coverage without having to shop around for it.
How To Enroll And Get Answers To Your Questions
You can learn more about and apply for ACA health care coverage in several ways.
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Visit HealthCare.gov to apply for benefits through the ACA Health Insurance Marketplace or you’ll be directed to your state’s health insurance marketplace website. vary by state.
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Find a local center to apply or ask questions in person.
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Download an application form to apply by mail
Find the answers to common ACA questions about submitting documents, getting and changing coverage, your total costs for health care, tax options, and more.
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Is There A Penalty For Not Having Health Insurance
Currently, there is no federal penalty fee associated with not having health insurance This means if you are uninsured, you will not be paying a penalty fee when you pay taxes.
However, some states have implemented their own individual mandates, so there are penalties for not having health insurance in California, the District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont. If you live in one of those states, check with your state to see what the penalty is.
Penalty fees still apply for years in which the ACA was law and if you were uninsured and without an approved exemption. If you do not belong to one of the exempt groups, do not qualify for a hardship exemption, and do not have health insurance, you can still be fined via a tax penalty tied to your tax returns for those years. This is also known as the individual shared responsibility payment, and the amount differs by year. If you did have health insurance for part of the year for 2018 or earlier, you dont have to pay the penalty for the months you were insured. For the purpose of the individual mandate penalty, according to the federal government, even having coverage for one day of the month counts as being covered for that month.
When The Individual Mandate Changed
As mentioned above, mandated health insurance began in 2014, which also happened to be the year the Affordable Care Act went into effect. The question is, why was having health insurance mandatory so short lived? Was it that much of a failure?
The jury is still out on whether the individual mandate was successful or not, but there is one thing for certain. Requiring Americans to enroll in insurance coverage was the lifeline of Obamacare, something President Trump knew all too well.
When President Trump took office, he vowed to repeal the ACA. After a few unsuccessful attempts, he decided to go after the health insurance mandate, which he hoped would cause an unravelling of the healthcare system at the time.
On January 20, 2017, President Trump signed an executive order referred to as Obamacare Relief, which called for the end of the individual mandate as of 2019. In the immediate aftermath, health insurance premiums began to rise in anticipation of few Americans enrolling in insurance coverage.
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When Is Open Enrollment If I Get Health Insurance From An Employer
The open enrollment periods tied to employer-sponsored health insurance plans often happen between October and December.
We cant give more specific dates because every employer sets its own health insurance open enrollment period.
So, if you get health insurance from an employer and you dont know its open enrollment 2023 deadlines, check with human resources.
Premium Tax Credits Can Help You Pay For Coverage
Tax credits are amounts taken off what you owe in taxes. You can use this savings to pay your health insurance premiums. To get a tax credit, you must buy through the federal marketplace. Your income must be between 100% and 400% of the federal poverty level.
You can’t get a tax credit if your employer offers affordable health insurance or your income is below the poverty level.
For more information about tax credits, visit HealthCare.govs Saving Money on Health Insurance page.
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Pros Of Offering Health Insurance Benefits
In addition to attracting quality candidates, here are six other advantages to investing in healthcare insurance for your employees:
- Employee retention : Research from the Society of Human Resource Management found that employees are more likely to stay with an employer if they like their healthcare plan.
- Lower premiums: Group plans typically cost less than individual plans, even within the ACA framework.
- Pretax benefit for employees: In many cases, small business-provided health insurance can reduce employees tax burden, which provides your workers with more take-home income.
- Healthier and productive employees: When employees have access to healthcare, they, and their dependents, can more easily address health issues early on. This results in healthier employees, which reduces the number of days employees take off because of illness.
- Creating an employee-focused company culture: Few things boost company culture more than offering benefits that employees truly value. Having a solid benefit offering shows employees that the company cares about them. Health care insurance is one of those key benefits that a business can offer its workers that powerfully delivers this message.
- Possible employer tax credit eligibility: Although it is not required for small businesses to offer group health insurance, some employers may benefit from a tax credit through the ACAs Small Business Health Options Program .
What Is The Affordable Care Act
The Affordable Care Act provides individuals and families greater access to affordable health insurance options including medical, dental, vision, and other types of health insurance that may not otherwise be available. Under the ACA:
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You may be able to purchase health care coverage through a state or federal marketplace that offers a choice of plans.
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Insurers can’t refuse coverage based on gender or a pre-existing condition.
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There are no lifetime or annual limits on coverage.
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Young adults can stay on their familys insurance plan until age 26.
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Seniors who hit the Medicare Prescription Drug Plan coverage gap or “donut hole” can get a discount on medications.
Read the full text of the ACA and learn more about its provisions and relationship to patients, insurers, businesses, and families.
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Do I Still Have To Pay A Penalty If I Dont Have Health Insurance
You dont have to pay a penalty if you dont have health insurance in 2019 or any year after that.
Through the end of 2018, the ACA required all U.S. taxpayers to have health coverage that met a minimum standard unless they qualified for an exemption due to certain life events, financial status, or other factors. This meant that if you had affordable health coverage options, but chose not to buy health insurance, you would have to pay a fee when filing your taxes. This fee was known as an individual shared responsibility payment. It was also sometimes called the penalty,fine, or individual mandate.
Congress changed this part of the law for plans starting in 2019 and after. The individual shared responsibility payment no longer applies starting in plan year 2019.
Note: If you didnt have coverage or an exemption in 2018, you may still have had to pay a fee when you filed your 2018 taxes in 2019.
Washington Dc Individual Mandate
- Tax penalty for residents who can afford insurance but go without it
- Provides exemptions to the tax penalty for circumstances such as financial hardship, pregnancy, or eviction
Individuals who go without qualifying health coverage for a full year and dont file for an exemption may owe a tax penalty. The penalty amount is either 2.5% of the gross family household income or $695 per individual and $347.50 per child youll pay whichever amount is greater.
According to dchealthlink.com, the maximum penalty for not having coverage in DC is based on the average premiums for bronze level health plans available on DC Health Link. In 2020, this amount is $3,448/year per person and, for households with more than one person without coverage, it is multiplied by the number of people in the household without coverage up to a maximum of five household members. So, potentially, a household of five or more that went the entire year without health coverage would have a penalty cap of $17,240 in 2020.
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Which States Require Health Insurance And Why
In addition to Washington D.C., there are five states that require health insurance. After the Obamacare individual mandate was repealed, there were several states that decided to require people to have health insurance on their own. These include New Jersey, Vermont, California, Rhode Island, and Massachusetts.
States and districts that require health insurance
The goal of requiring health insurance is to prevent people from only purchasing health care plans if they know they are going to need it. In the event of an emergency, they would have to pay a large out-of-pocket sum for care if they are uninsured. Requiring health insurance also essentially fobirds health insurance companies from denying coverage to those who need it the most. Companies are not allowed to discriminate or deny coverage to seniors or people who have pre-existing health issues. They also cannot charge them more despite the fact that they cost more to insure.
In the states that require health insurance, the average monthly premium is lower for taxpayers as there are more people insured. Overall, the individual mandate is meant to protect consumers.
How To Avoid Paying A Penalty For No Health Insurance
The easiest way to avoid paying a penalty for not having health insurance is to enroll in an accepted and creditable health plan for your state. The Affordable Care Act, sometimes called Obamacare, specifies anopen enrollment period when people can enroll in plans offered through the federal or state health insurance marketplaces. An open enrollment period is a set time when people can sign up for or change their plans. When you sign up for health insurance during the open enrollment, the insurer must provide you insurance. If you do not sign up during this time, you cannot sign up until the next open enrollment unless you experience certain life events. For 2023, open enrollment begins on Nov. 1, 2022, and ends on Jan. 15, 2023.
Besides plans on the Marketplace, you can during two main periods in the year:
- Initial enrollment period
- Open enrollment period
Some people can enroll in health insurance plans offered on the state and federal exchanges during times other than thespecial enrollment period , if they experiencecertain life events, such as:
- Losing health coverage due to divorce or legal separation
- Having or adopting a child or placed a child for foster care
- Losing coverage due to domestic violence or a death in the family
- You turned 26 and are no longer on your parents insurance
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