Answers to last-minute questions about health care coverage




Posted on March 31, 2014 at 3:50 PM

Updated Monday, Mar 31 at 5:40 PM

What happens if you do not have insurance by Tuesday, April 1?

Those in the process of getting insurance have a grace period to finish the process. If you say you tried to enroll before the deadline but had trouble, you can still sign up without penalty. Those without insurance will face a penalty.

What is the penalty and how is it assessed?

If you aren't exempt and cannot show proof of acceptable coverage, you will be liable for a tax penalty that will be withheld from your tax refund. The penalty in 2014 will be 1 percent of your income, or $95 per adult and $47.50 per child in a household -— whichever of the two amounts is greater. There is a maximum of $285 per family.

The penalty increases every year. In 2015, it’s 2 percent of income, or $325 per person. In 2016 and later years, it’s 2.5 percent of income or $695 per person. After that, it's adjusted for inflation.

If you’re uninsured for just part of the year, one-twelfth of the yearly penalty applies to each month you’re uninsured (if you're uninsured for more than three months). If you’re uninsured for less than three months, you don’t have to make a payment.

What happens if you are in the system, but have not been able to finalize your plan by midnight Monday?

Consumers who have begun to apply for coverage on, but who do not finish on Monday, will have until about mid-April to ask for an extension. Under the new rules, people will be able to qualify for an extension by checking a blue box on to indicate that they tried to enroll before the deadline.

What happens if you lose your job/insurance within the next year and it’s not during open enrollment?

To buy marketplace insurance outside open enrollment, you must qualify for a special enrollment period due to a qualifying life event, such as marriage, divorce, birth or adoption of a child, or loss of a job.

You can buy insurance at any time outside of the marketplace, but you won’t have access to government subsidies that reduce your premium costs for non-marketplace plans.

How will the government know if you have or don’t have insurance?

When you file your 2014 tax return, you will have to enter information about your coverage (or your exemption) on the return. In 2015, if you have health insurance, your insurer will send a form that verifies coverage. That form will need to be submitted with your tax return. If you don't have coverage, the IRS will either withhold the fee amount from your tax refund or bill you, if you owe money.

If you sign up Monday, when does coverage begin?

Coverage begins May 1, 2014. Individuals should check with the specific insurance company regarding deadlines for paying premiums and when they can expect to get their health card.