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Obamacare Penalty Enforcement: How It Works

Author: Jacob Smith

We're only days away from a deadline (January 31, 2016) that could cost you a lot of money if you're not in compliance. You may have missed hearing about it on the news, but it's vitally important that you address it. It's the date when open enrollment through the Health Insurance Marketplace for 2016 ends.

If you don't have qualifying insurance through some other means, you probably want to get it through the Health Insurance Marketplace (see Find The Cheapest Health Insurance Providers). If you don't, you may have to wait until November for the next open enrollment period to open or get insurance through a private company.

Here's how it works. Under the Affordable Care Act, also known as Obamacare, you are required to have health insurance. As long as you have insurance through your employer, insurance your purchased on your own, Medicare, Medicaid, a Veterans plan or some other qualifying coverage, you have nothing to worry about. You can check to see if your plan qualifies by clicking here.

How You Pay the Penalty

If you don't have health insurance you pay a penalty on your tax return at the time you file your income taxes.

If you didn't have coverage in 2015, you'll owe 2% of your yearly household income or $325 per person ($162.50 per child under 18) – whichever is higher. There's nothing you can do right now about 2015, other than talk to a tax specialist and hope that there's something that will exempt you from the penalty (see below).

You also should move fast to get coverage in time for 2016, when penalties will rise to 2.5% of household income or $695 per person ($347.50 per child under 18) – again, whichever is higher. You can read more about the penalties here.

Getting an Exemption

Like anything involving taxes, there are exemptions and situations where the penalty can be reduced, but you will likely need the help of a tax advisor to figure it all out. You can see if you qualify for an exemption from the penalty by clicking here.

Getting Coverage Between Enrollment Periods

You're out of luck if you missed the deadline, except under certain circumstances when you can still enroll through the Health Insurance Marketplace. If a major life event happens – you have a baby or lose your job, for example – you can get coverage through the Marketplace during non-enrollment periods. Click here to learn more about what the Marketplace calls "qualifying life events."

Also check with your state. Some states run their own Health Insurance Marketplace.

The Bottom Line

Time is running out. You only have a few days to get healthcare during the current open enrollment period at the Health Insurance Marketplace (see Avoid the Obamacare No-Insurance Penalty By Jan. 31.) . If you miss the window, your coverage might be more expensive and your tax bill could be hefty in 2016. If you still need coverage, click here to sign up for coverage.

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