Upravo popunjavam povracaj poreza i izgleda da cemo proci bez kazne, najverovatnije jer smo premalo zaradili, a mozda i jer smo ispod 6 meseci u US u 2017-oj.
Pod-pitanja iz help-a:
What counts as health insurance?
You met the Affordable Care Act requirement to have health insurance in 2017 if you were covered through:
- Your employer (employer-sponsored health insurance, or insurance through your work, your spouse's or parent's work)
- A state, federal or private Health Insurance Marketplace (including Healthcare.gov, and plans purchased through state Marketplaces, which are also known as exchanges)
- Health plans offered by a college or university you’re enrolled in that began on or after December 31, 2016
- Your parent’s health insurance plan (if you’re under 26 years old)
- The Medicaid program in your state (Medi-Cal, MassHealth, Medical Assistance Program, SoonerCare, TennCare, MaineCare, HuskyHealth, etc.)
- Medicare (at least Part A, Part C or Medicare Advantage)
- A retirement program from your former employer
- Veteran’s Administration (VA), CHAMPVA, or TRICARE
- The Children’s Health Insurance Program (CHIP) in your state
- A union that you’re a member of
- The Peace Corps
- COBRA
- Refugee Medical Assistance (RMA)
- The Nonappropriated Fund Health Benefit Program
- State high-risk pools for plan or policy years that begin on or before December 31, 2016
- A private plan purchased from a health insurance company such as Kaiser, UnitedHealth, Aetna, Humana, Blue Cross, Blue Shield, etc.
- Other coverage recognized by the Department of Health & Human Services as minimum essential coverage
- A combination of any of the above that doesn't result in a coverage gap of 3 months or more or more than one coverage gap during the year
If you’re not sure if the coverage you had counts, call your health insurance provider and ask if your plan is recognized as minimum essential coverage.
What doesn’t count as health insurance?
The following do not meet the Affordable Care Act minimum requirement for health insurance.
- Health care services through clinics (e.g., CVS Minute Clinic, Planned Parenthood)
- Other types of insurance (e.g., stand alone dental or vision plans, car, homeowner’s)
- Plans that discount drugs or doctor visit fees, but do not pay for health care services
- Plans that pay for services that treat one specific disease or condition, such as cancer plans
- Workers' compensation
- Accident or disability policies
- Short-term plans and long-term care plans
- Plans that pay you a set amount if you are sick or in the hospital, but do not pay for health care services
- Travelers insurance
What’s the Affordable Care Act Penalty?
It’s the penalty for not having health insurance and is also known as the Shared Responsibility Payment. It only applies to the months you did not have health insurance.
The penalty is calculated two different ways—and the higher amount gets charged as the penalty:
- Percentage of your income. For 2016, this penalty is 2.5% of your 2016 household taxable income. It applies to the whole household, regardless of how many family members went without health insurance in 2016. The maximum penalty for this method is the total yearly premium for the national average price of a Bronze plan sold through the Marketplace.
- Per person fee. For 2016, the penalty is $695 per uninsured person for the year ($347.50 per child under 18). The maximum penalty using this method is $2,085.
What health care penalty exemptions can you claim if you weren’t required to get insurance?
The Affordable Care Act, requires that you either have health insurance or pay a penalty on your taxes, unless you qualify for an exemption based on your situation.
Exemptions you can claim if you weren’t required to get insurance:
- If you spent 330 days or more outside U.S., you can claim a penalty exemption on your taxes and no further paperwork is needed.
- If you were a resident of foreign country or U.S. territory, you can claim a penalty exemption on your taxes and no further paperwork is needed.
- If you were not a U.S. resident, you can claim a penalty exemption on your taxes and no further paperwork is needed.
- If you’re a member of a health care sharing ministry, you can claim a penalty exemption on your taxes and no further paperwork is needed.
- If you’re an Indian tribe member or eligible for Indian health care, you can claim a penalty exemption on your taxes and no further paperwork is needed.
- If you spent time in jail, you can claim a penalty exemption on your taxes and no further paperwork is needed.
What health care penalty exemptions are there for financial hardships?
If one of the following hardships kept you from getting health insurance in 2017, you can apply for a penalty exemption before you file your taxes. If approved, you'll qualify to get back all or some of your penalty.
You may qualify if you had any of the following hardships:
- You were homeless.
- You were evicted or were facing eviction or foreclosure.
- You received a shut-off notice from a utility company.
- You experienced domestic violence.
- You experienced the death of a family member.
- You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
- You filed for bankruptcy.
- You had medical expenses you couldn’t pay that resulted in substantial debt.
- You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
- You claim a child as a tax dependent who’s been denied coverage for Medicaid and CHIP for 2017, and another person is required by court order to give medical support to the child. In this case you don’t have to pay the penalty for the child.
- As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace in 2017.
- You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid in 2017 under the Affordable Care Act.
- Your "grandfathered" individual insurance plan (a plan you’ve had since March 23, 2010 or before) was cancelled because it doesn’t meet the requirements of the Affordable Care Act and you believe other Marketplace plans are unaffordable.
How do I figure out if health insurance through work was not affordable in 2017?
- If the lowest priced plan through your job that covered just you and would cost you more than 8.16% of your household income, then it was considered unaffordable. If you don't take the insurance, you won't have to pay a penalty on your tax return.
- If the cost is not more than 8.16% of your household income and you don't take the plan, you will have to pay a penalty on your return.
How do I figure out if no affordable health insurance options were available in my area?
- If you were not offered health insurance through a job and the minimum amount you would’ve paid toward the premiums on the lowest-cost coverage available through your state’s Marketplace would have cost you more than 8.13% of your household income, then coverage was not affordable for you.
- Example: Earl is unmarried with no dependents with household income of $30,000. He has no medical coverage offered through work. The premium for the lowest cost bronze plan in his area would be $5,000 and he would have been able to claim a $1,700 credit if he had enrolled in the plan. Earl can claim the exemption for unaffordable coverage since the cost of the plan, $3,300 ($5,000 minus $1,700) is more than 8.13% of his household income ($30,000 times 8.13% equals $2,439).
How do I figure out if individual coverage is unaffordable?
- If you’re married without children and both you and your spouse were offered health insurance through a job, it’s unaffordable if the combined cost of coverage for both of you was more than 8.16% of your household income. But if either of you were offered a family plan that cost less than 8.16% of your household income, coverage was affordable.
- Example: Dan and Joanna are married without children and both of them have jobs. Joanna was offered health insurance through her job that would have cost 5% of her and Dan’s household income. Dan’s lowest-priced health insurance option through his job also cost 5% of his and Joanna’s household income. Joanna and Dan are both eligible to get the penalty for going without health insurance in 2017 waived because together, their insurance was unaffordable. However, if either of them were offered family coverage at a cost less than or equal to 8.16% of their household income, the exemption would not apply.
- If you were only offered coverage for part of the year, it’s OK. You can calculate whether it was affordable by multiplying the monthly premium by the 12 months of the year. If that number is more than 8.16% of your annual household income, health insurance was unaffordable.
- The Health Insurance Marketplace may follow up to confirm the details of the health insurance plan you or your spouse was offered through work.
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