Individual Requirement for Health Insurance 

The Affordable Care Act (ACA) - often called Obamacare - is a new law that requires all Americans to have health insurance or pay a penalty. Qualified insurance could be job-based insurance, a private plan, Medicaid, Medicare, or another government-sponsored plan. You will sometimes hear this referred to as the "Individual Mandate". Use this chart to see if you meet the requirements.
 

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  1. You are an undocumented immigrant.

  2. You are incarcerated.

  3. You are a member of an Indian tribe.

  4. You are part of a religion that is opposed to accepting a health insurance policy.

  5. Your family income is below the threshold for filing a tax return.

  6. You have to pay more than 8% of your income in health insurance premiums.

Do any of these apply?

No
Yes

There is no penalty for not having health insurance.

Do any of these apply?

  1. You have an individual health insurance policy, minimum of Bronze benefit level.

  2. You have insurance through your employer's group plan.

  3. You have Medicare.

  4. You have Medicaid or Children's Health Insurance Plan (CHIP)

  5. You have TRICARE.

  6. You have a veteran's health plan.

  7. You have a grandfathered health insurance plan issued before the Affordable Care Act was enacted.

No
Yes

You will pay a penalty for not having health insurance

You have satisfied the individual requirement for health insurance. You will not pay a penalty.

2014

 

Penalty is $95 per adult and $47.50 per child (up to $285 per family) or 1% of family income, whichever is greater. 

2015

 

Penalty is $325 per adult and $162.50 per child (up to $975 per family) or 2% of family income, whichever is greater. 

2016

 

Penalty is $695 per adult and $347.50 per child (up to $2,085 per family) or 2.5% of family income, whichever is greater.