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TrueChoices ACA FAQs

TrueChoices Affordable Care Act Frequently Asked Questions

Most people must have major medical health coverage to avoid a government mandated fee or penalty.

If you're one of the several million people hit with new federal fines for going without health insurance, beginning March 15, you will get another opportunity to sign up for 2015 coverage through HealthCare.gov.  2015 marks the first year that fines are being collected, with H&R Block claiming penalties that average $170 per customer (foxbusiness.com).  If you have incurred a fee, you will have until April 30 to sign up for coverage to avoid larger fines next year.  

I have limited medical coverage. Does that eliminate or reduce the fee? 

Who does not have to pay the penalty?

• If you are uninsured for less than 3 months of the year.
• If the lowest priced coverage available to you is more than 8% of your household income
• If you don't have to file a tax return because your income is too low (usually around $10,000 a year - see Table 1 at this link for details.) 
• If you are a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
• If you are a member of a recognized health sharing ministry 
• If you are a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
• If you are incarcerated
• If you are not lawfully present in the US
• If you qualify for a Hardship Exemption

What is a Hardship Exemption?

• You are homeless
• You were evicted, facing eviction or foreclosure
• You received a shut-off notice from the utility company
• You recently experienced domestic violence
• You recently experienced the death of a close family member
• You experienced fire, flood, or other some disaster which caused substantial damage to your property
• You filed for bankruptcy in the last 6 months
• You had medical expenses you could not pay in the last 24 months that resulted in substantial debt
• You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member
• You expect to claim a child as a tax dependent who has been denied coverage in Medicaid and CHIP (The Children's Health Insurance Program), and another person is required by court order to give medical support to the child.  In this case, you do not have to pay the penalty for the child.
• As a result of an eligibility appeals decision, you are 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 were not enrolled in a QHP through Marketplace
• You were determined ineligible for Medicaid because your state did not expand eligibility for Medicaid under the Affordable Care Act
• Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable
• You experienced another hardship in obtaining health insurance

YOU MUST APPLY FOR ANY OF THESE HARDSHIPS HERE.

What health plans qualify as minimum essential coverage?

• Any Marketplace plan, or any individual insurance plan you already have
• Any employer plan, or any individual insurance plan you already have
• Any employer plan (including COBRA plans - with or without "grandfathered" status)
• Retiree health plans
• Medicare
• Medicaid
• The Children's Health Insurance Program (CHIP)
• TRICARE (for current service members and military retirees, their families, and survivors)
• Veterans' health care programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spina Bifida Health Care Benefits Program)
• Peace Corps Volunteer plans
• Self-funded health coverage offered to students by universities for plan or policy years that begin on or before December 31, 2014

For more information on fees and exemptions, please visit the healthcare.gov website.