If you can afford health insurance but choose not to buy it, you must have a health coverage exemption or pay a fee. (The fee is sometimes called the “penalty,” “fine,” “individual responsibility payment,” or “individual mandate.”)
The fee for not having coverage in 2015
If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:
- 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
- $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.
The fee for not having coverage in 2014
If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts:
- 1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
- $95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.
The fee in future years
If you don’t have coverage in 2016, you’ll pay the higher of these two amounts:
- 2.5% of your yearly household income
- $695 per person ($347.50 per child under 18)
In future years, the fee is adjusted for inflation.
How you pay the fee
You’ll pay the fee on the federal income tax return you file for the year you don’t have coverage. Most people will file their 2014 returns in early 2015 and their 2015 returns in early 2016.
Learn more about the individual shared responsibility payment from the Internal Revenue Service.
More answers
- What if I’m uncovered for just part of the year?
If you’re uninsured for just part of the year, 1/12 of the yearly penalty applies to each month you’re uninsured.
If you’re uninsured for no more than 2 months of the year, you don’t have to make a payment.
- If I’m unemployed, do I have to pay the fee?
It depends on your household income. If insurance is unaffordable to you based on your income, you may qualify for an exemption from the fee. Other exemptions are based on low income too. Learn more about exemptions and how to claim them.
- How is the penalty collected?
You’ll pay the penalty when you file the federal income tax return for the year for which you’re seeking coverage. Most people fill out their 2014 tax returns early in 2015 and their 2015 tax returns early in 2016.
- What happens if I don’t pay the fee?
The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee.
- Are the rules the same in each state?
Yes. The rules about paying penalties are the same whether the Marketplace is run by your state or the federal government.
Benefits @ Work 