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Affordable Care Act Requirements

November 15, 2017

Affordable Care Act – Health Insurance Requirements for 2018

 

At this writing, the Affordable Care Act (ACA or Obama Care) will be in effect for 2018.  You must enroll every year if you do not have health insurance coverage provided by an employer sponsored health plan, you are not on COBRA, or covered by Medicare or Medicaid.  The enrollment period for 2018 closes on December 15, 2017 so be sure to enroll by then.

 

ACA mandates every person to have health care coverage for 2018.  You must have a policy that offers Essential Health Benefits.  This includes coverage for:

  • Doctor’s services
  • Inpatient and Outpatient hospital care
  • Prescription drug coverage
  • Pregnancy and childbirth care
  • Mental health services

Pre-existing conditions and preventative health services are also part of the ACA coverage.

 

How to Enroll

If you do not have health coverage for 2018, you need to enroll in the ACA.  Go to www.healthcare.gov and create an account.  Follow the prompts to complete your application.  You need to know how much you or you and your spouse expect to earn in 2018.  If you just want to browse the plans offered, you can do this without creating an account.

 

Penalties

If you do not have essential health insurance for 2018, you will pay a penalty to the US government on your 2018 tax return.  The penalty for not having coverage is $695/adult per year, $347.50/child not covered per year with a family maximum of $2,085.   However, if you are a high income family, the penalty for no health insurance can be over $13,000 for 2018.

 

In 2018, if you live in Northern Virginia and you are enrolled in ACA, you have the choice of insurance through Cigna, Kaiser Permanente and if you live east of Route 123 perhaps Care First.

 

Example

61 year old, single woman in 20151 zip code:  lowest monthly premium is $852/month and highest monthly premium is $2,085/month.  Premiums vary based on deductible amounts, maximum annual out of pocket amount and co-pay percentage.  Some of these plans also include dental coverage.

 

Don’t delay – sign up TODAY.  If you have any questions, please call our office.