Summary

A Short Intro to Healthcare Reform:

You must have health coverage or pay a tax penalty.

  • Most individuals will have to have health insurance coverage. If you don't, you will pay a tax penalty on your federal income tax return at the end of the year. How much? In 2015 it's 2% of your income or $325 per person. In 2016 and later years it's 2.5 percent of income or $695 per person.

You will be able to get insurance, even if you've been turned down before.

  • You are guaranteed health insurance coverage, even if you have a serious or long-term condition, illness or injury. It doesn't matter if you've applied before or have been turned down for coverage.

You may qualify for a break on your insurance premiums.

  • Those who make less than four times the Federal Poverty Level may qualify for a break on their insurance premiums. Depending on your income and household size, you could pay as little as $0 each month. Use our online premium assistance tool to see if you may qualify for premium assistance.

Many health insurance plans will include broader benefits.

  • Preventive and wellness services will be covered by your insurance at $0 when you go to an in-network provider. In other words, when you go to the doctor, you won't pay for these services out-of-pocket if you go to a doctor in your network.

Other important points about the healthcare system:

  • No more annual or lifetime dollar limits on essential benefits

    • Insurance plans cannot put annual dollar limits or lifetime dollar limits on the amount of claims they pay for essential benefits.

  • Health Insurance Reforms

    • The new rating factors in the individual and small group market are only based on age, where you live and smoking status. Premium is not based on your health.
  • Acceptable Coverage Required

    • If you do not have health insurance coverage, you may be charged a penalty of at least $325 in 2015 and $695 in 2016.

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