Ask a Tax Expert: How Can I Get Health Insurance?
Ed Note: Starting in 2014, most U.S. citizens and lawfully present aliens will be required to have health insurance for themselves and for their dependents. There are just a few exceptions to this mandate (certain religious exemptions, for example), and the health insurance must meet minimum essential coverage standards. That is, the primary purpose of the insurance must be to provide basic health care benefits.
The new laws don’t take effect until 2014 — but if you’re confused about what to do right now, we can help. We turned to The Tax Institute at H&R Block for answers to your most pressing health care questions.
Do I need to do anything to tell if I am impacted by the new health care laws?
If you already have health insurance, you do not have to do anything. If you anticipate a change in your situation (you’re getting married, expecting a baby, changing jobs, retiring, etc.) you may want to think about whether you will continue to have health insurance coverage for all family members when the mandate goes into effect in 2014. For example, suppose you currently have health insurance through your employer but you are in the process of starting your own business before the end of 2013. You will need to consider your health insurance options after you no longer work for your employer. One of those options will be to purchase insurance through an exchange.
How do I get health insurance?
You may already have health insurance through a government-sponsored health plan (such as Medicare, Medicaid, Tri-Care, or CHIP), through your employer, or from a private plan. If you do not qualify for health insurance through one of these programs, you may purchase health insurance through a health insurance exchange. An exchange is a state-sponsored “marketplace” in which you will have access to a variety of health insurance options. If your state does not have a state-sponsored exchange, a federally-sponsored exchange will be available to you.
What is a subsidy?
If you purchase health insurance through an exchange and meet certain requirements, the federal government will pay part of the
cost of your monthly health insurance premium directly to the health insurance plan. You will be responsible for paying the balance of the premium to the plan. The amount of subsidy you may be eligible to receive depends on your income and family size.
Who qualifies for a subsidy?
You may qualify for a subsidy if a) you purchase insurance through a health insurance exchange and b) you meet certain income guidelines. The size of your subsidy depends on your household income and your family size. Your “family” includes you, your spouse and your dependents.
- Household income: For many people, your household income will simply be your adjusted gross income (AGI) shown on your tax return. However, some things may be added to that amount, such as nontaxable social security benefits. If your child or other dependent has income, such as income from a job, that income may be included in some situations.
- Family size. The “family” for this purpose includes you, your spouse, and your dependents.
What do I do now to prepare for next October?
If you intend to purchase insurance through a health insurance exchange, you will need to have information about your income and your family. For many people, the information that the exchange will use will come directly from the 2012 tax return that is filed now, during the 2013 filing season.
What do I do in the fall to be part of the exchange?
The first open enrollment period starts October 1, 2013, and continues through March 31, 2014. You will be able to contact the exchange in one of several ways (in person, online, via mobile app, or by phone). As we get closer to that time, there will be information available about how/where to sign up and what information you will need to enroll in an insurance plan through an exchange.
I have more health care questions. Who can I ask?
Drop in to any one of our offices if you have specific questions about the new health care laws and your taxes — or visit us in the ‘Your Health’ section of the H&R Block Community to get a discussion going.