ObamaCare: No Penalties for Small Gaps in Coverage
The Healthcare Exchange begins January 2014. There have been a lot of questions in regards to whether gaps in coverage will penalize an individual. We have found that there are exceptions to penalization for individuals without coverage who would otherwise not be exempt.
Partial-Month Coverage Counts for the Month
With the new Healthcare Exchange an individual is considered as having coverage for a month so long as he or she has coverage for any one day of that month. For example, an individual who starts a new job on March 27 and is enrolled in employer-sponsored coverage on that day is treated as having coverage for the month of March.
Similarly, an individual who is eligible for an exemption for any one day of a month is treated as exempt for the entire month. Click here to learn of about Healthcare Exchange Penalties and Exemptions.
Payment Waived for First Part of Coverage Gap Spanning Multiple Years
The Healthcare Exchange allows for gaps in coverage of less than three months. It generally specifies that such gaps be measured without regard to the calendar years in which the gap occurs. For example, a gap lasting from November through February lasts four months and therefore generally would not qualify for the exemption.
However, recognizing that many individuals file their tax returns as early as January, before the length of an ongoing gap may be known, the Healthcare Exchange regulations provide that if the part of a gap in the first tax year is less than three months, then no shared responsibility payment is due for the part of the gap that occurs during the first calendar year, regardless of the eventual length of the gap. For example, for a gap lasting from November through February, no payment would be due for November and December.
Update: If you enroll by March 31, 2014 you not be charged a penalty.
Further Questions
To learn more about penalties and the Healthcare Exchange call 800-930-7956 or contact Medicoverage.
Comments and Questions
Click to leave a CommentComment from Wylene Thorpe on December 15, 2015
Since I am going to start paying for Medicare on March 1,2016 do I still have to have the affordable health care for January and February of 2016. I am unable to afford the $259.24 for those two months.? Will this be considered a short gap in insurance?
Thanks
Wylene
MEDICOVERAGE AGENT RESPONSE
Wylene,
You might have some options for coverage. 1) You may qualify for subsidies or Medicaid, and therefore not be without insurance, or, 2) You could forego insurance, and most likely because it’s a small gap, you would not owe a penalty. Now if you go with option #2, if you were to have an emergency between now and then, you would have to pay everything out of pocket for coverage.
You may also want to consider your Medicare health insurance options, to be prepared for your upcoming enrollment. Please call 800-930-7956 to speak with a licensed insurance agent.
-Chris from http://www.medicoverage.com/