Most people are required to have health insurance or pay a penalty if they don’t. Coverage can include employer-provided insurance, coverage you buy on your own, Medicare, TRICARE, Medicaid, and FAMIS.
The fee for not having health insurance in 2016 & 2017
The fee is calculated 2 different ways – as a percentage of your household income, and per person. You’ll pay whichever is higher. The fee rises with inflation. Final 2018 amounts will be published when available.
Percentage of household income
- 2.5% of household income
- Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace
- $695 per adult
- $347.50 per child under 18
- Maximum: $2,085
Several groups are exempt from the requirement to obtain coverage or pay the penalty, including:
- People who would have to pay more than 8 percent of their income for health insurance.
- People who fall into Virginia’s “Medicaid Gap” because the state has not expanded its Medicaid program to cover more low income adults.
- People with incomes below the threshold required for filing taxes.
- People who qualify for religious exemptions.
- Undocumented immigrants.
- People who are incarcerated.
- Members of Native American tribes.
If you do not have insurance and do not fit into one of these categories, then you will likely pay a penalty. Learn more about the individual shared responsibility payment from the Internal Revenue Service.