Health Reform for Individuals

You can enroll in a Marketplace plan by using the secure link health insurance .

Under the Affordable Care Act ("Obamacare"), everyone is generally required to have minimum essential health insurance for every month of 2014 unless they qualify for an exemption. You are covered if you currently have health insurance through:

  • Medicare
  • Medicaid
  • CHIP
  • Veterans health care programs
  • Peace Corp Volunteer plans
  • Self-funded coverage offered by your university that begins on or before Dec. 31, 2014
  • A non-Marketplace plan purchased from an individual insurance market

If you do not currently enroll in one of those plans, you can try to apply for an exemption to avoid paying the penalty. You can apply for an exemption by visiting the exemption page. A hardship exemption is available for individuals who enroll in a Marketplace plan before the end of open enrollment, March 31, 2014. To qualify for the exemption the plan must be purchased from a Marketplace.

You can also shop for insurance through an agent or broker, or directly from an insurance company. However, shopping for a plan outside the Marketplace will mean that you are not eligible for a refundable Premium Tax Credit (Subsidy) which is intended to help taxpayers with low or moderate income pay for a health insurance premium.

Whichever plan or source you choose; you must have medical coverage to avoid the penalty. The minimum penalty is $95 per adult or 1.0% of income whichever is higher up to $2,448 per adult in 2014. The minimum penalty is $325 per adult or 2.0% of income whichever is higher up to $3,816 per adult in 2015. To find out more information about the penalty amount visiting the penalty page. If you have only dental care or emergency care coverage, for example, you will not be considered as covered and will incur the penalty. 

When enrolling in a Marketplace, make sure you have:

  1. Social security number or document number for legal immigrants.
  2. Basic physical information on each covered person, namely, each person’s age and whether a smoker/non-smoker.
  3. Last year’s tax information for your family.
  4. Your projected income for this year.
  5. Employer and income information for each working member of the family, i.e., W-2 forms, employer name and address, any social security or pension income, etc.
  6. Information on deductions, namely any alimony paid or student loan interest.
  7. Policy numbers for any health insurance you currently have.

When selecting a plan from the Marketplace, please consider:

  1. How often do you need to visit a doctor or refuel a prescription medication?
  2. Do you need special care ? Has this been included in the plan?
  3. Is your doctor included in the plan network?
  4. Does the cost of the plan (premium, co-payments, and coinsurance) fit within your budget?
  5. Make you sure you check if you qualify for lower costs.

You may qualify for an advanced tax credit on your health insurance premium if your modified adjusted gross income is between 100%-400% of the poverty level. In 2013, that is approximately $46,000 for an individual and $94,000 for a family of four. You can find out your subsidy amount by visiting the subsidy calculator page

If you have questions about Affordable Care Act, please visit the FAQ section by using the FAQ page or contact us. 

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L & M Tax Group, 420 Chinquapin Round Rd, # 2 i, Annapolis, MD 21401