Get Coverage Fees-exemptions

The fee you pay if you don't have health coverage

If you can afford health insurance but choose not to buy it, you must have a health coverage exemption or pay a fee. (The fee is sometimes called the "penalty," "fine," "individual responsibility payment," or "individual mandate.")

  • You owe the fee for any month you, your spouse, or your tax dependents don’t have health insurance that qualifies as minimum essential coverage. See all insurance types that qualify.
  • You pay the fee when you file your federal tax return for the year you don’t have coverage.
  • In some cases, you may qualify for a health coverage exemption from the requirement to have insurance. If you qualify, you won’t have to pay the fee. Learn about health coverage exemptions.

Learn more about the individual shared responsibility payment from the Internal Revenue Service.

The fee for not having coverage 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.

Percentage of income

  • 2.5% of your yearly household income.

  • Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

Per person

  • $695 per adult

  • $347.50 per child under 18

  • Maximum: $2,085

Paying the fee

  • Using the percentage method, only the part of your household income that’s above the yearly tax filing requirement: The minimum amount or (threhold) of income requiring you to file a federal tax return. 2016 filling requirements for most taxpayers: Gross income of at least $10,350(individuals) or $27,700(married filling jointly). Different thresholds apply for dependants, people 65 and order, and those who use other tax filling statuses (like married filling separtely)
  • Using the per-person method, you pay only for people in your household who don’t have insurance coverage.
  • If you have coverage for part of the year, the fee is 1/12 of the annual amount for each month you (or your tax dependents) don’t have coverage. If you’re uncovered only 1 or 2 months, you don’t have to pay the fee at all. Learn about the “short gap” exemption.
  • You pay the fee when you file your federal tax return for the year you don’t have coverage.

Estimating your fee

Use this IRS tool to estimate your individual responsibility payment.

The fee in previous years

The fee for not having coverage in 2015

The penalty for 2015 is the higher of these:

  • 2% of household income
  • Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

or

  • $325 per adult
  • $162.50 per child under 18
  • Maximum: $975

The fee for not having coverage in 2014

The penalty for 2014 is the higher of these:

  • 1% of household income
  • Maximum: Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

or

  • $95 per adult
  • $47.50 per child under 18
  • Maximum: $285

Common questions

It depends on your household income. If insurance is unaffordable to you based on your income, you may qualify for an exemption from the fee. Other exemptions are based on low income too. Learn more about exemptions and how to claim them.

The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee.

 
 

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