Health insurance has a lot of benefits. It can help you save on care, protect you in case of an emergency and may include added perks (like discounts for fitness clubs) and benefits (like wellness programs to help you feel your best). But do you have to have it?
The short answer is “no.” As of Jan. 1, 2019, having health insurance is not mandatory at the federal level. But there are exceptions depending on the state you live in.
If you’ve moved to a new state or are wondering about your individual or family health insurance options, here's what you should know about health insurance requirements.
The Affordable Care Act’s impact on health insurance requirements
After the Affordable Care Act (commonly known as Obamacare) was passed in 2010, it made health insurance more accessible for people who can’t afford health insurance and don’t qualify for Medicaid. It also required all eligible Americans to have health coverage. If you went without health insurance for more than two months back-to-back, you would receive a tax penalty. This requirement was known as the individual mandate.
But in 2017, Congress passed the Tax Cuts and Jobs Act. While having health insurance was still required, the penalty was reduced to zero dollars. This took effect in 2019.
So is the individual mandate gone?
Yes and no. The federal individual mandate that required people to buy health insurance is still on the books, but the tax penalty for failing to do so is zero. But it is no longer illegal to not have health insurance.
Are there penalties for not having health insurance?
There are no federal laws that impose a penalty or fine for not having health insurance. But there are some states, and one district, that have individual health insurance mandates.
If you live in one of these states, you need health insurance coverage:
- California
- Massachusetts
- New Jersey
- Rhode Island
- Vermont
- Washington D.C.
Qualifying plans, penalties and exemptions vary by state, so it is important to review the requirements of your state’s system.
The advantages of health insurance and how it keeps you protected
Although the legal requirements around having health insurance have ebbed and flowed over the years, one thing remains constant: your health is one of your most valued assets. And a good health insurance plan can protect not only your health but your financial future. Below are some of the benefits that can come with your coverage. You might find something you hadn’t considered before.
No-cost preventive care
If your health is your most valued asset, preventive health care is the stuff you do (before you get sick) to stay healthy and protect that investment. It helps you identify health problems like high blood pressure, diabetes and certain cancers earlier, when they’re easier to treat. And, as a result, can lower your health care costs. A lot of preventive services are folded into what you already pay for your health insurance – so you won’t pay an extra cent for it.
A network of qualified clinicians you can see for a discount
When you buy things in bulk, like paper towels, the cost per roll is less expensive than when you buy them individually. The same idea applies for health care. Health insurance plans like HealthPartners represent hundreds of thousands of members and can negotiate more affordable prices on your behalf. So, when our plan members get in-network care they know they can count on affordable, quality care from qualified clinicians with a variety of specialties.
Value-added perks
HealthPartners members enjoy special discounts, perks and benefits that come with their health plan, including no-cost well-being programs, advice for better health, fitness club discounts, travel assistance and more.
Protection in case of an emergency
An accident, unexpected illness or medical emergency can happen any time, even if you are in good health. And an ambulance ride or hospital visit can become a big expense if you’re uninsured. Having health insurance can give you peace of mind, help you avoid medical debt and protect your financial future.
How can insurance protect you from financial loss?
When someone accidentally bangs up your bumper at a stop sign, car insurance helps cover the cost so you don’t have to take on the full financial burden yourself. The same is true for health insurance. Whether it’s something planned (like the birth of a child) or something unexpected (like a serious accident or illness), your health plan makes health care more affordable and protects you from catastrophic financial loss.
Have more questions about your individual health insurance options?
Our experts will help you find a health plan you’re confident in – no matter your situation.