Universal Health Care System

ANSWERS

The Massachusetts Health Care Reform Law requires that most residents over 18 who can afford health insurance have coverage for the entire year or face a tax penalty. Penalties accumulate for each month you fail to comply, but a grace period allows coverage lapses of three or fewer consecutive months. You must be enrolled in health insurance plans that meet Minimum Creditable Coverage (MCC) requirements.

 

Whether or not you are required to file a Massachusetts personal income tax return, anyone 18 years or older must obtain and maintain creditable health insurance coverage as long as it is considered affordable under the Massachusetts Health Connector’s schedule. This includes those who are not required to file taxes. This mandate for health care applies to:

Residents of Massachusetts and people who become residents of Massachusetts within the next 63 days Residents who cancel any prior creditable coverage within 63 days must obtain and maintain creditable coverage within the next 63 days.

Minimum Creditable Coverage (MCC) is the minimum level of benefits required in Massachusetts to be considered insured and avoid tax penalties.

These advantages include the following:

Coverage for a wide range of services (e.g., doctor visits, hospital admissions, day surgery, emergency services, mental health, substance abuse, and prescription drug coverage).
Preventive care doctor visits are not subject to a deductible.
Annual deductibles are limited to $2,000 for individuals and $4,000 for families.
An annual maximum on out-of-pocket spending of no more than the annual limit set by the IRS for high deductible health plans for plans with upfront deductibles or co-insurance on core services. Out-of-pocket costs for an individual plan are limited to $8,150 in 2020 and $16,300 for a family plan.
There are no caps on total benefits for a specific illness or a single year.
No policy only covers a set dollar amount per day or stay in the hospital, leaving the patient responsible for all other costs.
A separate prescription drug deductible cannot exceed $250 for an individual or $500 for a family in policies that have one.

Fill in the “No MCC/None” oval in line 3 of the Schedule HC if your plan did not meet the MCC requirements for the entire time the mandate applied to you.

If we determine that you did not have access to affordable insurance that met MCC, you will not be penalized.

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Universal Health Care System