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Attention Medicaid Participants: Eligibility Renewals Restarted April 1, 2023
Rita Landgraf, Secretary
Jill Fredel, Director of Communications
302-255-9047, Pager 302-357-7498
Email: jill.fredel@delaware.gov
Date: February 20, 2015
DHSS-2-2015
NEW CASTLE (Feb. 20, 2015) - The U.S. Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period for certain individuals and families who did not have health coverage in 2014 and are subject to paying a penalty when they file their 2014 taxes.
The special enrollment period will allow residents of Delaware who were unaware or didn't understand the implications of this new requirement to enroll in 2015 health insurance coverage through the federal Health Insurance Marketplace (HealthCare.gov) from March 15 to April 30.
If these consumers do not purchase coverage for 2015 by April 30, they may have to pay a fee when they file their 2015 income taxes next year.
Delawareans who do not qualify for an exemption and who went without health coverage in 2014 will have to pay a fee - $95 per adult or 1 percent of their income, whichever is greater - when they file their taxes this year. The fee increases to $325 per adult or 2 percent of income for 2015.
Individuals who take advantage of the special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015. The special enrollment period is designed to allow such individuals to get covered for the rest of the year and avoid additional fees for 2015.
Those eligible for the special enrollment period live in states that use HealthCare.gov as their enrollment system and:
If a consumer enrolls in coverage before the 15th of the month, their coverage will be effective the first day of the following month.
"I'm glad the federal government is granting this special, limited chance for Delawareans to get covered and avoid additional penalties," said Rita Landgraf, secretary of the state's Department of Health and Social Services. "Despite considerable efforts to make the public aware of the requirement to either have coverage, claim an exemption, or pay a fee, it has become clear that the implications of going uninsured are just now hitting home for some individuals as they prepare their 2014 taxes."
Landgraf reminded consumers that if they go uninsured, they not only face the penalty but are responsible for 100 percent of their health-care expenses.
Consumers can access the special enrollment period by going to HealthCare.gov or the federal call center at 1 (800) 318-2596. Free help from local enrollment specialists is available at ChooseHealthDE.com
This year's tax season is the first time individuals and families are being asked to provide basic information regarding their health coverage on their tax returns. Individuals who could not afford coverage or met other conditions may be eligible for an exemption for 2014. To help consumers who did not have insurance last year determine if they qualify for an exemption, the federal Marketplace has launched a health coverage tax exemption tool on HealthCare.gov and CuidadodeSalud.gov.
About three-quarters of taxpayers will need only to check a box when they file their taxes to indicate that they had health coverage in 2014 through their employer, Medicare, Medicaid, veterans care or other qualified health coverage that qualifies as "minimum essential coverage."
The remaining taxpayers will take different steps. The federal government expects that 10 percent to 20 percent of taxpayers who were uninsured for all or part of 2014 will qualify for an exemption from the requirement to have coverage. A much smaller fraction of taxpayers, an estimated 2 percent to 4 percent, will pay a fee.
If consumers have questions about their taxes, need to download forms, or want to learn more about the fee for not having insurance, they can find information and resources at HealthCare.govTaxes or IRS.gov Consumers can also call the Marketplace Call Center at 1-800-318-2596. Consumers who need help filing their taxes can visit IRS.gov/VITA or IRS.gov/freefile
Is your Form 1095-A correct?
CMS also said today that 800,000 consumers received an incorrect Form 1095-A in the mail, although officials did not offer a state-by-state breakdown. Form 1095-A is an important tax statement from the Health Insurance Marketplace that is needed to fill out 2014 federal income tax returns.
If you enrolled in a plan through the Marketplace for 2014, you should have received a Form 1095-A by this month. Most people received a correct form. If you were mailed the wrong form, it does not mean your tax credit was incorrect; this is purely an error in what was printed on the form.
You will get a call, letter and email from the federal Marketplace in the next few days and a message in your Marketplace account on HealthCare.gov. Once you log in, you should select your 2014 application and then select "Tax forms." You will see a message letting you know if your 1095-A form is being corrected. This is also where you will find your corrected form when it is completed. When the corrected form is ready, you will get a message in your Marketplace account. All corrected forms should be available by early March.
If your form was incorrect, please wait until you get your corrected Form 1095-A to file your 2014 Federal income taxes. If you can't wait, and want to find the correct information that applied to your household in 2014, you have two options:
Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.