The Affordable Care Act, also known as the health care law, was created to expand access to affordable health care coverage to all Americans, lower costs, and improve quality and care coordination. Under the health care law, people will:
The Health Insurance Marketplace helps individuals find health coverage. On the Marketplace, some people may be eligible for lower costs on health premiums and out-of-pocket costs based on their income.
You do not have to pay a fee if you have coverage that meets a minimum standard (called “minimum essential coverage”). VA is required by law to notify the IRS of Veterans’ enrollment status in the VA health care system in 2015. Veterans who are not enrolled in the VA health care system and who do not have qualifying medical insurance, unless given an exemption, will be charged a fee beginning on their 2015 federal income tax return, which most people will file in the spring of 2016. The fee is prorated based on the amount of time in the calendar year the Veteran does not have medical insurance that meets minimal essential coverage standards. VA is committed to ensuring Veterans are aware of the opportunities to meet the health care reform law’s minimum essential standards for coverage either through enrollment with VA or through the purchase of insurance offered by the Health Insurance Marketplace. The fee either will be a flat fee or a percentage of your taxable household income, depending on which amount is higher. The fee will be phased in according to the schedule below:
Exemptions from the fee will be granted under certain circumstances. For more information on these exemptions, visit www.healthcare.gov.
Yes. Beginning in 2015, VA will send Veterans and eligible beneficiaries a letter and IRS form 1095B which will provide the details of the health care coverage provided by VA for the previous year. As required by law, VA also will notify the IRS.
Yes. If you are enrolled in any of VA’s programs below, you have coverage under the standards of the health care law:
Enrollment in VA health care means you have:
You may apply in one of three convenient ways: visit www.va.gov/healthbenefits/enroll, call 1-877-222-VETS (8387) or visit your local VA health care facility.
Yes. You can continue to use VA for all your health care needs, or complement your VA care with private health insurance or coverage by other federal health care programs, including Medicare, Medicaid, and TRICARE.
The Marketplace is a way to shop for and purchase private health insurance (for example, health coverage other than VA health care programs) that fits your budget and meets your needs. People who purchase insurance through the Marketplace may be able to lower the costs of health insurance coverage by paying lower monthly premiums.
Since VA care meets the standard for health care coverage, you wouldn’t be eligible for assistance to lower your cost of health insurance premiums if you chose to purchase additional health care coverage outside of VA. However, you may still purchase private health insurance on or off the Marketplace to complement your VA health care coverage.
VA can’t make this determination. If you use the Marketplace, you will find out if you can get lower costs on your monthly premiums for private health insurance plans. Remember, if you are enrolled in a VA health care program, you don’t need to take additional steps to meet the health coverage requirements under the health care law.
Your family members who are not enrolled in a VA health care program should use the Marketplace to get coverage. They may get lower costs on monthly premiums or out-of-pocket costs. They could be eligible for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). For more information, visit www.healthcare.gov.
The Health Insurance Marketplace open enrollment period is November 1, 2015, through January 31, 2016.
Individuals with a qualifying life event can enroll in health coverage or change their coverage outside of the open enrollment period and have it be effective for that coverage year. Qualifying life events include having a baby or getting married. Visit www.healthcare.gov/coverage-outside-open-enrollment to learn more about these qualifying life events and other circumstances for special enrollment.
Yes. However, acceptance for future VA health care coverage will be based on eligibility factors at the time of application, which may result in a denial of health care coverage.
Beginning in 2015, the Affordable Care Act requires most U.S. taxpayers to declare they have minimum essential health coverage on their federal tax form. In December, VA will begin a mailed letter effort to notify all enrollees of their VA health care coverage period in 2015. This information will be reported using IRS Form 1095-B, “Health Coverage,” which the Veteran will then use to complete his or her 2015 income tax forms. Mailings are expected to be completed by the end of January 2016. The law also requires VA to provide this information to the IRS.
Yes. Line 61 on Internal Revenue Service Form 1040, Line 38 on the 1040A and various other entries on IRS income tax forms require taxpayers to self-declare whether they had health care coverage in 2015.
For information on VA health care and the Affordable Care Act, visit VA’s website at www.va.gov/aca, or call 1-877-222-VETS (8387), Monday through Friday from 8 a.m. until 8 p.m. eastern. For information on the Marketplace, visit www.healthcare.gov or call 1-800-318-2596.