FAQ for Individuals and Families

Requirements

  • Does everyone have to purchase health insurance?

    Yes. All U.S. citizens, legal residents and lawfully present individuals are required to obtain health insurance coverage. Many will be covered by an employer plan, some will qualify for health programs and others will purchase it themselves.

  • What happens if I don’t buy coverage?

    You will owe a tax penalty. The penalty will increase over time:

    • In 2014, it will be the greater of $95 per adult or 1% of taxable income (up to a maximum of $285 per family).
    • In 2015, it will be the greater of $325 per adult or 2% of taxable income (up to a maximum of $975 per family).
    • In 2016, it will be the greater of $695 per adult or 2.5% of taxable income (up to a maximum of $2,085).
    • After 2016, the tax penalty increases annually based on a cost-of-living adjustment.
    • A person will only pay one-twelfth of the total annual penalty for each month without coverage.
    • The penalty for a child is half that of an adult.
    • A maximum penalty would be calculated based on premiums for plans offered through MNsure.

    It's important to remember that even if you pay the penalty you still won't have any health insurance coverage, and are responsible for 100% of the cost of your medical care.

  • Are there any exceptions to the Individual Mandate?

    Yes. Exemptions are available for:

    • Individuals and families below a certain income level
    • Individuals who cannot afford the coverage that is available
    • Individuals who have suffered a hardship, including eviction, bankruptcy or domestic violence
    • Individuals who have been uninsured for less than three months
    • Members of a federally-recognized tribe
    • Members of a religious group that objects to health coverage
    • Members of a recognized health care sharing ministry
    • Individuals who are incarcerated
  • How do I apply for an exemption from the individual mandate?

    See the instructions on how to apply for an exemption from the individual mandate.

  • I am young and healthy. Why should I buy health insurance?

    Accidents or sickness can happen to anybody. The average cost for a broken arm using hospital emergency services in Minnesota is $2,500. Plus, you are required to do so by law.

Cost

How MNsure works

 

Minnesota Comprehensive Health Association (MCHA)

  • I am currently enrolled in coverage through the Minnesota Comprehensive Health Association (MCHA) and am losing my coverage on December 31, 2014. Can I enroll in a qualified health plan (QHP) through MNsure without a gap in coverage?

    Yes, current MCHA enrollees who are losing their coverage at the end of 2014 should apply online through MNsure for coverage. Applicants can chose whether or not they wish to apply for financial help. Applicants who are eligible for QHP can enroll in coverage that begins January 1, 2015. 

    In order to avoid a gap in coverage, we strongly encourage you to complete your online application through MNsure and select a plan between November 15 and December 15. You do not need to report your 2014 MCHA coverage on your application for 2015 coverage. You must pay your first premium to the carrier by the due date provided on the carrier’s invoice in order to have your coverage go into effect.

  • What if I select a plan through MNsure after December 15?

    If you apply and select a plan between December 16, 2014 and December 31, 2014 you are still eligible for January 1, 2015 coverage, but the system will not show this. You will need to call the MNsure Contact Center (1-855-366-7873) and report your loss of MCHA coverage. The MNsure Contact Center can assist in manual enrollment for January 1, 2015 coverage. Be prepared to provide a copy of your MCHA closure notice to your carrier to confirm that you are eligible for the January 1, 2015 effective date. 

    You must pay your first premium to your insurance company by the due date provided on the insurance company's invoice in order to have your coverage go into effect.

  • Will I have a gap in coverage if I wait until after my MCHA coverage ends to select a plan through MNsure?

    Yes. 

    If you select a plan between January 1, 2015 and January 31, 2015, you will be eligible for coverage February 1, 2015. If you select a plan between January 16, 2015 and January 31, 2015, you will need to call the MNsure Contact Center and report loss of MCHA coverage on December 31, 2014. The MNsure Contact Center can assist in manual enrollment for February 1, 2015 coverage. Be prepared to provide a copy of your MCHA closure notice to your carrier to confirm that you are eligible for February 1, 2015 coverage. 

    If you select a plan between February 1, 2015 and February 28, 2015, you will be eligible for coverage March 1, 2015. If you select a plan between February 16 and February 28, you will need to call the MNsure Contact Center and report loss of MCHA coverage on December 31, 2014. The MNsure Contact Center can assist in manual enrollment for March 1, 2015 coverage. Be prepared to provide a copy of your MCHA closure notice to your carrier to confirm that you are eligible for March 1, 2015 coverage. 

    March 1, 2015 is the last day you can select a plan to receive coverage for April 1, 2015. A current MCHA enrollee who does not apply for insurance by March 1, 2015 will not be eligible to enroll in coverage until the 2016 open enrollment period, unless you experience another qualifying life event or you qualify for Medical Assistance or MinnesotaCare.

Special Enrollment