Veterans and the Affordable Care Act



At Gardner and Billing CPAs, PLLC, we’ve had clients ask if they are exempt from the insurance requirements of the Affordable Care Act if they are veterans. The following is taken directly from the Veterans Administration website.


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What happens if I do not have health coverage?
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 2014. 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 2014 federal income tax return, which most people will file in the spring of 2015.

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:

$95 or 1% of your taxable income in 2014
$325 or 2% of your taxable income in 2015
$695 or 2.5% of your taxable income in 2016

Exemptions from the fee will be granted under certain circumstances. For more information on these exemptions, visit www.healthcare.gov.

Will VA notify the IRS of health care coverage provided to each Veteran and eligible beneficiary?
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.

If I’m enrolled in a VA health care program, do I meet the requirement for health care coverage?
Yes. If you are enrolled in any of VA’s programs below, you have coverage under the standards of the health care law:

Veteran’s health care program
Civilian Health and Medical program (CHAMPVA)
Spina bifida health care program

What are the benefits of enrollment in VA health care?
Enrollment in VA health care means you have:
·         Medical care rated among the best in the U.S.
·         Immediate benefits of health care coverage. Veterans may apply for VA health care enrollment at any time.
·         No enrollment fee, monthly premiums, or deductibles. Most Veterans have no out-of-pocket costs. Some Veterans may have to pay small copayments for health care or prescription drugs.
·         More than 1,700 places available to get your care. This means your coverage can go with you if you travel or move.
·         Met the new requirement to have health care coverage that meets the minimum standard.
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In summary, if you are a veteran and are enrolled for health insurance coverage under the VA or the Health Insurance Marketplace, you meet the insurance requirements of the Affordable Care Act.  If you do not have insurance under the VA health care system and do not have qualifying medical insurance, unless given an exemption, you will be charged a fee beginning on your 2014 federal income tax return.

The bottom line is, veterans are not exempt from the Affordable Care Act insurance requirements.

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