Pennsylvania Obamacare Coverage Rules 2020

Learn whether you must have health coverage under the Affordable Care Act (Obamacare) in Pennsylvania.
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Do I Have to Get Health Insurance in Pennsylvania?


Technically, the Affordable Care Act -- aka Obamacare -- still says that you must have health insurance. Practically, however, the tax penalty for going without health insurance has been "zeroed out." That means you'll still have to report your coverage status on your tax return, but you won't have to pay a penalty if you aren't covered.

A handful of states have passed their own health insurance requirements, but as we approach open enrollment for 2020 health plans, Pennsylvania is not one of them.

If you're interested -- or if the tax penalty comes back -- the Affordable Care Act requires that you have "minimum essential coverage" (MEC).

What Qualifies as Minimum Essential Coverage?

If you have any of the following types of health coverage, you won’t have to pay a penalty:

  • an individual insurance plan, whether purchased on your own or through $EXCHANGE, the exchange serving Pennsylvania
  • a plan (including COBRA or a retiree plan) provided by your employer
  • Medicare, Medicaid, or coverage under the Children’s Health Insurance Program (CHIP) 
  • TRICARE (coverage from the U.S. military)
  • coverage under a veterans health care program 
  • coverage through the Peace Corps, or
  • any other type of coverage cleared as MEC by the Department of Health and Human Services.

If you aren’t sure whether your current plan qualifies, talk to the plan provider.

What Doesn’t Qualify as Minimum Essential Coverage?

Some types of health plans don’t meet the requirements for coverage under Obamacare. These include vision insurance, dental insurance, workers’ compensation, coverage that is limited to a specific condition, and plans that offer only discounted medical services.

Learn More

To find out how to get covered, see How to Sign Up for Obamacare in Pennsylvania.

For information about costs, see How Much Does Obamacare Cost in Pennsylvania?

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