Personal Health care mandate
Beginning January 1, 2020, California residents must either:
- Have qualifying health insurance coverage
- Obtain an exemption from the requirement to have coverage
- Pay a penalty when they file their state tax return
You will begin reporting your health care coverage on your 2020 tax return, which you will file in the spring of 2021.
Health care forms
- Premium Assistance Subsidy (FTB 3849)
- Health Coverage Exemptions and Individual Shared Responsibility Penalty (FTB 3853)
- California Health Insurance Marketplace Statement (FTB 3895)
For more information on Health Care Mandate forms, check out this video: Health Care Mandate Video - Forms for Tax Season
Make sure you have health care coverage
To avoid a penalty, you will need minimum essential coverage (MEC) for each month beginning on January 1, 2020 for:
- Your spouse or domestic partner
- Your dependents
Many people already have qualifying health insurance coverage through:
- Employer-sponsored plans
- Coverage purchased through Covered California or directly from insurers
- Medicare (Part A and C)
- Most Medicaid plans
Visit the California Department of Managed Healthcare to view the types of health coverage that qualify as MEC.
Contact your plan provider to verify if their specific plan meets the MEC requirements.
If you do not have coverage, open enrollment continues through January 31, 2020. Visit Covered California to sign up for health care coverage.
Special enrollment period
Due to the economic impacts from COVID-19, individuals may now enroll in health care coverage during Covered California’s special enrollment period now underway. Eligibility requirements are similar to those in place during the annual open-enrollment period. Visit Covered California or call (800) 300-1506 to get more information.
You may qualify for an exemption to the penalty. Most exemptions may be claimed on your state income tax return while filing.
|Exemptions Claimed on State Tax Return||Exemptions Processed by Covered California|
Visit Covered California for more details.
You can apply for exemptions granted by Covered California starting in January 2020.
If you need help meeting the requirements for health care coverage, the state may provide financial help. Help is available for qualifying individuals and families through Covered California and is based on:
- Household size
This financial help is through the state. You can still receive financial help from the state even if you receive federal financial help through Covered California.
Options for no-and low-cost coverage are also available through the Medi-Cal program.
To find out more about health insurance options and financial help, visit Covered California.
You will have to pay a penalty, the Individual Shared Responsibility Penalty, when you file your state tax return if:
- You did not have health coverage
- You were not eligible for an exemption from coverage for any month of the year
The penalty for no coverage is based on:
- The number of people in your household
- Your California state income
Use our Penalty Estimator tool to estimate the penalty you may owe.
|Household size||If you make less than||You may pay|
|Family of 4 (2 adults, 2 children)||$142,000||$2,250|
The penalty for a dependent child is half of what it would be for an adult, $375.
How to estimate
The penalty will be the higher of either:
- A flat amount, based on the number of people in the tax household, or
- A percentage of the household income
Pay $750 per adult and $375 per child.
Percentage of household income
Pay 2.5% of the amount of gross income that exceeds the filing threshold requirements based on the tax filing status and number of dependents.
Example:A family of 3 with a gross household income of $150,000 that includes:
- 2 parents
- 1 child
Flat amount calculation
$750 per adult, $375 per child: ($750 x 2) + $375 = $1,875
Percentage of household income calculation
2.5% of gross income that exceeds filing threshold: ($150,000 - $49,085 ) x .025) = $2,522.88.
Since the percentage of household income was higher than the flat amount, the penalty amount for this family is $2,522.88.
 $49,085 is the state filing threshold for a married couple, both under 65 years old with one dependent for the 2019 tax year.