Choosing not to buy health insurance as required by Obamacare will result in IRS penalties withheld when you file your income tax returns. But you will still get billed by your doctor, the ER and the hospital – which could affect your credit rating, and in the case of an expensive emergency hospital admission put you into enormous long term debt if not bankruptcy.

The NPR published FAQs on “Understanding The Health Insurance Mandate And Penalties For Going Uninsured.” For example:

“Do I have to carry health insurance? Yes, just about everyone is required to have insurance as of Jan. 1, 2014, or else they’ll be liable for a tax penalty. That coverage can be supplied through your job (including COBRA or a retirement plan), public programs such as Medicare, Medicaid or the VA, or an individual policy that you purchase.

Can I go to jail if I don’t have health insurance? No, you can’t go to jail for not paying the penalty; the government can’t even garnish your wages. The most the IRS can do is withhold your tax refund.

If I opt to pay the tax penalty, am I covered with insurance? No. Paying the tax penalty does not buy you anything. If you decide to go that route, you do not have insurance. You can still see a doctor or go to a hospital, but you’ll have to pay all the bills.

What if I don’t have health insurance and I get sick or have to go to the emergency room? If you don’t have insurance, you’ll get a bill, just as it’s always been. If you can’t pay, the hospital or other health care provider will still try to collect from you, although there are some provisions of the law aimed at discouraging some of the most aggressive collection tactics that have been used in the past. If they don’t collect, the health care provider would have to eat the cost. That’s why hospitals were so anxious to have most people covered by insurance, so they could stop having to provide so much free care to people who couldn’t pay.

Can I wait until I get sick to sign up for insurance? No. You can’t just sign up when you’re sick and facing big medical bills. Otherwise that’s what everyone would do. The exchanges under the Affordable Care Act have been designed pretty much the same way most employer insurance plans are: There’s an open season every year when you can buy or change plans, and that’s generally the only time you can buy or change plans. This year’s open season is a lengthy one — it runs from Oct. 1 to March 31, 2014. In future years it will begin in October and end in December of each year.”

Click here to read the full NPR article “FAQ: Understanding The Health Insurance Mandate And Penalties For Going Uninsured.”

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Doctor, Did You Wash Your Hands? ™ provides information to consumers on understanding, managing and navigating health care options.

Jonathan M. Metsch, Dr.P.H., is Clinical Professor, Preventive Medicine, Icahn School of Medicine at Mount Sinai; and Adjunct Professor, Baruch College ( C.U.N.Y.), Rutgers School of Public Health, and Rutgers School of Public Affairs and Administration.

This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.

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