Massachusetts requires most residents age 18 and older to maintain health insurance that meets the state's Minimum Creditable Coverage (MCC) requirements. If you did not have qualifying coverage during part or all of the year, you may qualify for an affordability exemption if health insurance was not considered affordable based on your income and available coverage options.
Program Entry
Massachusetts Return → Health Care Information (Schedule HC)
What Does "Affordable" Mean?
For Schedule HC purposes, Massachusetts considers whether qualifying health insurance was reasonably available based on the taxpayer's income and circumstances.
Affordability is determined by reviewing the cost of available health insurance compared to the taxpayer's income.
Massachusetts considers:
- Employer-sponsored health insurance
- Government-subsidized health insurance
- Private health insurance
If available coverage exceeds the affordability standards established by Massachusetts, the taxpayer may qualify for an affordability exemption from the health insurance penalty.
You can access the affordability worksheet here.
Types of Health Insurance Considered
Employer-Sponsored Health Insurance
Health insurance offered through an employer.
The affordability calculation considers whether the coverage offered by the employer was affordable to the taxpayer.
Government-Subsidized Health Insurance
Health insurance programs that reduce the cost of coverage for eligible individuals.
Examples may include:
- ConnectorCare plans
- Other subsidized plans available through the Massachusetts Health Connector
Private Health Insurance
Health insurance purchased directly from an insurance company or through the Massachusetts Health Connector without employer sponsorship.
Massachusetts considers whether this coverage was available and affordable based on the taxpayer's income.
The Following Questions May Be Asked
Did Your Employer Offer Affordable Health Insurance?
If Your Employer Did Not Offer Affordable Health Insurance, Were You Eligible for Government-Subsidized Health Insurance?
Were You Able to Afford Private Health Insurance?
Notes
- An affordability exemption does not automatically apply simply because a taxpayer did not have health insurance.
- Massachusetts reviews income and available coverage options when determining affordability.
- Taxpayers may qualify for an affordability exemption even if they were uninsured for part of the year.
- Affordability is only one of several exemptions that may be available on Schedule HC.
- A taxpayer who qualifies for an affordability exemption may not be subject to a Schedule HC penalty for the applicable months.