Instructions For Schedule Hc - Health Care - 2012 printable pdf download

2012 Massachusetts Schedule HC Health Care

Special Section on Minimum Creditable Coverage

What is “Minimum Creditable Coverage” (MCC)?

• Doctor visits for preventive care, without a deductible;

It’s the minimum level of health insurance benefits that adult tax filers need

• A cap on annual deductibles of $2,000 for an individual and $4,000 for a

to be considered insured and avoid tax penalties in Massachusetts.

family;

• For plans with up-front deductibles or co-insurance on core services, an

How do I know if my plan met MCC?

annual maximum on out-of-pocket spending of no more than $5,000 for an

Massachusetts-licensed health insurance companies must put an MCC-

individual and $10,000 for a family;

compliance notice on their plans to indicate if it does or does not meet MCC.

Most do meet the MCC standards. If you received a Form MA 1099-HC

• No caps on total benefits for a particular illness or for a single year;

from your insurer, that form will indicate whether your insurance met MCC

• No policy that covers only a fixed dollar amount per day or stay in the

requirements. For a list of plans that automatically meet MCC, please refer

hospital, with the patient responsible for all other charges;

to the plans listed on this page.

• For policies that have a separate prescription drug deductible, it cannot

What if I did not receive a Form MA 1099-HC from my insurer?

exceed $250 for an individual or $500 for a family;

You can call your insurer or your employer’s human resources department

• All services must be provided to all of those covered (for example, a plan

or benefits administrator for help, if you get health coverage through your

that covers dependents must extend maternity services to them); and

job. If your insurer or your employer is unable to assist you, please refer

• No cap on prescription drug benefits.

to the “Benefits Required Under MCC” section on this page to see if your

policy meets these requirements. If your plan meets all of the requirements,

Other ways of meeting MCC:

you may certify in line 3 of the Schedule HC that you were enrolled in a plan

that met the MCC requirements during that time period.

You automatically meet MCC if you are enrolled in:

• Medicare Part A or B;

What if my plan did not meet MCC for all of 2012?

• Any Commonwealth Care, Commonwealth Care Bridge plan;

If you were enrolled in a plan that did not meet the MCC requirements for all

of 2012, you must fill in the “No MCC/None” oval in line 3 of the Schedule

• Any Commonwealth Choice plan (including Young Adult Plans);

HC and follow the instructions on the Schedule HC. You will not be subject

• MassHealth;

to a penalty if it is determined that you did not have access to affordable

insurance that met MCC. If you had access to affordable insurance that met

• A Student Health Insurance Plan (SHIP) offered in Massachusetts or

MCC but did not purchase it, you are subject to a penalty. However, if you

another state;

are subject to a penalty, you may appeal and claim that the penalty should

• A tribal or Indian Health Service plan;

not apply to you. For more information about the grounds and procedure

for appeals, go to page HC-4. No penalty will be imposed pending the out-

• TRICARE;

come of your appeal.

• The U.S. Veterans Administration Health System;

What if I was enrolled in an MCC plan for only part of the year?

• A health insurance plan offered by the federal government to federal

If you were enrolled in an MCC plan for only part of the year, you should fill

employees or retirees;

in the “Part-Year MCC” oval in line 3 of the Schedule HC and go to line 4.

• Peace Corps, VISTA or AmeriCorps or National Civilian Community Corps

In line 4, only provide the health insurance information for the MCC plan(s)

coverage; or

you were enrolled in. Do not provide health insurance information in line 4

for a plan that did not meet the MCC standards.

• A Pre-Existing Condition Insurance Plan (PCIP).

Note: A federally-qualified High Deductible Health Plan (HDHP) offered

Benefits Required Under MCC

with a Health Savings Account (HSA) or Health Reimbursement Arrange-

For most plans, the 2012 “Minimum Creditable Coverage” standards include:

ment (HRA) may meet MCC if it complies with most of the benefits de-

• Coverage for a comprehensive set of services (for example: doctor visits,

scribed above.

hospital admissions, day surgery, emergency services, mental health and

For more information on MCC requirements, visit the Health Connector’s

substance abuse, and prescription drug coverage);

website at

HC-1

Instructions For Schedule Hc - Health Care - 2012

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