Exemptions from the fee for not having health coverage

– from Healthcare.gov

Most people must have qualifying health coverage or pay a fee (also known as the “penalty,” “fine,” “individual shared responsibility payment,” or “individual mandate”). But if you qualify for a health coverage exemption you don’t have to pay the fee.

There are a variety of exemptions, many of which you can claim on your federal tax return. There are also “hardship” exemptions that you must apply for with a paper application.

• See the kinds of health coverage that qualify as “minimum essential coverage” under the health law. If you’re covered by any of these plans, you don’t have to pay the fee or have a health coverage exemption.

Find exemptions that may work for you

Select the button below. We’ll ask you a few questions and show you all health coverage exemptions that may apply to you.

FIND EXEMPTIONS

Health coverage exemptions, forms and instructions

Following is a list of exemptions, including hardship exemptions. For details on each exemption, including forms you need and how to apply, follow the links below.

Income-related exemptions

• The lowest-priced coverage available to you, through either a Marketplace or job-based plan, would cost more than 8% of your household income
• You don’t have to file a tax return because your income is below the level that requires you to file

Health coverage-related exemptions

• You were uninsured for no more than 2 consecutive months of the year
• You were uninsured any number of months before May 2014, but enrolled in a plan starting no later than May 1, 2014
• You lived in a state that didn’t expand its Medicaid program but you would have qualified if it had
• You enrolled a child in the Children’s Health Insurance Program (CHIP) during the 2014 Open Enrollment period and didn’t have coverage for the child earlier in the year
• You were enrolled in a type of health coverage through Medicare or TRICARE that covers only certain limited services
• You declined an offer of a job-based health plan that started in 2013 and ended in 2014
• You had health insurance through AmeriCorps, VISTA, or the National Civilian Community Corps (NCCC)

Group membership exemptions

• You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
• You’re a member of a recognized health care sharing ministry
• You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare

Other exemptions

• You’re incarcerated (serving a term in prison or jail)
• You’re a U.S. citizen living abroad, a certain type of non-citizen, or not lawfully present
• You experienced one of the hardships below

Hardship exemptions and forms

In addition to the exemptions above, you may qualify for a “hardship” exemption. Hardships are life situations that keep you from getting health insurance.

To claim a hardship exemption, you must fill out a paper application and mail it in to the Marketplace. For details and forms, follow the links below.

Hardships that qualify you for exemptions include:

1. You were homeless
2. You were evicted in the past 6 months or were facing eviction or foreclosure
3. You received a shut-off notice from a utility company
4. You recently experienced domestic violence
5. You recently experienced the death of a close family member
6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property
7. You filed for bankruptcy in the last 6 months
8. You had medical expenses you couldn’t pay in the last 24 months that resulted in substantial debt
9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member
10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you don’t have the pay the penalty for the child.
11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace
12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act
13. Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable
14. If you experienced another hardship in obtaining health insurance, use this PDF form to apply for an exemption with the Marketplace.

More details about hardship exemptions