Treasury Releases Affordable Care Act Exemption Fact Sheets

The U.S. Treasury is providing information about the exemptions from the requirement to have health coverage if individuals could not afford coverage or met other conditions, and about how to claim an exemption during tax filing.

The following fact sheets on exemptions are also available from the Department of Health and Human Services:

 

For additional information, see this fact sheet: Health Coverage and Federal Income Taxes

FACT SHEET: Claiming a Health Coverage Exemption

The Affordable Care Act is making health insurance more affordable, helping more people get covered, and improving the quality of care that millions of Americans receive.  Under the Affordable Care Act, individuals who can afford to are now required by law to have health coverage.  If you can afford health coverage but chose not to buy it, you may have to pay a fee.

However, those who can’t afford coverage or meet other conditions may qualify for an exemption.  It is important for individuals to know that exemptions are available and to understand the steps they need to take to request one.

If you qualify, receiving an exemption is simple and easy, and means you won’t have to pay a fee.  There are a variety of exemptions available.  You can claim most exemptions on your tax return, but some exemptions are only available through the Health Insurance Marketplace. See the chart available here for more information on the types of exemptions available and how to apply. An online tool is available on HealthCare.gov to help consumers who did not have health coverage last year understand if they might qualify for an exemption.

 

Who’s exempt from having health coverage?

You may be exempt from the requirement to have health coverage if:

The cost of coverage would have been too high as a share of your income (Coverage Considered Unaffordable):If you would have had to pay more than eight percent of your household income for health coverage.  For more information see Exemption information if you couldn’t afford health coverage.

You were uninsured for only a short period of time (Short Coverage Gap): If you were uninsured for one period of less than three consecutive months during the year.  For more information see Exemption information if you had a short gap in health coverage.

Your state did not expand Medicaid (Resident of a state that did not expand Medicaid): If you live in a state that did not expand Medicaid and you have low household income.  For more information, see: Exemption information if your state didn’t expand Medicaid.

You experienced a hardship (General Hardship): If you experienced a hardship that prevented you from obtaining coverage, such as if you had medical expenses that resulted in substantial debt, if a close family member passed away, or if you experienced domestic violence, among other hardships, you may be eligible for an exemption. If you experienced a hardship, you will have to apply for an exemption through the Marketplace; you cannot qualify for this exemption on your tax return.  For more information, see Exemption information if you experienced a hardship.

You qualify for one of the many other exemptions, such as if you: were unable to renew existing coverage in 2014; were without health coverage at the beginning of 2014 – but enrolled by May 1, 2014; have income below the requirement for filing a tax return; are a member of an Indian Tribe or eligible for coverage through Indian health service; were living abroad; were incarcerated; had a gap in Children’s Health Insurance Program (CHIP) coverage; were covered by limited benefit Medicaid or TRICARE; were offered only a non-calendar year plan by your employer; were a member of a health care sharing ministry; or were a member of certain religious sects. ​

How do I claim an exemption?

Most exemptions for 2014 are now only available on your tax return, and are simple and easy to claim. A few exemptions – including if you experienced a hardship in 2014 – must be claimed through the Marketplace.

  • Tax return: If you qualify, simply select the exemption that fits your situation when filing your taxes.
  • Through the Marketplace: You can apply for an exemption through the Marketplace by filling out the correct form at https://www.healthcare.gov/fees-exemptions/apply-for-exemption/. If you receive an exemption through the Marketplace, you’ll receive an Exemption Certificate Number to include when you file your taxes. If you have applied for an exemption through the Marketplace and are still waiting for a response, you can put “pending” on your tax return where you would normally put your Exemption Certificate Number.

Where can I go for help?

We want to make this process easy. If you have questions about Marketplace exemptions or about your Exemption Certificate Number, visit HealthCare.gov/taxes, or call the Marketplace call center at 1-800-318-2596.

If you have questions about how to apply for an exemption on your tax return, visit the Internal Revenue Service webpage on exemptions, available here.  Most people use software to file their taxes, which is the easiest way to complete your tax return as it guides you through the process and does all the math. Resources are available to help you file your taxes, including free tax filing services if you meet certain income requirements:

 

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