Questions & Answers

How do I qualify for an exemption from the CA health insurance mandate?

Exemptions from the Payment
Under certain circumstances, you won't have to make the California individual responsibility payment. This is called an exemption.

You can request most exemptions on your California state income tax return, but there are a few exemptions that must be claimed through Covered California .

You may qualify for an exemption and claim the exemption on your state income tax return if:
  • You are uninsured for less than 3 months of the year.
  • The lowest-priced health insurance available costs more than 8.27% of your household income.
  • You don't have to file a tax return because your income is too low.
  • You are a member of a federally recognized tribe or eligible for services through an Indian Health Services provider.
  • You lived abroad for 330 days of the past year or you are a resident of a foreign country.
  • You are a resident of another state during any month without California minimum essential coverage
  • You are a member of a recognized health care sharing ministry.
  • You are incarcerated (either detained or jailed).
  • A member of your tax household was born, adopted, or died.
  • Certain Medi-Cal (Medicaid) programs that are not minimum essential coverage

You may qualify for, and claim the following exemptions through Covered California :
  • You're a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare.
  • You didn't have access to affordable coverage based on your estimated household income. - Coverage considered unaffordable based on projected income
  • General hardship exemptions listed below:

Hardship Exemptions
Hardship exemptions are usually provided for the month before the hardship, the months of the hardship, and the month after the hardship. However, the Covered California state marketplace may provide the exemption for additional months after the hardship, including up to a full calendar year.

If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a hardship exemption:
  • You were homeless.
  • You were evicted or were facing eviction or foreclosure.
  • You received a shut-off notice from a utility company.
  • You recently experienced domestic violence.
  • You recently experienced the death of a close family member.
  • You experienced a fire, flood, or other disaster that caused substantial damage to your property.
  • You filed for bankruptcy.
  • You had substantial debt from medical expenses you couldn't pay.
  • You experienced unexpected expenses due to caring for an ill, disabled, or aging family member.
  • Your dependent was denied coverage for Medicaid and CHIP, and another person is required to give medical support to the child.
  • You didn't have health insurance while you were appealing eligibility for a Marketplace plan and the appeal was later granted.
  • You were determined to be ineligible for Medi-Cal
  • You had another hardship.

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