Questions & Answers

How do I qualify for an exemption to the Individual Responsibility requirement?

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

You can request some exemptions when you file your tax return. You'll need to apply for other exemptions, such as the religious objection and most of the hardship exemptions through the Healthcare Marketplace.

You may qualify for an exemption if:

  • You're uninsured for less than 3 months of the year.
  • The lowest-priced health insurance available costs more than 8.05% of your household income.
  • You don't have to file a tax return because your income is too low.
  • You're 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'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.
  • You're incarcerated (either detained or jailed).
  • A member of your tax household was born, adopted, or died.
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 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 could have enrolled in Medicaid, but your state didn't expand the Medicaid program for the Affordable Care Act.
  • You didn't have access to affordable coverage based on your estimated household income.
  • Your employer-sponsored health insurance is unaffordable.
  • You had another hardship.
For further guidance see the Coverage Exemption Table in the Form 8965 instructions.

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