But not everyone who wants to “opt out” of coverage can. There are very specific circumstances that qualify you for an exemption.
Qualifying and applying for an exemptionYou could qualify for an exemption from the individual mandate to have health coverage if:
- You aren’t required to file a tax return because your income is too low
- Your lack of insurance coverage was for only three months or less
- The lowest-price health care coverage amounts to more than 8% of your income
- You are part of a Native American tribe
- You are in the U.S. illegally
- You are a member of a health care sharing ministry
- Your religion objects to insurance
- You are incarcerated
- You qualify for a hardship exemption
Enter your ZIP code to see plans and prices. All plans qualify for discounted prices under the Affordable Care Act.
Call Mike to find out if you qualify for a penalty exemption.
Applying for an exemption does take some effort. The necessary application form depends on the exemption you are hoping to qualify under.
Some exemptions, like being unaffordable, can be claimed when you file your taxes. Others, like being a member of a religion that objects to insurance, require you to fill out an application form. These forms and related instructions can be found on the Healthcare.govwebsite, or through helpful online tools like the Turbo Tax Exemption Check.
Look here for more information on how Obamacare will affect your taxes.
If your gap in coverage does not exceed three months, if you are not in the U.S. lawfully, or if your income is low enough that you are not required to file an income tax return, you do not have to apply for or claim your exemption.
Qualifying and applying for a hardship exemptionFinancial problems can make it difficult to pay the bills, let alone take on new expenses like health insurance. A hardship exemption is tied to an event or obstacle that may have made the health insurance requirement particularly difficult.
You may qualify for a hardship exemption if:
- You faced eviction or foreclosure in the past six months
- You filed for bankruptcy in the past six months
- You were homeless
- A utility company delivered a shut-off notice
- A flood, fire or other disaster caused substantial property damage
- You are a recent victim of domestic violence
- You were ineligible for Medicaid because your state failed to expand Medicaid
- Your health insurance coverage was cancelled and the plans offered in the Marketplace are unaffordable
- You had significant and unexpected increases in expenses while caring for an ill, disabled or elderly family member
- A close family member recently died
- Following an appeals decision, you are now eligible for lower-cost health insurance coverage, but you may have gone without it while appealing
- Another person is required to provide medical support to your child, making you not responsible for the child’s penalty
- You encountered “other hardships” in trying to get health coverage