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Qualifying Exemptions from the Requirement to have Health Insurance for 2014

May 7, 2014


Individuals who do not have health insurance for at least nine months in 2014 will owe an additional tax (penalty) when they file their 2014 federal income tax return unless they qualify for an exemption.

The following scenarios may qualify an individual for an exemption:

  • The amount required to pay for the lowest price coverage is more than 8% of the household income
  • Individual does not have to file a tax return because their income is too low
  • Individual is not lawfully present in the U.S.
  • Member of federally recognized Native American tribe
  • Member of religious sect that is recognized by the Social Security Administration as conscientiously opposed to accepting insurance benefits
  • Member of recognized health care sharing ministry
  • Individual is incarcerated

If an individual does not qualify for one of the above exemptions they may qualify for a hardship exemption. Some of the hardship exemptions an individual may qualify for are:

  • Filed for bankruptcy in the last six months
  • Had medical expenses that the individual could not pay in the last 24 months
  • Recently experienced domestic violence
  • Determined ineligible for Medicaid because the individual’s state did not expand eligibility for Medicaid under the Affordable Care Act
  • Experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.

The type of exemption an individual is eligible for can determine how they obtain the exemption. Some exemptions may be obtained only through the Marketplace (Exchange), others only from the IRS, and yet others from either the Exchange or the IRS.

For a list of where and how various exemptions can be obtained, see the ACA - Exemptions page on the IRS website.

For a more complete list of exemptions that can be obtained through an Exchange, see How Can I Qualify for an Exemption? on healthcare.gov.

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PUTTING CUSTOMERS FIRST SINCE 1974