Affordable Care Act Exemptions

According to the Affordable Care Act (ACA), beginning in 2014, individuals and their family members are required to have qualified health insurance (i.e., minimum essential coverage), qualify for an exemption, or make a shared responsibility payment when filing their federal income tax return. If certain criteria are met, individuals and family members will be exempt from the individual mandate and won’t have to obtain coverage or make a shared responsibility payment when filing their tax returns. The following is a list of the exemptions available:

  • You’re uninsured for less than 3 months of the year
  • The lowest-priced coverage available to you would cost more than 8% 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’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), and not being held pending disposition of charges
  • You’re not lawfully present in the U.S.
  • You qualify for a hardship exemption

Certain exemptions including hardship exemptions must be approved by the state’s health care exchange and the taxpayer must receive a certificate number, which is entered on their tax return prior to filing. To obtain the exemption, individuals must first submit an application to the exchange along with the necessary documentation. The process takes at least two weeks, and may take considerably longer if individuals delay their applications and April 15th is closing in.

To avoid delay of your refund and to avoid complications in preparing your return, we encourage you to obtain you exemptions now at: https://www.healthcare.gov/fees-exemptions/

As is generally the case, the rules are evolving and can be complicated.  Please give us a call, we’re here to help.