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ProSense

(116,464 posts)
Mon Sep 30, 2013, 08:16 PM Sep 2013

Wow! Healthcare.gov has answers, including exemptions from fee due to hardship.

How do I get an exemption from the fee for not having health coverage?

Starting 2014, most people must have health coverage or pay a fee (the “individual shared responsibility payment”). You can get an exemption in certain cases.

The individual shared responsibility payment

If you can afford health insurance but choose not to buy it, you must pay a fee known as the individual shared responsibility payment.

The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher.

In 2014 the payment for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.

You make the payment when you file your 2014 taxes, which are due in April 2015.

Exemptions from the payment

Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an exemption if:

  • 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 (Learn about the filing limit.)

  • 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, and not awaiting the disposition of charges against you

  • You’re not lawfully present in the U.S.
Hardship exemptions

If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

  1. You were homeless.

  2. You were evicted in the past 6 months or were facing eviction or foreclosure.

  3. You received a shut-off notice from a utility company.

  4. You recently experienced domestic violence.

  5. You recently experienced the death of a close family member.

  6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.

  7. You filed for bankruptcy in the last 6 months.

  8. You had medical expenses you couldn’t pay in the last 24 months.

  9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.

  10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.

  11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.

  12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.
How to apply for an exemption

If you are applying for an exemption based on: coverage being unaffordable; membership in a health care sharing ministry; membership in a federally-recognized tribe; or being incarcerated:


- more -

https://www.healthcare.gov/exemptions/

Much more information:

All Topics
https://www.healthcare.gov/all-topics/

15 replies = new reply since forum marked as read
Highlight: NoneDon't highlight anything 5 newestHighlight 5 most recent replies
Wow! Healthcare.gov has answers, including exemptions from fee due to hardship. (Original Post) ProSense Sep 2013 OP
K&R BumRushDaShow Sep 2013 #1
The repubs will have shutdown the government for nothing. Turbineguy Sep 2013 #2
This one is really important for all the GOP states with asshole governors nobodyspecial Sep 2013 #3
Exactly! ProSense Sep 2013 #8
That's exactly the position my family and I are in. Brewinblue Oct 2013 #14
Well, I certain that the GOP will tell them nobodyspecial Oct 2013 #15
I'm very impressed w/ the site. It's easy to navigate and find answers. n/t Triana Sep 2013 #4
It really is. Check this out ProSense Sep 2013 #5
Marvelous! Triana Sep 2013 #6
Kick! n/t ProSense Sep 2013 #7
Kick! n/t ProSense Oct 2013 #9
k&r HappyMe Oct 2013 #10
Some are still pushing distortions. ProSense Oct 2013 #11
Some play golf, others tennis HappyMe Oct 2013 #12
LOL! ProSense Oct 2013 #13

Turbineguy

(37,332 posts)
2. The repubs will have shutdown the government for nothing.
Mon Sep 30, 2013, 08:30 PM
Sep 2013

"I think that this situation absolutely requires a really futile and stupid gesture be done on somebody's part!"

nobodyspecial

(2,286 posts)
3. This one is really important for all the GOP states with asshole governors
Mon Sep 30, 2013, 08:59 PM
Sep 2013

"You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act."

If you would have been eligible Medicaid expansion, you will NOT get a subsidy, which means you can't the premiums and will remain uninsured. However, you make too much or won't pass the assets test for regular Medicaid. Basically, you get royally screwed. No wonder they want to delay this. A LOT of people are going to be pissed when they see friends and neighbors get insurance and they can't.

Brewinblue

(392 posts)
14. That's exactly the position my family and I are in.
Wed Oct 2, 2013, 12:15 PM
Oct 2013

It's the fault of my POS red-state governor and legislature, don't get me wrong. But it is equally the fault of the PPACA itself, which is a POS bit of compromise legislation. This will piss a lot of people off, but who will they blame?

ProSense

(116,464 posts)
5. It really is. Check this out
Mon Sep 30, 2013, 09:18 PM
Sep 2013

Under "What is the Marketplace in my state? "

California

Health Insurance Marketplace in California

If you live in California, Covered California is the Health Insurance Marketplace to serve you. Instead of HealthCare.gov, you’ll use the Covered California website to apply for coverage, compare plans, and enroll. You can apply as early as October 1, 2013. Visit Covered California now to learn more.


New Jersey

Health Insurance Marketplace in New Jersey

If you live in New Jersey, you’ll use this website, HealthCare.gov, to apply for coverage, compare plans, and enroll. Specific plans and prices will be available on October 1, 2013, when Marketplace open enrollment begins. Coverage can start as soon as January 1, 2014.


Texas

Health Insurance Marketplace in Texas

If you live in Texas, you’ll use this website, HealthCare.gov, to apply for coverage, compare plans, and enroll. Specific plans and prices will be available on October 1, 2013, when Marketplace open enrollment begins. Coverage can start as soon as January 1, 2014.


Vermont

Health Insurance Marketplace in Vermont

If you live in Vermont, Vermont Health Connect is the Health Insurance Marketplace to serve you. Instead of HealthCare.gov, you’ll use the Vermont Health Connect website to apply for coverage, compare plans, and enroll. You can apply as early as October 1, 2013. Visit Vermont Health Connect now to learn more.


Under "What is the Health Insurance Marketplace?"

Apply online, by mail, or in-person

You can apply for Marketplace coverage three ways: online, by mail, or in-person with the help of a Navigator or other qualified helper. Telephone help and online chat are available 24/7 to help you complete your application. Downloadable and paper applications will be available October 1.

Open enrollment starts October 1, 2013. Plans and prices will be available then. Coverage starts as soon as January 1, 2014. Open enrollment ends March 31, 2014.


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