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Health coverage exemptions: Forms & how to apply

Exemption types & forms

To get an exemption to enroll in a
, you need to submit an application. If approved, we'll mail you a letter with an approval number (called an "Exemption Certificate Number (ECN)") to enroll in a Catastrophic health plan.
Notice:
If you're over 30 and want to enroll in a Catastrophic plan, you must apply and get approved for an exemption. (You don't need an exemption if you're under 30.)

Affordability (income-related) exemptions

To qualify: The lowest-priced coverage available to you, through either a Marketplace or job-based plan, costs more than 7.97% of your household income.
You also need to submit copies of documents that show your household income with your application.
If approved, the exemption is only for coverage you get in the future through the end of this year. (You can't use it to get health coverage for months already passed.)
To request an exemption for next year's coverage (January 1-December 31), you must submit your application before January 1.
Get affordability application

Hardship exemptions

To qualify: You or your household had one of these situations in the last 2 years that kept you from getting health insurance:
  • Death of a close family member
  • Disaster (Fire, flood, or other natural or human-caused disaster that caused substantial damage to your property)
  • Evicted, facing eviction, or facing foreclosure
  • Filed for bankruptcy
  • Got a shut-off notice from a utility company
  • Homeless
  • Ineligible for Medicaid because your state didn't expand eligibility for Medicaid under the Affordable Care Act
  • Marketplace appeal decision said you're eligible for enrollment in a Marketplace plan, lower monthly premiums, or
    during a time when you didn't have Marketplace coverage
  • Medical expenses you couldn't pay
  • Medical support for a child (You claim a child as a tax dependent who's been denied coverage for
    or the
    , and another person is required by court order to give medical support to the child.)
  • Unexpected increase in necessary expenses due to caring for an ill, disabled, or aging family member
  • Victim of domestic violence
  • Another hardship that kept you from getting health insurance.
Notice:
Unemployment alone doesn't count as a hardship.
Your hardship had to occur less than 2 years ago. You can apply for an exemption to enroll in a Catastrophic plan for up to 2 years after your hardship ended.
In most cases, you also need to submit copies of documents (or tell us in writing) about your hardship.
To request an exemption for next year's coverage (January 1-December 31), you must submit your application before January 1.
If approved, the exemption is for the rest of the current year or next year.

Examples of hardship timing

Your exemption dates depend on which year you want the exemption. You’ll pick the year on your application.
Example when you pick this year on your application:
Your hardship started 2 years before and ended December of last year. In May of this year, you apply for an exemption to enroll in a Catastrophic plan. In your application, you choose that you want the exemption for this year. Your exemption is approved and it ends December 31 of this year.
Example when you pick next year on your application:
Your hardship started 2 years before and ended August of this year. In November of this year, you apply for an exemption to enroll in a Catastrophic plan. In your application, you choose that you want the exemption for next year. Your exemption is approved and it starts January 1 and ends December 31 of next year.
Get hardship application
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