Hardships are financial situations and other circumstances that keep you from getting health insurance. If you qualify for a hardship exemption, you don’t have to pay a fee for the months you were uncovered.
- Starting with the 2019 plan year (for which you’ll file taxes by July 15, 2020), the penalty no longer applies. (The fee is sometimes called the “Shared Responsibility Payment” or “mandate.”) If you don’t have coverage during 2019 or later, you don’t need an exemption to avoid the penalty.
- If you are 30 or older and want to buy a Catastrophic health plan, you must apply for a hardship exemption to qualify. Learn about hardship exemptions and Catastrophic plans for 2019 or later.
How to apply for a hardship exemption
- For information on completing an application and submitting documentation for hardship exemption, you may follow the instructions below.
Need a hardship exemption form?
Get instructions for downloading the hardship exemption form, and a link to the form itself.
Following are all hardship exemptions, with links to details, forms, and instructions.
- You were homeless
- You were evicted or were facing eviction or foreclosure
- You received a shut-off notice from a utility company
- You experienced domestic violence
- You experienced the death of a family member
- You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property
- You filed for bankruptcy
- You had medical expenses you couldn’t pay that resulted in substantial debt
- You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member
- You claim a child as a tax dependent who’s been denied coverage for Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case you don’t have to pay the penalty for the child.
- 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
- You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act
- The exemption for "grandfathered" individual insurance plans is no longer available for 2017 and later
- You had another hardship. If you experienced another hardship obtaining health insurance, use this form to describe your hardship and apply for an exemption.
Details about hardship exemptions
- How long hardship exemptions last
Hardship exemptions usually cover the month before the hardship, the months of the hardship, and the month after the hardship.
But in some cases the Marketplace may provide the exemption for additional months, up to a full calendar year.
- For people ineligible for Medicaid only because a state hasn’t expanded Medicaid coverage, the hardship exemption will be granted for the whole calendar year.
- For people eligible for Indian Health Services, the hardship exemption lasts as long as you remain eligible.
- For people under 21 who are eligible for an exemption due to religious conscience, you’ll need to reapply if you remain a member when you turn 21.
- Exemptions if you’re unemployed
- There’s no hardship exemption based only on employment status. But several health coverage exemptions apply to people with no or little income.