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How do I apply for an exemption?

For some types of exemptions, you must apply through the health insurance Marketplace; for other types, you must apply when you file your taxes; some types of exemptions can be claimed either way.

The religious conscience exemption and most hardship exemptions are available only by going to a health insurance Marketplace and applying for an exemption certificate.  In the federal Marketplace, you cannot apply for an exemption online.  Instead, you can download a paper application for an exemption from healthcare.gov, fill it out and mail it in.  You will receive a response by mail and, if the exemption is approved, it will include an exemption certificate number.  Save this document, you will need to include the exemption certificate number on IRS Form 8965, which you will need to submit with your tax return when you file your federal income taxes.  If you need help applying for an exemption, you can contact the Marketplace call center or a Navigator or other in-person assister.  Your Marketplace website has a list of Navigators and other assisters.

The exemptions for unaffordable coverage, members of Indian tribes, members of health care sharing ministries, and individuals who are incarcerated are available either by going to a Marketplace and applying for an exemption certificate or by claiming the exemption as part of filing a federal income tax return.

The hardship exemption for persons who live in states that have not expanded Medicaid eligibility and who have income below 138% of the federal poverty level can also be claimed as part of filing a federal income tax return.

The exemptions for short coverage gaps, certain hardships and individuals who are not lawfully present in the United States can be claimed only as part of filing a federal income tax return. You will need to file a return and include with it Form 8965.  If you already received an exemption from the Marketplace, you will include the Marketplace exemption certificate number on this form.  Otherwise, instructions for this form will explain the steps you must take and information you must enter on your federal tax return so that you won’t owe a tax penalty.

The exemption for having income under the federal income tax return filing threshold is available automatically. No special action is needed.  However, if you are filing a tax return anyway (for example, to have refunded taxes that were withheld during the year), you should include Form 8965 with your tax return and check the special box indicating that your income is below the tax filing threshold.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.