QUESTION

Are there exemptions to the penalty? What are they?

Individuals with no coverage | Individual Responsibility Requirement (Individual Mandate)
ANSWER

Yes. You may be eligible for an exemption if any of the following apply to you:

  • Coverage is considered unaffordable because the cost of an employer-sponsored plan or lowest cost bronze plan through the marketplace is 8.05 percent or more of actual household income (as computed on a tax return) or projected household income in 2018. For 2017, that threshold was 8.16 percent of household income.
  • Coverage is considered unaffordable because the combined cost of employer-sponsored coverage for two or more family members is 8.05 percent or more of actual household income in 2018. For 2017, that threshold was 8.16 percent.
  • Are not a U.S. citizen, a U.S. national, or a resident alien lawfully present in the U.S.
  • Are a U.S. citizen or resident living abroad*
  • Had a gap in coverage for less than three consecutive months during the year
  • Participate in a recognized health care sharing ministry or are a member of a recognized religious sect with objections to health insurance
  • Are a member of a federally recognized Indian tribe or eligible for services through an Indian Health Care Provider
  • Are incarcerated
  • Won’t file a tax return because your income is below the tax filing threshold
  • You were determined ineligible for Medicaid solely because the state you resided in did not expand Medicaid
  • Your household income is below 138% of FPL and at any time during the year, you were a resident of a state that did not expand Medicaid
  • Are engaged in service through the AmeriCorps State and National, VISTA or NCCC program and are covered by short-term duration coverage or self-funded coverage provided under these programs
  • Received pregnancy-only Medicaid coverage, coverage through enrollment of an unborn child in CHIP, or Medicaid medically needy coverage with limited benefits that is not considered minimum essential coverage
  • Experienced a hardship making it difficult to purchase insurance (e.g., homelessness, eviction, foreclosure, death of a close family member, domestic violence, and unpaid medical bills). (26 U.S.C. § 5000A (e)); 45 C.F.R. § 155.605; IRS, Individual Shared Responsibility Provision-Exemptions: Claiming or Reporting; HealthCare.gov, Hardship exemptions, forms & how to apply; 81 Fed. Reg. 94058, Dec. 22, 2016).

*additional requirements apply, listed here.

Individuals with no coverage
Individuals with coverage
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