QUESTION

I can’t afford to continue my health insurance premiums because of hurricane/wildfire related expenses. Do I qualify for an exemption or will I have to pay a penalty for being uninsured?

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

The marketplace offers a hardship exemption for floods or disasters causing substantial damage to your property and keeping you from getting health insurance. This exemption can apply to your entire tax household, and to disasters you experienced in the last three years. To qualify for the exemption, you must fill out the hardship exemption application, available here, and provide a copy of a “police record, insurance claim or other document including a news source” about the event, and mail the application and documents to the following address:

            Health Insurance Marketplace – Exemption Processing

            465 Industrial Blvd.

            London, KY 40741

Note that this exemption is prospective, meaning you have to apply for the exemption now and be approved to be able to claim the exemption when you file your 2017 taxes. You can also request this exemption for 2018 coverage.

If you receive a hardship exemption, you may be eligible to purchase catastrophic coverage, which may be less expensive than a marketplace plan. You may want to consider this coverage to protect yourself financially if you have an unexpected illness or injury. This type of coverage will provide for coverage of emergency or catastrophic health events, but note that catastrophic health plans have much higher out-of-pocket costs like deductibles when you want to use your coverage. You also cannot use any federal premium tax credits to purchase a catastrophic plan. (26 U.S.C. § 5000A (e)(5); 45 C.F.R. § 155.605; HealthCare.gov, Hardship exemptions, forms & how to apply).

Individuals with no coverage
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