A Guide to Health Insurance Hardship Exemptions

According to the Affordable Care Act, most United States citizens must purchase health insurance or be penalized with a fine. However, certain hardship exemptions exist and can eliminate the fine for qualifying individuals.

How to Qualify for a Hardship Exemption

Three basic qualifications can exempt you from purchasing health insurance. They include: 

1. A sudden increase in living expenses that makes purchasing insurance impossible. 
2. Purchasing health insurance would deprive you of necessities like food, shelter or clothing. 
3. Another legitimate circumstance that prevents you from obtaining health insurance.

Additionally, you may qualify for an exemption if you meet one of these criteria. 

  • You recently experienced a disaster like a fire or flood that substantially damaged your home.
  • You are a recent domestic violence victim.
  • Your close family member recently died.
  • You care for an ill, disabled or aging family member and face an increase in living expenses.
  • You've filed for bankruptcy within the past six months.
  • You have incurred significant medical expense debt in the past 24 months.
  • You've received a shut-off notice from a utility company.
  • You're facing eviction or foreclosure.
  • You've been evicted from your home within the last six months.
  • You're homeless.
  • Your state does not offer expended Medicaid coverage so you are ineligible for Medicaid.
  • You win an appeal for an exemption and become exempt from paying the fine for the months in which you did not have coverage. 

How To Get the Hardship Exemption

To qualify for a hardship exemption, fill out the application on your state's health insurance exchange. Be prepared to provide proof of the incident that prompts the hardship exemption. It must be legitimate and have happened fairly recently. 

You may also contact your health insurance agent for details. He or she can walk you through the process and discuss alternatives like catastrophic health insurance. It covers major medical and typically includes low premiums that may be affordable despite your situation. 

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