Individuals who are exempt from the coverage requirements of the Affordable Care Act

United States citizens are required to carry minimum essential health insurance coverage beginning January 1st 2014. This is also commonly referred to as the ‘individual mandate’ and some people are exempt from this individual mandate including:

• Members of recognized religious sects that are exempt from self-employment tax.

• Members of health care sharing ministries.

• Individuals who are not U.S. citizens or nationals who are nonresident aliens or are present in the U.S. illegally.

• Incarcerated individuals, other than those who are incarcerated after dispositions of charges. If the charges are pending, this exemption doesn’t apply.

• Native Americans.

• Individuals with short coverage gaps – generally less than 3 months.

• Individuals whose household income is below the threshold for having to file an income tax return. Note that household income generally includes the income of all dependents claimed by the taxpayer. It’s possible to have no filing requirement, but not be exempt if the household income is over the threshold.

• Individuals who can’t afford coverage based on expected contribution being higher than 8% of household income.

• Individuals with a hardship exemption certificate based on facts and circumstances when all the other exceptions do not apply as determined by the state marketplace, not the IRS.

For more information on determining if you qualify to be exempted from the individual mandate, see IRC §5000A.

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