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Exemptions from the Health Coverage Mandate

You may qualify for an exemption from the requirement to maintain health insurance coverage. Available exemptions include:

  • Individuals who are not required to file a tax return because their income is too low. You don't need to ask for an exemption if you're not required to file a federal income tax return because your income is below the filing threshold. If you aren't sure if this applies to you, you may want to apply for an exemption.
  • Individuals who cannot afford the coverage that is available through MNsure
  • Individuals who cannot afford the coverage that is available through their employer
  • Individuals who have suffered a hardship, including eviction, bankruptcy or domestic violence
  • Individuals who have been uninsured for less than three consecutive months
  • Members of a federally recognized tribe or eligible for services through an Indian Health Services provider
  • Members of certain religious groups that object to health coverage
  • Members of a health care sharing ministry
  • Individuals who are incarcerated
  • Citizens living abroad and individuals who are not U.S. citizens, not U.S. nationals, or not lawfully present in the U.S.

An individual age 30 or older wanting to purchase catastrophic coverage must receive a hardship or unaffordable coverage exemption. Individuals under age 30 do not need an exemption to purchase this type of coverage.

How to Apply for an Exemption

Depending on the type of exemption you qualify for, you will need to submit an application to Healthcare.gov or request the exemption from the Internal Revenue Service (IRS) when you file your taxes. (MNsure does not accept applications).

  • Federal Health Insurance Marketplace (Healthcare.gov): Go to HealthCare.gov to determine which exemption to request. Print out, complete and mail the federal Application for Exemption. The completed form and any supporting documents should be mailed to:
    Health Insurance Marketplace - Exemption Processing
    465 Industrial Blvd.
    London, KY 40741
  • IRS: Information for claiming an exemption through the IRS when you file your taxes can be found at www.irs.gov.

MNsure uses the federal Health Insurance Marketplace to process exemption applications. The federal government will notify you if you qualify for an exemption. If you apply to HealthCare.gov and qualify, you will receive an Exemption Certificate Number that you'll need for your federal income tax return you file for the year of the exemption. For questions about the status of your application or your eligibility for an exemption, visit HealthCare.gov, or call the Health Insurance Marketplace Help Center at 1-800-318-2596. TTY users should call 1-855-889-4325. If you have questions about how to get a copy of and where to submit the application form, call the MNsure Contact Center at 1-855-366-7873.

Exemption for Unaffordable Coverage through MNsure

If you are applying for an exemption based on coverage being unaffordable, you have two options.

  1. You can claim this exemption for the months in 2016 when you did not have coverage when you fill out your 2016 federal tax return, which is due in 2017; or
  2. You can claim this exemption for future months by applying for the exemption at HealthCare.gov.

For either of these options you will need some information from MNsure. You need to include anyone in your household who needs the exemption and who does not have access to health coverage through a job, or another person's job (such as a parent). NOTE: If you are applying for an exemption for unaffordable coverage from your employer, you do not need any information from MNsure. You will need to follow the directions on the federal exemption application to submit information about your employer's plan.

1) Exemption for Unaffordable Coverage for Past Months (2016)

You can claim this exemption when you file your taxes using the federal Form 8965. You do not need to complete a MNsure application for insurance to claim this exemption. You will need to use the following information to complete Form 8965:

  • The premium for the lowest cost 2016 bronze plan that would have covered all members of your household seeking an exemption; and
  • The premium for the second lowest cost 2016 silver plan that would have covered all members of your household seeking an exemption.

This information is easy to find using the instructions below or by using this instruction sheet (PDF).

2) Exemption for Unaffordable Coverage for Future Months (2017)

You can apply at HealthCare.gov before the month or months for which you need the exemption. See also the application for marketplace affordability exemption on HealthCare.gov. You should apply before the end of an enrollment period during which you could have purchased the coverage (such as January 31, 2017). You need to complete MNsure's application for insurance with assistance (but do not enroll in a plan) to get this information:

  • The maximum premium tax credit for which your household qualifies. Submit, with your federal application, a copy of MNsure's eligibility summary screen displaying the tax credit amount (press print screen from your computer keyboard). Do not send a copy of your eligibility notice since it does not contain the tax credit amount.
  • The premium for the lowest-cost bronze plan that covers all members of the household seeking the exemption. This information is simple to find by following the steps below or by using this instruction sheet (PDF).

How to Look Up 2016 and 2017 Plan Costs 

  1. Open the Plan Lookup Tool
  2. Click the orange Start button in the lower right of the screen.
  3. Enter your ZIP code:
    • If you need information for filing for an exemption for unaffordable coverage in 2016, then enter your ZIP code for where you lived on January 1, 2016.
    • If you need information for filing for an exemption for unaffordable coverage in 2017, enter your current ZIP code.
    • Enter your household information
  4. Enter the Coverage Start Date:
    • If you need information for filing for an exemption for unaffordable coverage in 2016, then enter the Coverage Start Date as January 1, 2016.
    • If you need information for filing for an exemption for unaffordable coverage in 2017, enter the Coverage Start Date as today's date.
  5. Enter your household information.
    • If you use tobacco, choose "Yes" for Tobacco Use to determine the premium for the lowest cost bronze plan. However, you will need to choose "No" for Tobacco Use to determine the premium for the second lowest cost silver plan. Tobacco use cannot be used in the premium calculation for the second lowest cost silver plan. You will need to enter your household information two separate times in order to search for the correct premium using the correct Tobacco Use status.
  6. Click the Submit button.
  7. On the next screen click the Skip to Plans link in the lower left
  8. You will now be on the plan results page where you can sort by Monthly Premium to find the lowest cost bronze plan and the second lowest cost silver plan available to you. Use the Sort By: drop-down menu to select Monthly Premium. (NOTE: If you are claiming the exemption for unaffordable coverage in 2017, you only need information about the 2017 lowest cost bronze plan. You do not need information about the second lowest cost silver plan.)
  9. After sorting by Monthly Premium you should see the lowest cost bronze plan at the top of the page. Find the second lowest cost silver plan by scrolling down the list.
  10. Print a copy of the plan results page. You may want to a copy of this for your records.

If you need assistance obtaining this information, call the Contact Center at 1-855-366-7873 (1-855-3MNSURE). Please know that MNsure cannot answer tax-related questions.

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