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GCNJ: Hardship Exemptions

GCNJ- Hardship Exemption


Did you experience a hardship last year?
You may be eligible for an exemption from the requirement to have health coverage.

The Affordable Care Act is making health insurance more affordable, helping more people get covered, and improving the quality of care that millions of Americans receive. Under the Affordable Care Act, everyone who can afford to is now required by law to have health coverage.

If you can afford health coverage but chose not to buy it, you may have to pay a fee. However, those who can’t afford coverage or meet other conditions may qualify for an exemption. If you qualify, receiving an exemption is simple and easy, and means you won’t have to pay a fee. It is important for individuals to know that exemptions are available and to understand the steps they need to take to request one.

You may be eligible for a Hardship Exemption if:
1. You were homeless.
2. You were evicted in the past six months or were facing eviction or foreclosure.
3. You received a shut-off notice from a utility company.
4. You recently experienced domestic violence.
5. You recently experienced the death of a close family member.
6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
7. You filed for bankruptcy in the last six months.
8. You had medical expenses you couldn’t pay in the last 24 months that resulted in substantial debt.

9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.

10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and Children’s Health Insurance Program (CHIP), and another person is required by court order to give medical support to the child and that person does not do so. In this case, you don't have to pay the penalty for the child.

11. You had a gap in coverage or were not enrolled in Marketplace coverage while you were awaiting the outcome of a Marketplace eligibility appeal – and you were found eligible to enroll the Marketplace, for lower costs on your monthly premiums, or for cost-sharing reductions.

12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act. For more information on this exemption, see here. Note: a similar exemption is also available to claim on your tax return instead of filling out a Marketplace application.

13. Your individual insurance plan was cancelled because it did not meet the minimum standards under the Affordable Care Act.

14. You experienced another hardship in obtaining health coverage. For example, you are engaged in service in the AmeriCorps State and National, VISTA, or NCCC programs and are covered by short-term duration coverage or self-funded coverage provided by these programs.


How do I apply for a hardship exemption?

Exemptions for the hardships above can be obtained from the Health Insurance Marketplace – not through your tax return. To apply for one of these Hardship Exemptions through the Marketplace, you have to complete the Marketplace application and send a copy of any required documentation. The application may be found at GetCoveredNJ. Instructions to help you fill out this form are available at GetCoveredNJ.

If you are granted this exemption through the Marketplace, you will receive an Exemption Certificate Number to include on your tax return. If you have applied for an exemption through the Marketplace and are still waiting for a response, you can include the word “pending” on your tax return where you would normally put your Exemption Certificate Number.

If you have questions about how to apply for an exemption or about your Exemption Certificate Number, visit HealthCare.gov/taxes, or call the Marketplace Call Center at 1-833-677-1010.


How long does a Hardship Exemption last?

Hardship Exemptions are usually provided for the month before the hardship, the months of the hardship, and the month after the hardship. However, the Marketplace may provide the exemption for additional months after the hardship, including up to a full calendar year. When you receive your Exemption Certificate Number from the Marketplace, the letter will also tell you which months are covered by the Exemption Certificate Number



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Christopher S. Kudryk

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Christopher S. Kudryk
Insurance Specialist

KBenefits specializes in health, dental, vision, life and medicare insurance for employers and individuals in NJ & NY.

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