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How to File for Exemption from the '(un)Affordable Heathcare Act'

Posted by Dave Denkhaus Posted on Apr 08 2014

Most people must have health coverage or pay a fee (the “individual shared responsibility payment”). You can get an exemption in certain cases.

The individual shared responsibility payment

If you can afford health insurance but choose not to buy it, you must pay a fee known as theindividual shared responsibility payment.

The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it's 2.5% of income or $695 per person, whichever is higher.

If you're paying under the $95 per person method, in 2014 the payment for uninsured children is $47.50 per child. The most a family would have to pay under this method in 2014 is $285.

You make the payment when you file your 2014 taxes, which are due in April 2015.

Exemptions from the payment

Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an exemption if:

  • You’re uninsured for less than 3 months of the year
  • The lowest-priced coverage available to you would cost more than 8% of your household income
  • You don’t have to file a tax return because your income is too low (Learn about thefiling limit.)
  • You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
  • You’re a member of a recognized health care sharing ministry
  • You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
  • You’re incarcerated, and not awaiting the disposition of charges against you
  • You’re not lawfully present in the U.S.

Hardship exemptions

If you have any of the circumstances below that affect your ability to purchase health insurance coverage, you may qualify for a “hardship” exemption:

  1. You were homeless.
  2. You were evicted in the past 6 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 6 months.
  8. You had medical expenses you couldn’t pay in the last 24 months.
  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 CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
  11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
  12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.
  13. Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable.
  14. You experienced another hardship in obtaining health insurance.

How to apply for an exemption

If you're applying for an exemption based on: coverage being unaffordable; membership in a health care sharing ministry; membership in a federally-recognized tribe; or being incarcerated:

You have 2 options:

  1. You can claim these exemptions when you fill out your 2014 federal tax return, which is due in April 2015
  2. You can apply for the exemptions using the right form below. See instructions to help you fill out an exemption application.

Note: If you get an exemption because coverage is unaffordable based on your expected income, you may also qualify to buy catastrophic coverage through the Marketplace. This may be more affordable than your other options.

If you’re applying for an exemption based on: membership in a recognized religious sect whose members object to insurance; eligibility for services through an Indian health care provider; or one of the hardships described above:

If your income will be low enough that you will not be required to file taxes:

  • You don’t need to apply for an exemption. This is true even if you file a return in order to get a refund of money withheld from your paycheck. You won’t have to make the shared responsibility payment.

If you have a gap in coverage of less than 3 months, or you're not lawfully present in the U.S.:

  • You don’t need to apply for an exemption. This will be handled when you file your federal tax return.

How to Choose a Tax Preparer

Posted by David Denkhaus Posted on Jan 30 2014
If you need help preparing your tax return, it’s important to hire a skilled professional. Not only can a professional find all the deductions you are entitled to, he is also less likely to make mistakes that could cost you money later, if your return is audited and found to be inaccurate.

Types of Tax Preparers

The type of paid preparer you choose should be based on your needs. How complex is your tax situation? Do you own rental property? A small business? Are you recently divorced? Just purchased your first house? Based on their expertise and fees, some preparers are better matches for certain taxpayers than others.

* Certified Public Accountants (CPAs)

These professionals must pass a rigorous exam to earn their credentials. Not all CPAs specialize in taxes, but those who do are a good choice for individuals with complex returns, such as small business owners and individuals who need tax advice all year, not just at tax time. If you’re seeking help with other aspects of your personal finances, choosing a CPA who is also a personal financial specialist can be an efficient way to handle all your financial needs.

To find a CPA in your area, or to check the credentials of a CPA you want to hire, visit your state’s board of accountancy Web site or state CPA society Web site.

* Enrolled Agents (EAs)

These agents are licensed by the federal government to prepare tax returns and represent taxpayers before the IRS in case of an audit. EAs have either passed a comprehensive exam or worked at the IRS for a minimum of five years, must complete ongoing professional education and must have passed an IRS background check. Many EAs can help you with more than just tax planning. Some EAs are also CPAs, and some EAs are also certified financial planners and/or accredited tax advisors.

* National Retail Tax Preparation Companies

Pricing for more complex returns can be harder to pin down ahead of time. Many consumer complaints about national tax preparation companies can be found online, and most of the complaints are about tax preparation fees. Customers state that the price they were quoted ahead of time was much lower than the price they were ultimately charged. Of course, the larger a company, the more likely it is to have some unhappy customers. H&R Block states that it prepared in 2009 15.2 million returns at its retail centers.

Also, be aware that when you visit a national chain, you may be pitched additional products, like refund anticipation loans. Whenever you are making a decision about a financial product, it’s a good idea not to make any on-the-spot decisions. The more services a company can sell you, the more money it will make, but you should do your own research to determine if a product is a good fit for you.

Choose Wisely

The right tax preparer for you is out there, no matter what your tax situation. Conduct careful interviews and research, and you may find someone who can make your life easier for years to come.