Individuals who are age 30 or older and want to enroll in a catastrophic health plan must qualify for a hardship or affordability exemption. Catastrophic plans have high deductibles and usually cost you less per month than a bronze plan, but they have the highest out-of-pocket costs when you need care. They are intended to protect you from very high medical costs if you get seriously hurt or injured. Click here to learn more about catastrophic plans.
Who qualifies for a hardship exemption?
You can qualify for a hardship exemption if you’re experiencing a financial hardship or other circumstance that’s preventing you from getting health insurance.
Examples of qualifying hardships include:
- You were homeless.
- You were evicted or were facing eviction or foreclosure.
- You experienced domestic violence.
- You experienced the death of a family member.
- You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
- You filed for bankruptcy.
- You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
- You are ineligible to receive financial help for a Marketplace plan because of your projected annual income.
- You experienced another hardship obtaining health insurance.
For more information, please visit HealthCare.gov.
Who qualifies for an affordability exemption?
You can qualify for an affordability exemption if the lowest-priced coverage available to you, through either a Marketplace or job-based plan, would cost more than 8.05% of your household income. For more information, please visit HealthCare.gov.
How do I obtain a hardship or affordability exemption?
You can apply for a hardship or affordability exemption at HealthCare.gov.
How do I report a hardship or affordability exemption and enroll in a catastrophic plan through Get Covered Illinois?
Once you have been approved for a hardship or affordability exemption by HealthCare.gov, you will receive a notice with your Exemption Certificate Number (ECN). After receiving your ECN, log into your Get Covered Illinois account and enter your ECN before shopping for plans to see Catastrophic plans available in your area in the shopping experience.
Do I need to apply for an exemption if I do not have health coverage in order to avoid a tax penalty?
As of 2019, you no longer pay a tax penalty (fee) for not having health coverage. If you don’t have coverage, you don't need an exemption to avoid paying a penalty.