ACA Exemption Codes


  • Exemptions apply only to months not covered.
  • MEC for 1 day counts as covered for the entire month.
  • See also the AARP ACA Exemption Reference Guide for additional information

Short coverage gap:

B
  • Gap can only be for 1 or 2 months.
  • Cannot be used for 1-2 months of a larger gap.
  • If there was a gap at the end of the previous year, those months are considered part of the gap unless they were covered by a different exemption (i.e, not “B”).
  • Exemption B can only be used once each year.

Situational exemptions (for months that apply):

C
D
  • Members of a health care sharing ministry.
  • Members of certain religious sects (Marketplace exemption only)
E
F
  • Persons confined in jail, prison, or correctional facility for at least 1 day.
  • Does not include time in jail pending disposition of charges.
  • Does not include time in probation, parole or home confinement.
G
  • Moved to Colorado from a state that did not expand Medicaid and household income below 138% of the Federal Poverty Level
  • Beginning in 2018, any of the Hardship exemptions listed below.
H
  • Member of the tax household born, adopted or died
  • Use this code if another exemption for the person is required for other months.

Coverage is unaffordable:

If no other code applies, check for unaffordable codes

A (individual) or

G (entire family).

See the ACA – Affordability resource page.

Hardship exemptions:

G (entire family).

Beginning in 2018: Marketplace certification is not required.

  • You were homeless;
  • You were evicted or facing eviction or foreclosure;
  • You received a shut-off notice from a utility company;
  • You experienced domestic violence;
  • You experienced the death of a close 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 had medical expenses you could not pay;
  • You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member;
  • Your child was denied Medicaid and CHIP, and another person is required by court order to provide coverage to the child;
  • You were without coverage while awaiting an appeals decision from the Marketplace;
  • You were determined ineligible for Medicaid in a state that did not expand Medicaid coverage;
  • You lived in a county where there is no qualified health plan offered, there is only one issuer offering coverage, or all affordable plans provide abortion coverage contrary to your beliefs;
  • You experienced personal circumstances that create a hardship, such as when no affordable plans provide access to needed specialty care; or
  • You experienced a hardship not included in this list that prevented you from getting health insurance.