An Exemption Certificate Number (ECN) is a unique identifier the Health Insurance Marketplace assigns when it approves your request for an exemption from federal health coverage requirements. Since the federal penalty for going uninsured dropped to zero in 2019, most people no longer need one to avoid a tax hit on their federal return.1HealthCare.gov. No Health Coverage for 2019 The number still does real work in two situations: it lets adults 30 and older buy lower-cost catastrophic health plans through the Marketplace, and it can document an exemption from a state insurance mandate if you live somewhere that enforces one.
What an ECN Lets You Do
Buy a Catastrophic Plan After Age 30
Catastrophic plans carry the lowest monthly premiums on the Marketplace and pair them with high deductibles. They are normally restricted to enrollees under 30. If you are 30 or older, you need a hardship or affordability exemption, and the ECN that comes with it, to enroll.2HealthCare.gov. Catastrophic Health Plans Each qualifying household member gets their own ECN, and the number goes on your Marketplace application when you pick the plan.3HealthCare.gov. Catastrophic Plan Information
Document an Exemption in a State With a Mandate
California, Massachusetts, New Jersey, Rhode Island, Vermont, and the District of Columbia require residents to carry health coverage under their own laws. If you go uninsured in one of these places without a qualifying exemption, you may owe a penalty on your state return (Vermont requires coverage but does not impose a financial penalty). A federal ECN can help support an exemption claim, but each state runs its own exemption process, so check with your state tax authority for the form and rules that apply to you.
Who Qualifies
Three paths lead to a Marketplace exemption: hardship, affordability, and religious conscience.
Hardship
Hardship is the broadest category. It covers circumstances that kept you from getting coverage, including:4HealthCare.gov. Health Coverage Exemptions, Forms and How to Apply
- Homelessness
- Eviction or foreclosure, or facing either
- A utility shut-off notice
- Domestic violence
- Death of a close family member
- Fire, flood, or other disaster causing substantial property damage
- Bankruptcy
- Substantial unpaid medical debt
- Unexpected increases in the cost of caring for an ill, disabled, or aging family member
- Being found ineligible for Medicaid only because your state did not expand coverage
- A tax dependent denied Medicaid or CHIP while a court order requires another person to provide the child’s medical support
- Other hardship that prevented you from obtaining coverage
The final catch-all gives the Marketplace room to consider situations that don’t match the listed examples. If yours is unusual, apply and explain it.
Affordability
If the cheapest Marketplace coverage available to you would cost more than a set percentage of your household income, you qualify for an affordability exemption. The statutory base is 8 percent, adjusted annually for premium and income growth.5Office of the Law Revision Counsel. 26 USC 5000A – Requirement to Maintain Minimum Essential Coverage The adjusted threshold for catastrophic plan eligibility in 2026 is 8.05 percent of income. You can claim an affordability exemption for past months directly on your tax return without going through the Marketplace, but if you need the ECN to enroll in a catastrophic plan going forward, apply to the Marketplace before the coverage period begins.4HealthCare.gov. Health Coverage Exemptions, Forms and How to Apply
Religious Conscience
This exemption applies to members of religious sects that object to accepting insurance benefits. The sect must have existed continuously since December 31, 1950, and be recognized by the Social Security Administration under Internal Revenue Code section 1402(g)(1).6Office of the Law Revision Counsel. 26 U.S. Code 1402 – Definitions Members must also waive all Social Security and Medicare benefits. In practice, this covers a small number of communities, primarily certain Amish and Mennonite groups.
How Long the Exemption Lasts
Hardship exemptions generally cover the month before the event, the months during it, and the month after, and the Marketplace can extend that up to a full calendar year in some cases.4HealthCare.gov. Health Coverage Exemptions, Forms and How to Apply The Medicaid-gap hardship runs the entire calendar year.
Affordability exemptions cover future months and can run through year-end. To get one for a full calendar year, apply before January 1 of that year. Religious conscience exemptions granted to someone under 21 require reapplication when the person turns 21. No exemption renews on its own; if the circumstances continue, submit a new application.
What You Need Before You Apply
For each household member on the application, gather:
- Full legal name, date of birth, and Social Security number
- Current residential and mailing addresses
- Household income for the relevant tax year
Attach documentation that matches the specific claim. A domestic violence exemption might be supported by a police report, restraining order, or shelter letter. Bankruptcy needs court filings. Medical debt claims need the bills. Applications with documentation that lines up directly with the claim move faster.
Get the income figures right. The Marketplace compares household income to the federal poverty level when it evaluates affordability-related claims, and inaccurate figures are one of the most common reasons applications come back for review.
How to Apply
HealthCare.gov posts separate PDF application forms for hardship and affordability exemptions.7HealthCare.gov. Download Health Coverage Exemption Forms There is no online submission option. Fill out the form, print it, and mail it with your supporting documents to:
Health Insurance Marketplace — Exemption Processing
465 Industrial Blvd.
London, KY 40741
Photocopy everything before you mail it. There is no online tracking, so your copies are your only record of what was submitted and when.
After You Apply
The Marketplace does not commit to a specific processing time. How long your application takes depends on its complexity, whether you filled everything in, and whether follow-up documents are needed.8HealthCare.gov. After You Apply for a Health Coverage Exemption Blank fields or skipped questions stall the file until the Marketplace can reach you and get the missing information.9Centers for Medicare & Medicaid Services. Marketplace Application Essentials If you are applying so you can pick a catastrophic plan during open enrollment, send it in as early as you can.
You will get a mailed notice with the decision. If it’s approved, the notice contains your ECN, which is the number you enter on your Marketplace application for a catastrophic plan or use to document an exemption on a state return.10HealthCare.gov. Exemption Certificate Number (ECN) If the Marketplace needs more information, respond quickly. Every day of delay pushes the decision back.
If your application is denied, you generally have 90 days from the date on the eligibility notice to appeal, and the notice tells you how.11HealthCare.gov. How to Appeal a Marketplace Decision Miss the window and you can still ask for an appeal by explaining why it’s late; the Marketplace decides whether the reason is good enough to hear the case.12Centers for Medicare & Medicaid Services. Appealing Eligibility Decisions in the Health Insurance Marketplace
Keep Your Records
Hold onto the eligibility notice, your ECN, a copy of the application, and every supporting document for at least three years after the tax year they apply to. That matches the standard IRS window for assessing additional tax.13Internal Revenue Service. Topic No. 305, Recordkeeping If you live in a mandate state, your state tax authority may want records for longer, so check before you throw anything out.