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Get Incarceration Exemption - Health Insurance Marketplace (cms.gov)
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How to fill out the Incarceration Exemption - Health Insurance Marketplace (cms.gov) online
Filling out the Incarceration Exemption form for the Health Insurance Marketplace can be a straightforward process when you know what to expect. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to successfully complete the exemption application.
- Click the ‘Get Form’ button to obtain the Incarceration Exemption form and open it in your editing tool.
- In Step 1, provide your legal name, home address, and contact information. Ensure to include a phone number for any follow-up communications.
- In Step 2, identify and list every person in your tax household who will be included in the application. Fill out the required information such as their names, relationships, dates of birth, and social security numbers if applicable.
- For each person listed, provide details about any periods of incarceration, including entry and release dates along with the facility information. Each person can have up to three periods documented within this step.
- In Step 3, review your answers carefully, and ensure to sign the application, certifying that the information provided is accurate to the best of your knowledge.
- Once you have completed and signed the application, gather the necessary documents that show your incarceration dates and mail the signed application to the provided address.
Start your application for the Incarceration Exemption online today!
If you're incarcerated you can use the Marketplace to apply for Medicaid coverage in your state. Medicaid won't pay for your medical care while you're in prison or jail. But if you enroll in Medicaid while you're incarcerated you may be able to get needed care more quickly after you're released.
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