Applications, forms, & notices

Find applications and forms to apply for health care and financial assistance, file an appeal, and enroll in a Catastrophic plan. You can also get samples of notices we mail to consumers and additional resources related to the enrollment process, appeals, and taxes.

Applications & forms

• Individual & family applications- Use these forms to apply for Marketplace coverage, with and without financial assistance.
• Exemption applications -You need an exemption if you’re 30 or older and want to enroll in a "Catastrophic" health plan. There are 2 types of exemptions: affordability and hardship. Use these forms to apply for an exemption.

Notices

• Notices we mail—Find eligibility notices and letters for redetermination and automatic enrollments, data matching issues, tax information, and more.
• Tax form notices—Get tax 1095-A forms we mail, fact sheets, and resources about filing taxes.

Additional resources

• Eligibility & enrollment – Discover information about coverage and complex enrollment situations, income rules, and more.
• Application process assistance—Find a variety of resources on Marketplace enrollment, financial assistance, and complex data matching situations.
• Appeals resources – Learn about types of appeals, the appeals review process, and more.
• Appeals forms—Get forms and instructions to file an appeal according to your state’s guidelines. 
  
  Find out how to appeal based on your situation.