Article: 50381

General Information

This screen is used to report healthcare coverage status and exemptions for taxpayers and their families in the District of Columbia. Both forms are located under the DC General tab.

Schedule HSR – Main Coverage Form

Indicate whether:

• All family members had qualifying healthcare coverage for every month of 2024, or
• No family members had qualifying healthcare coverage in 2024.

If any member did not have qualifying coverage, you must complete an Exemption Form for that individual.

Schedule HSR – Coverage Exemptions for Individuals

This form is completed separately for each person who did not have qualifying coverage.

• Who is this for? – Select the taxpayer, spouse, or dependent.
• Full Year – Check this box if the individual had coverage all year. If checked, exemption type is ignored.
• Exemption Type – Select from the dropdown list.
• If coverage or exemption applied all year, enter once. Otherwise, complete month-by-month coverage and exemptions for January–December.

Exemption Types

The following exemption codes may apply:

• A – Affordability: You received an affordability exemption certificate.
• B – Short coverage gap: Without coverage for less than 3 consecutive months.
• C – Citizens abroad and certain noncitizens.
• D – Member of a healthcare sharing ministry.
• E – Members of Indian tribes or Alaska Native Claims Settlement Act shareholders.
• F – Incarceration.
• G – General hardship: Certificate issued by Health Benefits Exchange Authority.
• H – Member of shared responsibility family born/adopted during the year.
• I – Member of shared responsibility family died during the year.
• N – Nonresident of the District of Columbia.
• J – Sincerely held religious belief exemption.
• K – DC Health Alliance Program.
• L – Low income: Federal AGI on D-40, Line 4, meets income thresholds.
• M – Religious sect exemption.
• X – No exemption.
• Z – Maintained minimum essential coverage.

How to Add These Screens

1. Click on the State Taxes section on the left-hand side of the screen.
2. Click the link “I’d like to see the forms I’ve filled out or search for a form.”
3. Use the drop list to select District of Columbia.
4. Under the General tab, select Schedule HSR – Healthcare Coverage Form and Schedule HSR – Coverage Exemptions for Individuals.
5. Complete the screens.
6. Click Save.

Further Information

For more details, please visit the DC Office of Tax and Revenue page for individual income taxpayers:
https://otr.cfo.dc.gov/service/individual-income-taxpayers