DC – Schedule HSR

Article:50617

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 – Coverage Exemptions for Individuals 

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

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. Open the State Taxes section in the left-hand navigation. 
2. Click the link I’d like to see the forms I’ve filled out or search for a form. 
3. Select District of Columbia from the state dropdown. 
4. Under the General tab, add the following: 
   •   Schedule HSR – Healthcare Coverage Form 
   •   Schedule HSR – Coverage Exemptions for Individuals 

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