• To apply for the exemption:
• A) Obtain an application here or contact a Patient Benefit Advocate in LA or Shawnee
• B) Complete the application and mail in with a copy of your AST enrollment card.
  Note: Descendants will be eligible with proper documentation issued by a Patient Benefit Advocate.
• C) Receive an exemption number from the federal government via mail. The number issued to you will be your federally-issued Native American Exemption Number to keep and file annually on your tax return.

Individual Shared Responsibility Payment for 2014: The payment is calculated according to whichever is higher: 1% of your yearly household income OR $95 per person, children $47.50 per person. The maximum penalty per family in 2014 is $285

Please note: Descendants will need federally-approved documentation verifying that they are eligibe to receive healthcare services through the Indian Health Service, tribes and tribal organizations, or urban indian organizations. Federally-approved documentation that will be accepted is currently in the approval stages and not available for descendants at this time. This documentation will be issued by Patient Benefit Advocates when it becomes available. You may periodically check with your Patient Benefit Advocate at the Little Axe Health Center or Shawnee Clinic for availability.

Application for Exemption for American Indians and Alaska Natives and Other Individuals Who are Eligible to Receive Services from an Indian Health Care Provider
About Marketplace Exemptions: How do I qualify for an exemption from the fee for not having health coverage?
Link to All Available Exemption Applications
AST Enrollment Application
AST Enrollment Research Form