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What you need for Learn how to appeal the health care penalty
You'll need a copy of Schedule HC: Health Care Information.
How to appeal Learn how to appeal the health care penalty
Fill in the oval for you (and your spouse, if applicable) on Schedule HC, Appeals Section that allows us to share information in your tax return, including Schedule HC, with the Massachusetts Health Connector. Be sure to attach pages 1 to 3 of Schedule HC with your return.
Make sure you have calculated the penalty amount that you're appealing but don't assess yourself or enter a penalty amount on your income tax return. While your appeal is pending, we won't assess you with a penalty.
Don't include any hardship documentation with your original return. You will have to submit supporting hardship documentation at a later date during the appeal process.
Next steps for Learn how to appeal the health care penalty
If you (and/or your spouse, if married filing jointly) fill in that oval on your return, you'll receive a follow-up letter from the Massachusetts Health Connector asking you to state your grounds for appeal in writing, and submit supporting documentation. Failure to respond to that form within the time specified will lead to your appeal being dismissed.
The Massachusetts Health Connector will then review the information you provided. You might have to participate in a hearing on your case and state your claims under pains and penalties of perjury.
More info for Learn how to appeal the health care penalty
You (and/or your spouse, if married filing jointly) are allowed only 1 opportunity to appeal. If your appeal is denied or dismissed by the Connector, you will receive a bill from DOR.
You may also be subject to a separate federal penalty if you were uninsured. Visit IRS for more information on the federal requirements. If you are subject to a federal penalty, you must enter that amount on Form 1, line 34c or Form 1-NR/PY, line 39c.