Obamacare Tax Form Exemptions Questionnaire Page 3

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Special Indiana exemption
Pay close attention to ►Code G - Resident of non-Medicaid expansion state
(Indiana)
and household income below
138% of FPL. They won’t know if they qualify, but you should know.
Family
138%
Size
of FPL
1
$15,856
2
$21,404
3
$26,951
4
$32,499
5
$38,047
6
$43,594
7
$49,142
8
$54,689

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