Am I exempt from the 80 hours?

The 80-hour rule is for adults ages 19 to 64 in the Medicaid adult group (or a similar state program).

• I am under 19, or I am 65 or older.The rule is for adults ages 19 to 64. If you were under 19 for any part of the month, you count as meeting it for that month.
• I am on Medicare.Medicare Part A, or Medicare Part B.
• My Medicaid is through a group other than the adult group.Not sure which group you are in? Ask your state Medicaid office.
• I am in jail or prison now, or I was in the last 3 months.This is for public jails and prisons.

The law names groups like these. This list is not complete, and your state decides how it applies. If one fits you, you may not need to show hours.

• I am pregnant, or I had a baby recently and I am still in my Medicaid postpartum coverage period.How long this lasts depends on your state.
• I was in foster care and on Medicaid when I turned 18 (or my state's older foster care age), and I am under 26.
• I am a member of a federally recognized tribe, or I am Alaska Native, or I can get Indian Health Service care.This also covers Urban Indian and California Indian people.
• I am a parent, guardian, caretaker relative or family caregiver of a child 13 or younger, or of a person with a disability.A guardian is named by a court. A caretaker relative lives with the child or person and is mainly responsible for their care. A family caregiver counts if they live with the person and give regular care, or are a relative who gives regular care, or are not related and do not live there but give 80 or more hours of care a month.
• I am a veteran with a VA disability rating of 100% (total).The rating can be temporary or permanent.
• I have a health condition that makes it very hard to meet the rule.States look at things like being blind or disabled, a substance use disorder (not if you have been in recovery for 5 years or more), a disabling mental health condition, a physical, intellectual or developmental disability that makes daily activities very hard, or a serious or complex medical condition. It has to make meeting the rule very hard. Your state has a list and a way to ask.
• I am following my state's TANF work rules.TANF is Temporary Assistance for Needy Families.
• I am in a drug or alcohol treatment program.Your state may set a minimum amount of time in the program.

States choose whether to offer these. For a hospital stay or medical travel, you have to ask your state. For a disaster or high unemployment, you do not have to ask.

• This month, I am in or was in the hospital, a nursing facility or other inpatient care.This can also cover care that keeps you out of an inpatient stay. In states that offer this, you have to ask.
• I live in a county under a Presidential emergency or disaster declaration.
• I live in a county with very high unemployment.That means 8% or more, or 1.5 times the national rate if that is lower. Your state has to ask the federal government to approve this one. You do not have to ask.
• I, or someone who depends on me, have to travel far from our community for a long time to get care for a serious or complex condition that we cannot get nearby.In states that offer this, you have to ask.