It’s a common question during open enrollment season: can I get insurance through the marketplace if my employer offers it? The answer is maybe. The first thing to understand is that there are two types of employer-sponsored insurance: group health insurance and individual health insurance. Group health insurance is typically offered by large employers and covers a set number of employees. Individual health insurance, on the other hand, is typically offered by small businesses and sole proprietorships. If you have an offer of individual health insurance from your employer, you can’t get a subsidy through the marketplace. However, if you have an offer of group health insurance, you may be eligible for a subsidy. To learn more about whether you can get a subsidy through the marketplace, read on.
What is the Marketplace?
The Marketplace is a site where you can shop for health insurance. It’s also sometimes called the Health Insurance Marketplace, the Health Insurance Exchange, or simply the Marketplace. You can shop for health insurance on the Marketplace with or without help from a navigator or other professional.
If you have an offer of job-based health coverage, you can compare it with other plans available through the Marketplace, and decide if another plan would be better for you and your family. If you decide to buy a plan through the Marketplace instead of taking job-based coverage, you may be eligible for a premium tax credit that lowers your monthly premiums.
If your employer offers insurance that meets certain standards, called minimum essential coverage, you can’t get a premium tax credit through the Marketplace. But you may still want to check out your options on the Marketplace – you might find a plan with lower premiums or better benefits than your job-based plan.
What are the eligibility requirements for the Marketplace?
To be eligible for coverage through the Marketplace, you must:
-Be a U.S. citizen or national, or be lawfully present in the U.S.
-Not be incarcerated
If you’re eligible for coverage through your employer, you can’t get subsidized coverage through the Marketplace.
Can I get insurance through the Marketplace if my employer offers it?
If you have an offer of employer-sponsored health insurance, you can enroll in that plan through the Marketplace. However, you may not be eligible for a subsidy through the Marketplace if your employer’s plan meets certain requirements.
To be eligible for a subsidy, your employer’s plan must not cover at least 60 percent of the costs of covered benefits. Also, the premium for your share of coverage cannot exceed 9.5 percent of your household income. If your employer’s plan meets these requirements, you can still purchase a Marketplace plan, but you will not be eligible for a subsidy.
If you are unsure whether or not your employer’s insurance meets these requirements, you can use the Marketplace Calculator to estimate your premium and subsidies.
How do I compare plans on the Marketplace?
The Affordable Care Act’s Health Insurance Marketplace is designed to help you find health coverage that fits your budget and meets your needs. You can compare plans side-by-side and see how much each would cost you based on your income, household size, and other factors.
Here’s what you need to know about comparing plans on the Marketplace:
There are four types of plans available: bronze, silver, gold, and platinum. Each type of plan has different levels of coverage and costs.
The amount you pay for premiums (monthly payments) and out-of-pocket costs (such as deductibles, copayments, and coinsurance) will vary depending on the type of plan you choose.
You can use the Marketplace’s Plan Finder tool to see an estimate of what each plan would cost you based on your specific circumstances.
When comparing plans, be sure to look at more than just the monthly premium. You’ll also want to consider the deductible (the amount you have to pay for covered services before your insurance starts paying), copayments (flat fees you pay for covered services), coinsurance (a percentage of the cost of covered services that you pay), and out-of-pocket maximums (the most you’d have to pay in a year for covered services).
What are the different types of Marketplace plans?
The different types of Marketplace plans are Bronze, Silver, Gold, and Platinum. Each plan has a different level of coverage, with Bronze having the least coverage and Platinum having the most. The amount you pay for your premiums and out-of-pocket expenses will also vary depending on which plan you choose.
If you have a job that offers health insurance, you may be able to get coverage through the Marketplace. However, you will need to decide whether or not to take your employer’s insurance or get a plan through the Marketplace. There are a few things to consider when making this decision, such as whether or not your employer’s insurance covers pre-existing conditions or if it meets your minimum essential coverage requirements.
You can also get coverage through the Marketplace if you are self-employed or do not have access to employer-sponsored health insurance. In this case, you will need to choose between a bronze, silver, gold, or platinum plan. The amount of coverage each plan offers varies, so be sure to compare them before enrolling in one.
How do I enroll in a plan on the Marketplace?
If you’re looking to enroll in a plan on the Marketplace, there are a few things you’ll need to do first. First, you’ll need to create an account on Healthcare.gov. Once you’ve done that, you’ll be able to fill out an application for coverage. When you’re filling out your application, you’ll need to provide information about your household income and any health insurance coverage you currently have.
Once you’ve submitted your application, you’ll be able to see all of the plans that are available to you and compare them side-by-side. You can look at things like the monthly premium, the deductible, and what kinds of services are covered under each plan. Once you’ve found a plan that fits your needs, you can enroll in it online or by calling the Marketplace call center.
What if I don’t have insurance through my job or the Marketplace?
If you are not offered insurance through your job or the Marketplace, you may still be able to get insurance through other sources. There are a few options for people who do not have access to employer-sponsored insurance or the Marketplace.
One option is to get insurance through a private company. Private companies offer a variety of plans, so you can choose the one that best fits your needs. You can also get insurance through the government’s health care program, Medicaid. Medicaid is available to low-income individuals and families. If you qualify, you will receive free or low-cost health coverage. Another option is to purchase a short-term health plan. Short-term health plans are designed to cover you for a limited period of time, usually up to 12 months. These plans are not required to provide all of the essential health benefits mandated by the Affordable Care Act, so they may not be ideal if you have a chronic condition or expect to need expensive medical care.
Conclusion
Though you may be eligible for subsidies through the Marketplace if your employer-sponsored insurance is considered unaffordable or does not cover minimum essential benefits, you will not be able to purchase a Marketplace plan if you are offered affordable coverage by your employer that meets minimum essential requirements. You can learn more about your eligibility for subsidies and how to apply for them by visiting Healthcare.gov or by contacting the Marketplace Call Center at 1-800-318-2596.
