Frequently Asked Questions about the ACA’s Health Insurance Marketplace
The comprehensive set of ACA FAQs has been discontinued and will no longer be updated. We have instead included the eight most popular ACA FAQs along with their Spanish translations, updated as of September 25, 2026, for the ACA 2027 Marketplace plan year.
- What are premium tax credits and how do they work?
- How much can I earn and qualify for premium tax credits in the Marketplace?
- What income is counted in determining my eligibility for premium tax credits?
- Who is eligible for Marketplace premium tax credits?
- Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?
- My employer pays 100% of the premium for workers, but nothing for spouses and kids. Could we get a better deal on the Marketplace?
- What happens if I want to quit a Marketplace health plan during the year?
- I’m covered under my parents’ health insurance plan, but I’m moving to another state. Can I remain covered on my parents’ plan?
While we have made every effort to provide accurate and up-to-date information in these FAQs, people should contact HealthCare.gov or the health insurance Marketplace in their state for guidance on individual circumstances.
How much can I earn and qualify for premium tax credits in the Marketplace?
Premium tax credits are available to people who buy Marketplace coverage and whose income is at least as high as the federal poverty level.
- For an individual, that means an income of at least $15,960 in 2027.
- For a family of four, that means an income of at least $33,000 in 2027.
This Marketplace subsidy calculator can show you estimates of your eligibility for premium tax credits at different income amounts and family sizes.
What income is counted in determining my eligibility for premium tax credits?
Eligibility for premium tax credits is based on your Modified Adjusted Gross Income, or MAGI. Click here for a list of the types of income that qualify as MAGI.
Who is eligible for Marketplace premium tax credits?
Premium tax credits are available to U.S. citizens and certain lawfully present immigrants who purchase coverage in the Marketplace and who have income at least as high as 100% of the federal poverty level ($15,960 for a single adult or $33,000 for a family of four in 2027).
Starting in 2027, eligibility for premium tax credits will be eliminated for many groups of lawfully present immigrants; only those with the following immigration statuses will qualify for subsidized coverage:
- Lawful permanent residents (LPRs or “green card” holders)
- Cuban and Haitian entrants
- People living in the U.S. under a Compact of Free Association (COFA)
In addition, to be eligible for premium tax credits, all individuals must not be eligible for public coverage—including Medicaid, the Children’s Health Insurance Program, Medicare, or military coverage—and must not have access to health insurance through an employer. (There is an exception in cases when the employer plan is unaffordable because the employee share of the premium exceeds 10.22% of the employee’s income in 2027. There is also an exception in cases where the employer plan doesn’t meet the minimum value standard.)
If your income is below 100% of the FPL, you typically will not qualify for premium tax credits under Marketplace plans. Check with your state Marketplace to find out what other options may be available to you.
Can I buy health insurance outside of the Marketplace that meets all ACA consumer protection standards?
Yes. Many insurers that offer plans through the ACA Marketplace also offer identical plans outside of the Marketplace that meet all ACA standards; however, premium tax credits and cost-sharing subsidies are not available for plans sold outside of the Marketplace. Some people prefer to buy health insurance outside of the Marketplace when they are sure they won’t qualify for financial assistance.
Like health insurance plans sold on the Marketplace, “ACA-compliant” plans sold outside the Marketplace cover essential health benefits, and they can’t turn you down, charge you more, or limit coverage if you have a pre-existing health condition.
ACA-compliant plans are sold only during the annual Open Enrollment period, or at other times during the year for people who are eligible for a special enrollment period (such as losing other coverage or having a baby).
Many types of health plans that are not ACA-compliant, such as short-term limited-duration plans and hospital indemnity plans, are also sold outside of the Marketplace, though comparison-shopping may be more difficult. Plans that are not ACA-compliant may have lower premiums because they can exclude people with pre-existing conditions and offer more limited benefits.
Some signs that a health plan is not ACA-compliant include:
- The plan brochure states that it is “NOT comprehensive health coverage.”
- The application asks questions about your health status or medical history
- The plan doesn’t cover essential health benefits, such as maternity care or prescription drugs
- The plan has annual or lifetime dollar limits on how much the plan will pay for covered benefits
- The plan is for sale outside of Open Enrollment, regardless of whether the person is eligible for a special enrollment period
If you are shopping outside of the Marketplace and you want an ACA-compliant plan, be sure to specify that to the insurer or broker you’re working with.
Finally, even if you think you won’t qualify for financial assistance for a Marketplace plan, it still might be worthwhile to shop for coverage on the Marketplace. All plans offered through the Marketplace will meet ACA standards; no non-ACA-compliant plans are sold there.
My employer pays 100% of the premium for workers, but contributes nothing toward the cost of adding my spouse and kids. Could we get a better deal on the Marketplace?
You can evaluate whether obtaining Marketplace coverage for you or your spouse and children may be more affordable compared to your employer’s coverage. Since your employer pays 100% of the premium to cover you, you will not be eligible for premium tax credits on the Marketplace. However, your spouse and children may be if the premium contribution you would have to pay for family coverage under your employer plan is more than 10.22% of your household income in 2027.
What happens if I want to quit a Marketplace health plan during the year?
It is important that you contact both the Marketplace and the health plan and let them know you no longer need coverage. Click here for details on how to terminate Marketplace coverage if you live in a HealthCare.gov state that uses the federally facilitated Marketplace. State-based Marketplaces may have their own process for terminating coverage. Check with your state Marketplace for more information if you live in one of these states.
Do not simply stop paying the premium for your Marketplace health plan as a way to terminate coverage. Nonpayment will eventually cause your coverage to end, but your insurer might still try to collect from you if they think you just got behind on your premium payments. In addition, if the government continues to pay premium tax credits on your behalf to your insurer for another month after you intended for your Marketplace plan coverage to end, you might end up having to repay some or all of that amount to the IRS.
I’m covered under my parents’ health insurance plan, but I’m moving to another state. Can I remain covered on my parents’ plan?
Yes, you are eligible to stay on your parents’ plan up to age 26 if they have coverage through a job, or until the end of the year you turn 26 if they have Marketplace coverage, regardless of where you live.
However, your parents’ health plan probably has a network of participating health care providers, and it may be difficult for you to find in-network providers when you are living in another state. If you find that your parents’ plan doesn’t cover health providers in the state where you’re moving, you can consider signing up for coverage on your own. If it’s outside of the regular Open Enrollment period, moving will qualify you for a 60-day special enrollment opportunity to enroll in other coverage.
Check your state Marketplace website or contact a health insurance navigator or other assister for more information about your options.
