Marketplace Health Plans and Premiums

Can my brother (or my church or another third party) pay my portion of the monthly health insurance premium for me?

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Possibly.  Federal rules require health plans offered through the Marketplace to accept premium and cost-sharing payments made on behalf of enrollees by the Ryan White HIV/AIDS Program, other Federal and State government programs that provide premium and cost-sharing support for specific individuals, and Indian tribes and tribal organizations.  Federal rules discourage Marketplace plans from accepting third-party payments from hospitals, other healthcare providers, and other commercial entities.  Check with your health plan for more information.

Finally, if you are a patient with end-stage renal disease undergoing kidney dialysis, you are eligible to enroll in Medicare.  However, some dialysis facilities have offered to pay premiums for patients who elect Marketplace coverage instead of Medicare.  If a dialysis facility offers to pay your Marketplace premium, directly or through a charity, it is required to first check with the Marketplace insurer to verify that it will accept this third party payment.  In addition, the dialysis facility must disclose other important information to you, including about the potential for gaps in coverage and penalties if Medicare enrollment is delayed.  Dialysis patients should contact a Marketplace navigator program or your state’s Senior Health Insurance Assistance Program, which provides information, counseling, and enrollment assistance for people eligible for Medicare.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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