Home FAQs FAQs: Health Insurance Marketplace and the ACA Help Paying Marketplace Premiums: When Other Coverage Is Available

Help Paying Marketplace Premiums: When Other Coverage Is Available

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I’m low income and enrolled in subsidized Marketplace coverage now. I just found out I’m pregnant. Under my state’s rules, I now qualify for Medicaid. Do I have to drop out of the Marketplace coverage and enroll in Medicaid? If I don’t will I have to pay back the premium tax credit subsidy?

I’m enrolled in COBRA now, but I want to drop it. Does that affect my eligibility for Marketplace subsidies?

My kids are eligible for the Children’s Health Insurance Program. Can I enroll them in our Marketplace health plan and get premium tax credits for them instead?

I’m under 26 and eligible to be covered as a dependent under my mom’s job-based policy. Mom no longer claims me as a tax dependent – I file my own taxes, though my income isn’t very high. If subsidized Marketplace coverage would be even more affordable to me, can I sign up for that instead?

My family and I are offered health benefits through my job, but we can’t afford to enroll. My employer pays 100% of the premium for workers, but contributes nothing toward the cost of adding my spouse and kids. Can we try to find a better deal in the Marketplace?

I’m married. I work full-time for a large employer that offers me health benefits but won’t cover spouses. Is that allowed? Can my spouse apply for coverage and subsidies in the Marketplace?

When can I apply for Marketplace premium tax credits when other coverage is available?

My employer offers health benefits to me and my family. The company pays the entire cost of my coverage but contributes nothing toward the cost of covering my family. We can’t afford to enroll my spouse and kids. Can they get coverage and subsidies in the Marketplace instead?

I enrolled in a Marketplace policy with premium tax credits for 2025, even though my employer offers health benefits, because the employer coverage was unaffordable (more than 9.02% of my projected income in 2025). Then mid-year I started a second part-time job. As a result, my annual income will be higher than I originally estimated, and, at this higher income, the cost of enrolling in my job-based plan would be less than 9.02% of my income. Unfortunately, I can’t sign up for my employer plan until the next open season. What should I do? When I file my taxes will I be required to pay back my premium tax credits because I had access to affordable job-based coverage after all?