Help Paying Marketplace Premiums: When Other Coverage Is Available

If I’m eligible for other coverage but haven’t enrolled in it yet, can I qualify for premium tax credits in the Marketplace?

For certain types of coverage, if you are eligible but not enrolled, then you can still qualify for premium tax credits. These include:

  • Retiree health coverage offered by a former employer
  • COBRA coverage
  • Student health plan coverage
  • Medicare Part A coverage requiring payment of premiums

In addition, during Open Enrollment, if you are already enrolled in these types of coverage, you can apply for Marketplace coverage and subsidies and then drop your other coverage as of the date your new Marketplace coverage will take effect.

However, if you are eligible for job-based coverage (that is affordable and meets minimum value) or for Medicaid or CHIP, but you didn’t enroll, then you are not eligible for premium tax credits.

Browse more questions in the Early Retirees, Medicare and Employer-Sponsored Health Coverage sections.

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.